Everything You Need to Know About Secondary Infertility

written by OJUS PATEL
secondary infertility"
secondary infertility
Source: Shutterstock
Source: Shutterstock

Each April during National Infertility Awareness Week, we’re collectively reminded of just how common it is for women to deal with infertility while trying to conceive. If you haven’t experienced infertility thus far in your own family planning, chances are, you know at least one person who has. According to the CDC, about 1 in 5 married women aged 15 to 49 years with no prior births are unable to get pregnant after one year of trying. And, sadly, secondary infertility—the inability to conceive after giving birth to one child—is just as common with about 11 percent of couples experiencing secondary infertility in the U.S.

Even when you already have a kid, secondary infertility is likely something that still crosses your mind (unless you’re truly done having babies), as planning for future babies can be more complicated than your first. This is compounded by the fact that not many of us talk about infertility within our friend groups, making the whole process even more confusing.

The Colorado Center for Reproductive Medicine (CCRM), one of the nation’s leading fertility treatment centers, found that 40 percent of surveyed Americans believe infertility is a socially taboo subject. This not only prevents those struggling with infertility from opening up about their own difficulties but can make them feel very alone while experiencing it firsthand. Fortunately, CCRM is looking to change all that by talking openly, honestly, and positively about infertility and family planning.

We spoke with Dr. Vasiliki Moragianni, a reproductive endocrinology and infertility specialist, and asked all of our questions about secondary infertility, including what it is, how it happens, and what we need to know about it. Read on for her expert answers and advice.

Meet the Expert

Vasiliki Moragianni, MD, MS

Dr. Moragianni is a managing physician and reproductive endocrinology and infertility specialist at Penn Fertility Care – Lancaster General Health.


What is secondary infertility?

Secondary infertility is the inability to conceive or carry a pregnancy to term after having given birth to at least one child. It can affect couples trying for their second child or even beyond that. 

How many women are affected by secondary infertility each year?

According to the United States Department of Health and Human Services, more than 6 million women between ages 15 and 44 struggle to become or stay pregnant—whether they’ve previously had kids or not—and one-third of those women are estimated to have secondary infertility. What that means is that secondary infertility is a lot more common than we think. Struggling to conceive a second child can be stigmatized and you may feel alone in your sadness and stress—but you aren’t.

Are there any known causes for secondary infertility? Is there anything mothers can to do prevent experiencing this?

The main causes of secondary infertility are similar to those of primary infertility: age, tubal blockage (due to endometriosis or pelvic infection), uterine fibroids or polyps, other hormonal factors (like your thyroid), and abnormal sperm. In addition, having had complications during a prior pregnancy or delivery could also contribute to difficulty conceiving in the future (scar tissue in your uterus can impact embryo implantation).

Are there any noticeable symptoms or signs that you may be experiencing secondary infertility while trying to conceive?

Unfortunately, there are no specific symptoms or warning signs, other than not being successful in achieving a pregnancy. If you do notice something “off” with your body (pain, inconsistent periods, etc.), definitely talk to your doctor. These could have a hand in possible infertility.

secondary infertility
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When should you talk to a doctor or see a specialist if you suspect secondary infertility?

If you have been unable to conceive after having had unprotected intercourse during the “fertile window” for 12 months and you are less than 35 years old (or 6 months if you are over 35) it is a good idea to see your gynecologist. She can give you a better idea of the next steps to take in your conception journey.

Does age have anything to do with whether or not you can experience secondary infertility?

The age of both partners plays a very important role in the process of conceiving, especially considering that most couples are older when attempting to conceive a second (or third) child. Both egg and sperm quality and their ability to lead to a healthy pregnancy decrease with age.

Unfortunately, biology hasn’t yet caught up with the fact that people are living much longer and having kids later in age—our natural ability to get pregnant still starts decreasing in the 30s and pretty much tapers off by the mid-40s. Not only does the number of available eggs go down, but the chances for each to be chromosomally healthy also declines.

Do certain methods of birth control have a higher rate of affecting your chances of secondary infertility?

There is no definitive evidence of an association between birth control and infertility. But, because birth control affects each body differently, it could take some women a while to begin ovulating again after weaning off of birth control. And, since birth control influences your periods, you may not notice any inconsistencies prior to discontinuing birth control.

What sort of testing will I have to go through if my doctor suspects secondary infertility?

It depends on the medical history of both partners and their families. Some basic testing includes assessment of ovarian reserve, fallopian tube patency, uterine anatomy, hormonal profile, and semen analysis. These tests help doctors determine where exactly your infertility might stem from before deciding a course of action to move forward with.

secondary infertility
Source: Shutterstock

Are there any supplements I can take or any lifestyle changes I can make to lessen my chances of secondary infertility?

Taking a daily prenatal vitamin that contains at least 400mcg of folic acid is recommended for anyone having unprotected intercourse, even if you’re not actively trying to conceive a child. Other supplements might be recommended by your doctor based on you and your partner’s medical history.

Smoking, consuming alcohol, or using drugs have all been associated with a negative impact on fertility so couples trying to conceive should definitely avoid them. Tobacco is particularly toxic to sperm and eggs and can make ovaries age faster than typical.

Leading a healthy lifestyle is always beneficial to your health. Eating a variety of fruits and vegetables, cutting down on sugars and caffeine, and getting a good amount of cardiovascular exercise can keep your body strong and healthy, overall.

What are the most common misconceptions of secondary infertility?

Patients often assume that having had no difficulty getting pregnant in the past automatically means that they will never have fertility problems in the future. But, so many factors can contribute to secondary infertility. Increasing age, changes in overall health, and other factors can have a negative impact on fertility, so when in doubt, get in touch with your doctor and have a conversation about your concerns, even if you’re not trying to conceive just yet.

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