Understanding secondary infertility

Don’t give up hope! The fact that you had a successful pregnancy in the past is a very positive sign.

Secondary infertility, the inability to conceive again despite relative ease with a first birth, can be one of the most frustrating infertility conditions. It is very difficult for women and couples to understand why, after prior pregnancy success, they cannot conceive again a second or third time.

Clearly, a woman is always older when trying to conceive again, and this often plays a role. As women age, their egg number and quality declines. If a woman is now over 35, age is a more significant factor.

Perhaps you have a new sexual partner. Male factor infertility accounts for at least 30% of unexplained infertility. Or even though you may have the same partner, perhaps he is on new medications or has had a significant lifestyle change.

Weight gain can also play a role in female and male secondary infertility. For women, weight gain can negatively affect menstrual cycle length and ovulation. For men, weight gain can negatively impact sperm quality.

Maybe your health history has changed and may include an abdominal surgery or pelvic infection in the interim. Sometimes adhesions can form after surgery or infections that affect fallopian tube functioning.

Or, even more frustrating, perhaps not much has changed at all. It is not uncommon for fertility physicians to hear that a couple conceived on their first or second month or trying, and now nothing has happened after 1-2 years of attempting conception.

Evaluating secondary infertility

The evaluation of secondary infertility is very similar to that of primary infertility.

First, we will check your fallopian tubes and uterus with a Hysterosalpingogram (HSG). An HSG test is to look for uterine polyps, fibroids or scar tissue and to determine if the tubes are patent. A pelvic ultrasound may also be performed to look for ovarian cysts or fibroids outside of the uterine cavity.

Secondly, we will want to evaluate your ovarian function. Your antimullerian hormone (AMH) level indicates if there is a normal number of remaining eggs in the ovaries, and your luteal progesterone level can confirm ovulation if there is any suggestion of irregular periods.

Lastly, a semen analysis is important to check the sperm count, motility and morphology. Other tests may be helpful based on a couple’s additional medical or surgical history.

Most of all, don’t give up hope! Given that a prior pregnancy has been successful, this is still a very positive sign. At Carolina Conceptions, we want to help you to achieve your goal of another successful conception.