Secondary Infertility
What is Secondary Infertility?
Secondary infertility occurs when a couple has difficulty conceiving after already having a child. This contrasts with primary infertility, where a couple has not had a child after trying to conceive for at least one year.
When Should You See a Specialist for Secondary Infertility?
Whether dealing with primary or secondary infertility, the American College of Obstetricians and Gynecologists (ACOG) advises that if you are under 35 and have been trying to conceive for up to a year, or if you are over 35 and have been trying for up to 6 months without success, it is time to consult a fertility specialist.
Since infertility can be due to factors affecting either partner, it's crucial for both male and female partners to undergo a comprehensive fertility evaluation to help determine the potential cause of secondary infertility.
Fertility Treatment for Secondary Infertility
The treatment options for secondary infertility are similar to those for primary infertility. After a thorough fertility evaluation, you and your fertility doctor will discuss the best treatment approach for your situation.
For women over 35 or couples who have experienced three or more consecutive miscarriages, in vitro fertilization (IVF) with preimplantation genetic testing for aneuploidy may be recommended. This process, also known as comprehensive chromosome screening (CCS), involves screening the cells of a day 5 embryo for chromosomal abnormalities. As women age, the likelihood of chromosomal abnormalities in embryos increases, which is a major cause of miscarriages. By selecting and transferring only chromosomally normal embryos, CCS reduces the risk of miscarriage and increases the chances of a successful pregnancy.
How Common is Secondary Infertility?
It's estimated that about 11% of couples experience secondary infertility.
Causes of Secondary Infertility
Age is one of the most significant factors contributing to secondary infertility. As a woman ages, both the quality and quantity of her eggs decline, increasing the risk of miscarriage and reducing the likelihood of a successful pregnancy. By the age of 35, a healthy woman has around a 15% chance of conceiving each month.
Men typically experience a decline in fertility around age 45, with studies suggesting that older men are at higher risk of genetic sperm defects, which can increase the chances of miscarriage, stillbirth, and passing on genetic conditions.
Other causes of secondary infertility include:
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Complications from previous deliveries that may impact future pregnancies, such as scar tissue in the uterus or fallopian tubes
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Lifestyle changes that affect sperm and egg quality, such as smoking, alcohol use, or weight gain
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Hormonal issues
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Endometriosis
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Uterine and tubal factors
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Diabetes