Questions About Secondary Infertility 

Dr Kristen Wright, New Hampshire fertility doctor, is often asked why, after giving birth once, a couple can have trouble getting pregnant again.

Couples are naturally surprised and confused when they have trouble getting pregnant after either or both have already had children.  This phenomenon, known as “secondary infertility”, is quite common. In fact it accounts for about 40% of infertility cases.

There are a number of reasons for secondary infertility.

1. A woman’s age can be a factor. If she had a child when she was 29 and is now trying for a second at age 34, natural physiologic changes of ovarian reserve (number of eggs available for fertilization) are likely to have occurred. At age 28, she had only about a 6% to 7% percent chance of an infertility issue. By age 35, that has jumped to an 11% possibility. (Between age 35 and 40, there is a significant increase. The Centers for Disease Control (CDC) report a 33% chance of infertility by age 40).

2. A time lapse between the birth of one child and an attempt for another can result in the development of other factors. Fertility potential can be decreased by the presence or worsening over time of endometriosis, or uterine changes such as the development of fibroids. A woman’s male partner may have changed or, if the same, may have a deterioration in sperm quality or quantity.

3. Factors involved in one’s original pregnancy are also important when we evaluate a case of secondary infertility. Was one’s first conception delayed, indicating a lower fertility potential? Were there complications during delivery and postpartum, such as retained placenta? A postpartum D&C can also lead to the formation of intrauterine adhesions, also diminishing fertility potential.

4. Changes of one’s lifestyle are also considerations for evaluating secondary infertility. These include excessive weight gain, or increased stress and/or anxiety.

One of the most important factors regarding secondary infertility is awareness that it can happen and, in fact, is quite common.  We find that couples dealing with secondary infertility are hesitant to see a specialist consult – largely because they are unaware of this phenomenon. Anyone 35 or under who has been trying to get pregnant for a year without success should seek specialty help. Over 35, help should be sought after 6 months. This basic fact is the same whether you are trying to have your first, second or even third child.

Dr. Wright, a Board Certified Reproductive Endocrinologist, sees patients at the Bedford, New Hampshire office of RSC New England.

This information is provided for general education purposes and is not intended to take the place of a discussion with your physician. If you have questions about any aspect of your health, you are advised to speak with your physician.

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