Some people assume that if they’ve successfully conceived before, then they won’t have a problem getting pregnant again. Unfortunately, that’s not true. Millions of couples experience secondary infertility, or the inability to get pregnant after having one or more children previously. When a couple is unable to get pregnant for the first time, it’s called primary infertility.
Doctors diagnose secondary infertility in the same way as primary infertility. If you and your partner have not been able to get pregnant after a year of trying, you should see a fertility specialist. For women over 35, many doctors recommend seeing a specialist after six months. These rules still apply if you’ve previously had a child.
Causes
The cause of secondary infertility can be hard to determine, and often there are multiple contributing factors. It is also possible that no cause can be determined. However, the following factors may make it difficult to get pregnant after you’ve had children previously.
Age
For most women, fertility starts to decline after age 30, and the decline is more drastic after 35. The older you are, the more difficult it could be to get pregnant, even if you’ve successfully carried a child before.
Age is also a factor in male fertility, although they are generally fertile longer, sometimes into their 50s and beyond. However, the likelihood of developing a sperm disorder increases as a man ages.
Complications from Previous Pregnancies or Surgeries
If you experienced complications during a previous pregnancy or delivery, it might be difficult to conceive afterward. Damage to the reproductive organs like the uterus is rare but can happen during childbirth. Also, if you’ve had certain surgeries, the scar tissue can make getting pregnant difficult.
Hormonal Imbalances
Your hormones are responsible for so many bodily functions and have a significant impact on fertility. Having hormone levels that are either too high or too low can disrupt ovulation in women and affect sperm production or cause ejaculation issues for men. These issues may not have been present when you previously conceived.
Worsening Endometriosis
If you have endometriosis but got pregnant without assistance before, you could still have trouble conceiving in the future. Endometriosis is a progressive disease, and scar tissue can worsen and affect fertility, especially if it is untreated.
Changes in Weight
Being overweight or underweight can affect how regularly you ovulate because weight impacts hormonal balance. If you’ve gained or lost a significant amount of weight since the last time you conceived, then that could factor into secondary infertility.
Male Factor Infertility
Even if the infertility is secondary and the man has fathered children before, male factor infertility can be a problem. Along with aging, poor diet, smoking, and obesity are all linked to sperm disorders. A condition called varicocele (enlarged veins within the scrotum) can develop and harm sperm production as well. Ejaculatory disorders like retrograde ejaculation and impotence can also cause problems.
Treatment Options
Like with primary infertility, treatment for secondary infertility depends on its cause and contributing factors.
Preconception Preparation
Making sure your body is in optimum condition for conception is essential. If you didn’t have trouble conceiving before, you might not be paying attention to good preconception health, which can improve the chances of pregnancy. Good preconception health includes things like getting regular exercise, taking the right supplements, eating a nutritious diet, limiting or eliminating alcoholic beverages, getting to a healthy weight, and stopping smoking.
Weight Management
Weight management is part of the preconception health checklist, but it is especially crucial if weight is one of the leading causes of infertility. Talk to your doctor about how to safely lose weight if you are overweight or obese. If you are underweight, your doctor can help you with a plan to put on weight before you get pregnant.
Balancing Hormones
If a hormonal imbalance is preventing conception, hormone therapy can treat the condition and potentially improve fertility. Also, lifestyle changes can help balance hormones. Getting enough sleep, eating well, not smoking, and staying active can all help balance hormones.
Assisted Reproductive Technology
In some cases, using assisted reproductive technology (ART) is recommended. These treatments don’t differ from those used to treat primary infertility and may include artificial insemination such as intrauterine insemination (IUI), in vitro fertilization (IVF), and ovulation induction. Depending on the cause of infertility, you may need to use a donor egg, donor sperm, or a gestational carrier.
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If you are struggling with infertility, either primary or secondary, Carolinas Fertility Institute can help. Our staff includes board-certified Reproductive Endocrinologists and Embryologists that can help you build the family of your dreams. Call us at (336) 448-9100 to make an appointment in the Triad, or (844) 686-2233 for our Charlotte office.