If you are experiencing fertility challenges while trying to expand your family, you aren’t alone. Secondary infertility occurs when a couple cannot conceive or maintain a pregnancy, even after previously giving birth to their first or second-born child. A study in the Lancet found that 9-12% of women will experience secondary infertility, despite previously getting pregnant with ease.
If you and your partner have been trying to conceive for over 6 months, or longer than the amount of time it took with a former pregnancy, you should speak with your family physician or reproductive endocrinologist.
Common Causes of Secondary Infertility
Despite becoming pregnant once (even twice) before, secondary infertility can occur the next time you try to conceive. The causes are typically the same as primary infertility and are categorized into four areas:
Is the couple having regular intercourse around the time of ovulation? Ideally, this amounts to 2-3 times during the fertile window, which is typically 10-14 days after the first day of bleeding.
Is the menstrual cycle regular? Is the female partner releasing an egg each month during ovulation? Is the egg mature and fertilizable? There are multiple factors that can affect egg quality, ranging from age to hormone conditions to oxidative stress.
Does the male partner have an optimal sperm count (how many?), motility (can they swim?), morphology (heads, tails, bodies?) and viscosity (thick or thin?) for conception? The male factor is a leading cause for secondary infertility.
Can the uterine environment support conception? Tubal issues occur more often in secondary than in primary infertility (as much as 20% of cases). This may include fallopian tube obstruction, endometriosis, scar tissue from a previous birth, C-section scars, complicated births, placenta issues, or uterine conditions.
Other risk factors for secondary infertility may be related to complications during a previous pregnancy, certain medications, weight and age.
Frequently Asked Questions
Below you will find the answers to commonly asked questions about secondary infertility.
How do I know I have second infertility?
If you have conceived once before and are having trouble getting pregnant again or maintaining a pregnancy, it can be an indication of secondary infertility. If you are under 35, we recommend trying to conceive up to 1 year and then seeking support from your physician. If you are over 35, we advise trying to conceive naturally for 6 months before seeking further medical support.
Is secondary infertility treated the same as primary infertility?
- From a naturopathic point of view, primary and secondary infertility are treated in similar ways, providing that the underlying issue is the same. There are a lot of overlapping causes between them, but there would be some cases of primary that wouldn’t translate over to secondary infertility. As an example, these can include genetic factors, congenital problems, congenital adrenal hyperplasia or premature ovarian failure. Your Conceive Health naturopathic doctor will do a detailed assessment to uncover the underlying issues and the best fertility treatment plan for you and your family.
How do I know which partner should treated for infertility?
It’s not always a clear answer whether the female or the male, or both, are contributing to difficulties conceiving. With the male partner, the main indication would be based on his sperm analysis. With the female partner, it’s sometimes more difficult to identify. As the first step(s), we will assess to see if she is ovulating, in hormonal balance, the uterine cavity is normal, and the fallopian tubes are unblocked. If those areas are optimal, then we would recommend a further medical investigation. From a naturopathic perspective, we will also address nutrition and lifestyle factors, among other areas, which can influence fertility.
What can I do to prevent second infertility from occurring?
The most important thing you can do is to start adjusting your lifestyle to support egg quality. This includes a high protein, low glycemic diet with healthy fats and antioxidants, such as CoQ10 ( always consult a health practitioner before starting a new supplement regimen).
The Conceive Health team specializes in preconception care and can help prepare your body (and that invaluable sperm and egg) to minimize a future risk of fertility challenges. If you know you will be expanding your family, start preconception care now — it’s never too early.
If I had fertility treatment before, when should I start preconception care?
- If it took longer to conceive the first time around, then you will want to make sure your body is ready when you want to grow your family again. That said, It’s advised to wait 1 year post birth or at least until you are finished breastfeeding. For example, you can’t take antioxidants while breastfeeding and you do need a window of time between weaning and beginning fertility treatment, such as IVF or IUI.
Can I do preconception care while breastfeeding?
While breastfeeding, you can do basic, low level egg quality support, such as dietary intervention and certain supplements, but avoid high dose antioxidants. If you have started the weaning process and are just breastfeeding morning and night, then we can begin to ramp up your program in preparation. It’s best to work in conjunction with a fertility naturopath — contact us today for more information.