Secondary infertility is the inability to become pregnant or to carry a baby to term after previously giving birth to a baby. This cool and clinical description defines the term accurately, but can’t begin to describe the bewilderment, anxiety and sheer pain that patients experiencing secondary infertility can feel.

Today we’re discussing this issue and how to address it. We’re considering what happens when ‘the little brother/sister’ doesn’t arrive.

How many people struggle with secondary infertility?

While there are no hard and fast secondary infertility statistics worldwide, some survey-based reviews of couples who already have a child and fail to become pregnant with another after one year of unprotected intercourse estimate that one in six, that is 16.6%, experience a conception difficulties. This compares with a figure of nearer to one in five, or 20%, for couples with no previous children. Other estimates put the figure closer to one in five for secondary infertility.

In addition, the American Society for Reproductive Medicine (ASRM) estimates that approximately 50% of couples seeking fertility treatment have secondary infertility issues.

Secondary infertility causes

As with primary fertility issues, possible secondary infertility causes include impaired sperm production, function or delivery in men and fallopian tube damage, ovulation disorders, endometriosis and uterine conditions in women.

Exclusively in the case of secondary infertility, there is the possibility of complications directly resulting from a previous pregnancy. Other risk factors like changes in health, weight, lifestyle or medication could also be factors to consider. In addition, those experiencing secondary infertility are inevitably that much older than they were when their first child was born, and it can be easy to overlook the fact that the chances of conception decrease as the years go by.

In addition, it may happen that a person struggles to conceive with one partner but not with another. This occurs when the combination of both reproductive potentials is not suitable.

What are the signs of secondary infertility?

As we reflected at the outset, secondary infertility involves difficulty in conceiving a child after one or more previous pregnancies. In this regard, the indications for visiting a specialist are the same as with primary infertility (when seeking the first child).

Most clinicians recommend that if you have frequent unprotected sex but don’t become pregnant after a year if you are under 35 or after six months if you’re 35 or older, it’s a good idea to seek advice to try to pin down the causes in your particular case.

How do you overcome secondary infertility?

Once you have a diagnosis, you can start to focus on potential solutions. Firstly, a comprehensive fertility assessment is necessary to evaluate the potential causes of this infertility. Previous pregnancy history will be taken into account, especially if prior pregnancies were achieved naturally or not.

For specialists to determine the reasons behind infertility, both primary and secondary, it’s necessary for the couple to undergo a series of tests. In the case of women, this typically involves hormonal analysis through blood samples and ultrasounds. Additional tests may be required depending on each patient’s situation.

On the other hand, men should undergo a semen analysis or spermogram to assess factors such as sperm count, motility, and morphology.

Secondary infertility tests – what should you expect?

The secondary infertility tests that you can expect when you visit one of our clinics include a complete medical history review and physical examination of both partners. The range of tests may be extended depending on the patient. To complete the diagnosis it will also be necessary to assess semen quality in the man via a seminogram test. These tests are in fact identical whether your individual case involves primary or secondary infertility. However, obviously your personal history is significant and will be taken into account.

Possible secondary infertility treatments which may be recommended as a result of the investigations and tests could include artificial insemination, IVF, sperm donation or egg donation, depending on the individual case.

• Artificial insemination consists of depositing a semen sample inside the woman’s uterus. This sample has been prepared in advance in the laboratory. This will increase the potential of the spermatozoa and improve the chances of the egg being fertilised. In this way, the distance separating the spermatozoon and the ovum is shortened, and the process whereby these come together is facilitated.
• IVF (In Vitro Fertilisation) is the assisted reproduction technique which is the best known in general. It consists of uniting the ovum with the spermatozoon in the laboratory (in vitro). This is how we obtain fertilised embryos for transfer to the patient’s uterus. The fertilisation can be carried out by means of the conventional IVF technique or by Intracytoplasmic Sperm Injection (ICSI).
• Sperm donation could be considered in cases where there has been a change in the viability of the sperm quality of the male partner. Sperm donation is a voluntary, altruistic act of solidarity through which a healthy male with very high-quality semen donates a sample to give those with infertility problems the chance to become parents. 
• Egg donation allows female patients to conceive without using their own eggs. In this case, oocytes from a donor are combined with spermatozoa to produce embryos; these are transferred to the recipient patient in order to achieve pregnancy. Egg donation is sometimes recommended in cases where a woman has repeatedly failed to become pregnant through IVF or who has suffered repeated miscarriages. To find out more, our video about egg donation explains the process.

What sources of support are available for those facing secondary infertility?

Our main message for anyone experiencing secondary infertility is not to suffer in silence, but to seek help. Find groups of supportive friends who can understand the issues. Above all consult a specialist that is geared up especially to help in individual cases such as yours. The most proactive form of support involves help exploring treatment options. This ought to banish the danger of depression and replace it with purposeful action which has a good chance of a positive result.

At IVI clinics, we have emotional support units that address all kinds of situations, including those that arise when another child does not arrive.

Getting in touch with IVI: what to expect

When you feel ready, why not contact one of our clinics for a consultation in which you can consider the professional advice of one of our specialists? You can also rest assured that many of our clinics in Spain are specifically geared up to care for visitors from abroad, and a mentor who speaks your language will accompany you through the whole patient journey. Furthermore, it is our goal at IVI to ensure that our patients are cared for emotionally as well as physically.

At IVI we offer a whole range of techniques and strategies which minimise the impact of the stress that inevitably results from fertility problems. We therefore work to promote better emotional well-being with the objective of providing an improved quality of life during assisted reproduction treatments.

You can get in touch using our online contact form or give us a call on our freephone number 08 000 850 035 if calling from the UK, or from other countries, on +34 960 451 185. You could soon be on your way to completing your family just as you have always wanted.