6 October 2021

Secondary Infertility: what is it and what are the treatments?

By the Editorial Comitee IVI Blog

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. Very often the feeling of loss can be exacerbated by a vague sense of guilt that one can’t be satisfied with ‘just the one’. None of this is alleviated in the slightest by well-meaning advice from friends and family to ‘count your blessings’. Indeed, secondary fertility depression is a phenomenon well known to professionals working in the field of assisted reproduction, and it may be that the depression results from people suffering in silence and the fact that secondary infertility support may be more difficult to access than support for sufferers of primary infertility.

At IVI, the largest assisted reproduction group in the world, we have a very broad accumulated experience of all kinds of issues around infertility, including secondary infertility. We have been offering the best techniques in assisted reproduction for more than 27 years, thanks to which more than 160,000 babies have been born to date. In this article we aim to share some information about secondary infertility statistics, causes, what you can expect when you seek assistance at one of our clinics and investigations which may be carried out as the first step to a solution.


Secondary infertility statistics

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 failure to conceive. 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, meaning that there is no significant difference in the incidence of primary or secondary infertility.


Secondary infertility causes

As with primary infertility, 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.

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. It’s quite possible that a diagnosis can come as a relief to people who have been suffering in silence and experiencing depression that is so often reported. Once you have a diagnosis, you can start to focus on potential solutions.


Secondary infertility investigations – what should you expect?

The secondary infertility investigations that you can expect when you visit one of our clinics include a complete medical history review and physical examination of both partners. In the case of the woman, the basic tests are: a basal hormone study; an ultrasound scan; and a hysterosalpingography (a fluoroscopy X-ray of the reproductive system). 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, although obviously your personal history is significant and will be taken into account.

Possible 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, which has been prepared in advance in the laboratory, inside the woman’s uterus in order to 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 – in order to obtain fertilised embryos for transfer to the patient’s uterus. The fertilisation of the ova 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. To learn more about the circumstances where this would be the recommended assisted reproduction treatment, you can have a look at the IVI video on semen donation on our YouTube channel.
  • 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 an option to consider for older women and women with ovarian failure due either to menopause or prematurely after ovarian surgery. It is also 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, and above all consult a specialist agency 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, we are proud to be the largest assisted reproduction group in the world. You can browse any part of our website to help you consider the possibilities for treatment. It will also help to know that 9 out of 10 couples that consult IVI due to problems with infertility and put their trust in us see their dream of becoming parents come true. Furthermore, from the outset IVI has pioneered many different techniques. Proof of their success can be seen in the more than 160,000 babies born to date with the help of IVI. In addition, the ongoing work of our professionals and the incorporation of all the latest technologies enable us to improve our pregnancy rates every year. You can have a look at our audited results for yourself here or take the time to watch the video on our YouTube channel about IVI and how our clinics work.


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.

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