Marking Fertility Awareness Week this week (31 October-6 November), we ask the experts how to cope with secondary infertility if you’re struggling to get pregnant second time around.
We spoke to Professor Geeta Nargund, Medical Director of CREATE Fertility and abc ivf, about a topic that is often overlooked and misunderstood: secondary infertility, where someone has had one or more pregnancies in the past, but is struggling to conceive again.
Fertility Awareness Week: How to Cope With Secondary Infertility
Fertility problems impact approximately 15% of the population, while secondary infertility impacts around 5%. If you are struggling with secondary infertility, it’s important to understand that there are treatment options and support available. Discover all you need to know below.
What are Some of the Causes of Secondary Infertility?
We can look to many of the main causes for primary infertility when identifying the issues that might be causing secondary infertility – including both female and male factors.
For women, causes of infertility include a range of conditions such as endometriosis, polycystic ovary syndrome, or damaged or blocked fallopian tubes. Male factor issues, which are often overlooked, can include problems with sperm count as well as the quality of the sperm or blockages preventing delivery of sperm.
Naturally, age may be a factor in play when it comes to secondary infertility – particularly if you have a number of years in between your attempts to conceive. It’s a better known fact that for women, fertility peaks at age 25, and declines from the age of 35. Lesser known is that men have a biological clock, too.
Despite reports in the media of older famous fathers such as Rod Stewart or Mick Jagger, research has shown that older paternal age can delay conception and reduce fertilisation rates – so it is important to consider age as a contributing factor for both men and women.
Another factor potentially in play could be excessive weight gain or weight loss that may have occurred in the time between your attempts to conceive. Weight gain or loss can result in hormonal imbalance, which can contribute to irregular periods or ovulation difficulties – with knock-on effects on fertility.
One distinguishing factor between primary and secondary infertility, which might also be worth considering, is potential complications from previous pregnancies or deliveries, such as in the case of a caesarean section. Do of course speak with your GP or fertility specialist to discuss the potential causes of your secondary infertility.
Is Fertility Treatment a Viable Option?
The treatment options available for primary and secondary infertility are largely the same. Given past success with pregnancy, your doctor may initially advise you to address any lifestyle factors that could be impacting your fertility. If you are not ovulating, they might also suggest ovulation induction, which uses hormones to stimulate the egg maturation and release.
If there is an obvious cause for secondary infertility, specific treatment is required. If you have a fibroid or polyp inside the uterine cavity, then removal through minor surgery might be the next course of action. Assisted conception is of course another common route for many couples struggling with their fertility.
Intrauterine insemination (IUI) is a less invasive form of fertility treatment and involves directly inserting washed sperm into a woman’s womb. If IUI is recommended for you, you will need to make sure that your fallopian tubes are checked and are not blocked before starting treatment.
In vitro fertilisation (IVF) is where the egg(s) is removed from the woman’s ovaries and fertilised outside of the body with sperm in a laboratory before the embryo is returned to the woman’s womb.
Whilst the government’s recent Women’s Health Strategy has laid out plans to improve access to fertility treatment on the NHS by removing non-clinical factors from the eligibility criteria, unfortunately we might not see this change take effect for some time now. At present, many couples facing secondary infertility are unable to access NHS treatment due to already having one or more children.
As a result, many couples facing secondary infertility are forced to turn to the private sector to pursue treatment, which can of course be an additional and unforeseen financial burden.
Breaking Down the Stigma Around Secondary Infertility
Although many of the causes and treatments for primary and secondary infertility are the same, the emotional experience can be very different. In particular, many people struggle with a sense of guilt for wanting more children, scared that others may see them as ungrateful for the child they already have (which is of course not the case).
It can be devastating realising that you might not be able to complete the family you once longed for, and it’s important to give space to these feelings and seek support from a counsellor if necessary.
If you have been trying to conceive regularly for over a year and haven’t had any success, you should seek advice from your doctor. For women aged 36 and over, we advise that you see your GP a little sooner – usually after about six months.
Secondary infertility can be a daunting and overwhelming diagnosis, but there are plenty of treatment options and support groups available. For example, FNUK has plenty of resources and support groups where you can learn more and connect with other couples facing secondary infertility.