Author: Dr. Priyanka Mohan

Qualification: MBBS, MS(OBG), FMAS, DMAS, FRM

Secondary infertility is a condition where a couple has had at least one child and is looking to get pregnant again, but the results aren’t in their favour despite trying for at least a year. This diagnosis and secondary infertility symptoms can be confusing at first, with many questions playing in mind. Why is it happening now when there was no trouble getting pregnant the first time? Let’s see why!


Most people assume that primary infertility (when a couple cannot conceive ) is more common than secondary infertility in women. However, as per the reports, secondary infertility is a common form of female infertility.

Couples diagnosed with secondary infertility may be more likely to avoid the treatment of secondary infertility and seek help. They think that people around them may look down upon their fertility struggles since they already have one child.

The truth is that whether you’re struggling for child number two or four, there is underlying anxiety and grief that needs proper secondary infertility management since coping with it has its challenges.

Each family has a different story and demands. You may be looking at a particular picture of how your family should look, or your child may be wishing for a sibling. And the medical causes of this condition aren’t any less challenging to diagnose and treat than primary infertility.


There are various causes of secondary infertility in women and men, which lead to the same issues seen with primary infertility, including:

  • Infertility in males is caused by low or zero sperm count, problems with sperm shape (morphology) or sperm movement (motility)
  • Issues with ovulation such as irregular ovulation or absent ovulation
  • Blockage in fallopian tubes (most common cause)
  • Fibroids
  • Endometriosis
  • Adhesions or uterine scarring
  • Recurrent MTPs
  • Issues with the endometrium
  • Immunological problems
  • Hostile cervical mucus
  •  Unexplained

Roughly one-third of infertility cases are linked with male infertility. At the same time, it could be due to female infertility, and the rest could be due to unexplained issues in both partners.

Risk Factors

The biggest question couples keep juggling after experiencing secondary infertility is why isn’t conception taking place this time around?
The following risk factors are associated with secondary infertility:

  • Age: Fertility naturally declines significantly with ageing, and having the first child at 35 and trying for the second at 38 may cause secondary infertility.
  • Change in a partner: if you’ve changed your partner after the first child, there may be an undiagnosed infertility problem.
  • Existing fertility problems worsened: There are chances that you might always have endometriosis or subclinical PCOS. Many females have their ovarian reserves on the downslide without any clue.
  • Weight gain: Weight can take a toll on your fertility. Women have experienced ovulatory issues because of being over or underweight, and this could also impact sperm health in men.
  • New health problem: There are chances that you or your partner may have developed diabetes or high blood pressure. Or perhaps there has been an underlying condition of depression.
  • Fertility issues due to last pregnancy or birth: Pelvic infection or multiple D&C procedures may cause blockage in the fallopian tubes or uterine adhesions.
  • The right time to seek help

Individuals under 35 years of age should consult doctors if they haven’t conceived after one year of trying. In the case of 35 years or older, they should seek help after trying for six months. Apart from that, one should seek advice regardless of age if they have experienced two consecutive miscarriages.

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