Secondary infertility refers to difficulty becoming pregnant, or carrying a pregnancy to term, after previously having one or more successful pregnancies without fertility treatment. It is typically diagnosed when a couple has been trying to conceive for 12 months without success. For women aged 35 and over, it is generally recommended to seek an evaluation after six months of trying.
Although it can feel unexpected and isolating, secondary infertility is relatively common, accounting for around 15–20% of infertility cases among couples.
What causes secondary infertility?
There are many possible reasons why conception may be more difficult the second time around. These may involve one partner, both partners, or sometimes no clear cause is identified despite investigation.
Age-related changes
Fertility naturally declines with age in both women and men. In women, egg quantity and quality reduce over time, while in men, sperm quality may also gradually change.
Gynaecological conditions
Certain conditions can affect reproductive health and make conception more challenging, including:
- Endometriosis
- Fibroids
- Polycystic ovary syndrome (PCOS)
These conditions may impact ovulation, fertilisation, or implantation.
Changes in health and lifestyle
Fertility can be influenced by changes in overall health and daily habits. Factors such as significant weight gain or loss, chronic medical conditions, smoking, and excessive alcohol consumption can all play a role.
Fallopian tube damage
The fallopian tubes are essential for egg transport and fertilisation. Blockages or damage may occur due to:
- Previous pelvic infections
- Pelvic inflammatory disease
- Prior surgery or adhesions
Male factor infertility
Male fertility can change over time as well. Issues affecting sperm count, movement, or quality may contribute, including:
- Varicocele
- Infections
- Hormonal imbalances
- Prostate conditions
- Lifestyle factors such as smoking, alcohol use, or heat exposure
Unexplained infertility
In some cases, standard fertility tests do not reveal a clear cause. This is known as unexplained infertility and can still be frustrating, even though it is not uncommon.
What treatment options are available?
Treatment depends on the underlying cause, as well as factors such as age, how long you have been trying to conceive, and personal preferences. Options may include medical treatment, lifestyle changes, or assisted reproductive techniques.
Importantly, many couples experiencing secondary infertility do go on to achieve a successful pregnancy with the right support and treatment plan.
If you are finding it difficult to conceive again, seeking medical advice can be an important first step in understanding your individual situation and exploring suitable options.
