Secondary infertility refers to when woman or a couple have conceived before naturally, but struggle when they try to extend their family. They have been fertile in the past, but something is different. Something has changed.
Fertility is relative, existing on a spectrum. Both women and men are most fertile in our youth. Both male fertility and female fertility declines with ageing.
Female infertility is disproportionately affected by advancing female age, dropping radically from the age of 35 onwards. The effect of age alone, associated with radically poorer egg quality, can be responsible for many cases of secondary infertility.
Sperm problems worsen with age also. Sperm that may have just made it over the line for natural conception in the past, may now be of inadequate quality for natural conception to occur.
Sometimes a first naturally pregnancy was a lucky break for a sub-fertile couple, as opposed to the loss of completely normal underlying fertility.
Many lifestyle factors and also many medical conditions can change over time. We can gain weight. Conditins such as endometriosis may worsen with time, impacting fertility. We can acquire hormonal imbalances and immune system problems that we did not have before. We may become diabetic.
Toxic exposures in our environment such as cigarette smoking, chemical exposures and ingesting endocrine disruptors through our diet can reduce both male and female fertility.
Some genetic causes of infertility are responsible for recurrent pregnancy losses, for example chromosome rearrangements. Both men and women can be the source of such abnormalities, which have been found to be over represented amongst couples with secondary infertility compared to the background population. The only way to discover this important cause of infertility is a blood test called a karyotype that needs to be performed for both partners.
Many causes of secondary infertility can be modified or treated and for others, thechnologies like IVF and ore-implantation genetic testing of embryos (known as PGT) can help to find the right embryo that can successfully make a baby.
Whatever the cause, it’s important to seek assistance in a timely fashion. Technologies like IVF can be helpful where secondary infertility occurs due to poor egg and sperm quality, however IVF success rates are overall poorer for older couples.
The first step to overcoming secondary infertility is to be thoroughly investigated as a couple by a CREI qualified fertility specialist.
At Women’s Health Melbourne, we are experts at assisting both men and women to overcome both primary and secondary infertility to have healthy families.