Secondary infertility: Causes, statistics, treatment options, and more Health ConditionsHealth ConditionsAlzheimer's & DementiaAnxietyArthritisAsthma & AllergiesBreast CancerCancerCardiovascular HealthCOVID-19Dermatology & SkincareDiabetesEnvironment & SustainabilityExercise & FitnessEye HealthHeadache & MigraineHealth EquityHIV & AIDSHuman BiologyInflammatory Bowel DiseaseLeukemiaLGBTQIA+Men's HealthMental HealthMultiple Sclerosis (MS)NutritionParkinson's DiseasePsoriasisSexual HealthWomen's HealthDiscoverNewsLatest NewsOriginal SeriesMedical MythsHonest NutritionThrough My EyesNew Normal HealthPodcastsHow to understand chronic painWhat is behind vaccine hesitancy?The amazing story of hepatitis C, from discovery to cureNew directions in dementia researchCan psychedelics rewire a depressed, anxious brain?Why climate change matters for human healthToolsGeneral HealthDrugs A-ZHealth HubsHealth ToolsBMI Calculators and ChartsBlood Pressure Chart: Ranges and GuideBreast Cancer: Self-Examination GuideSleep CalculatorHealth ProductsAffordable Therapy OptionsBlood Pressure MonitorsDiabetic SuppliesFitness TrackersHome GymsGreen Cleaning ProductsHow to Shop for CBDQuizzesRA Myths vs FactsType 2 Diabetes: Managing Blood SugarAnkylosing Spondylitis Pain: Fact or FictionConnectAbout Medical News TodayWho We AreOur Editorial ProcessContent IntegrityConscious LanguageNewslettersSign UpFollow UsMedical News TodayHealth ConditionsDiscoverToolsConnectSubscribe What is secondary infertility Medically reviewed by Sanaz Ghazal, MD, FACOG — By Mary West on June 30, 2022Secondary infertility happens when a person cannot conceive or carry to term after giving birth in the past. The cause may stem from factors involving one or both partners. Secondary infertility affects approximately 11% of couples in the United States. In females, the most common cause of secondary infertility is polycystic ovary syndrome (PCOS). However, endometriosis, genital infections, and other conditions can also cause it. Some causes in males include hormone imbalances, aging, and ejaculation disorders. Treatment may include medications to improve fertility or surgery to manage an underlying condition. Doctors may also recommend assisted reproductive technology methods, such as intrauterine insemination (IUI) or in vitro fertilization (IVF). This article explores the causes and diagnosis of secondary infertility, treatment options, and more. A note about sex and gender Sex and gender exist on spectrums. This article will use the terms, “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more. What is it Share on PinterestSanti Nuñez/Stocksy“Infertility” describes when a couple cannot conceive after having a year of unprotected sex. There are two types of infertility: primary and secondary. Primary infertility refers to a couple who has never conceived. In contrast, secondary infertility describes a couple who is unable to conceive or carry to term after having at least one successful conception in the past. Conditions that affect females cause approximately one-third of secondary infertility cases, while conditions that affect males cause another third. The remaining cases are unexplained and stem from conditions involving both partners. How common is it Primary infertility is relatively common and affects 19% of females in the U.S. This is nearly 1 in 5 people. Secondary infertility is less common, affecting 11%, or about 1 in 10 couples. Causes in females There is a range of causes of infertility in females. Some common causes include: Polycystic ovary syndrome The most common cause of female infertility, polycystic ovary syndrome (PCOS) is the inability to ovulate or ovulate regularly. Ovulation is the release of an egg and normally happens once per menstrual cycle. PCOS affects about 10% of females of childbearing age. It can lead to the formation of cysts, or fluid-filled sacs, in the ovaries. Learn more about PCOS. Endometriosis In people with endometriosis, tissue similar to the uterine lining grows outside of the uterus. Researchers do not know exactly what causes endometriosis, but we know it can impact fertility in several ways. Endometriosis can cause inflammation, which can affect the quality of the eggs. It can also cause scar tissue to form, which can distort or change the reproductive anatomy and may make it harder for the serum to reach the egg. Endometriosis can also affect implantation. Learn more about endometriosis. Genital infections Chlamydia and gonorrhea are sexually transmitted infections (STIs) that can cause pelvic inflammatory disease (PID), an infection of the female reproductive system. Approximately 1 in 8 females with a history of PID has difficulty getting pregnant. Learn more about PID. Primary ovarian insufficiency Primary ovarian insufficiency (POI) happens when a person’s menstrual cycle becomes irregular before the age of 40. About 5–10% of people with POI conceive and have a normal pregnancy, but many people with the condition have difficulty conceiving. The cause is often not known, but chemotherapy, radiation to the pelvis, and other conditions may cause it. Learn more about POI. Hormonal disorders Hormonal disorders happen when a malfunction occurs in the hypothalamus and pituitary glands in the brain. These make hormones that maintain the working of the ovaries, so issues with them can affect the reproductive system. A malfunction here can cause a female not to ovulate. Learn more about hormonal imbalances. Fallopian tube obstruction An older 2013 study notes that fallopian tube obstruction occurs in 29% of females with secondary infertility. Chlamydia can cause an infection of the fallopian tubes, which may lead to permanent damage. Learn more about blocked fallopian tubes. Uterine conditions Since the uterus is essential to becoming pregnant, any condition that affects it can increase the risk of infertility. Such conditions may include:fibroids, which are noncancerous tumorsadhesions, accumulations of scar tissueadenomyosis, a condition where the lining of the uterus grows into the uterine wallcongenital anomalies present at birth that lead a person to have an unusual uterus Causes in males The following are conditions that can cause secondary infertility in males. Testicular or ejaculation function disruption A variety of factors can cause this. They include:trauma to the testes, which may decrease sperm productionvaricocele, a condition involving large veins within the testicle that may affect the shape and number of spermlifestyle habits, such as excess alcohol consumption and smokingcancer treatment that involves radiation, certain types of chemotherapy, or surgery to remove one or both testes Hormonal imbalances The hypothalamus and pituitary glands produce hormones that regulate testicular function. Various conditions that affect these structures may damage them and change their hormone production. This can result in a low sperm count or no sperm. Aging Some effects of aging may lead to problems that result in male infertility. Examples include:prostate enlargementreduced hormone productioncomplications of advanced diabetesirritable male syndrome and other conditions that affect older males Genetic conditions Several genetic conditions can lead to a low sperm count or no sperm. These include:Y-chromosome microdeletion, a condition that affects sperm productionKlinefelter syndrome, a condition that causes small testicles and low testosterone productionmyotonic dystrophy, a condition where muscles progressively weaken Most genetic causes contribute to primary infertility, but can still be a factor in secondary infertility. Diagnosis Diagnosis of secondary infertility may involve the following: A medical history The doctor will ask for information about:past illnesses, STIs, and surgeriesany previous pregnancies or deliveriesa history of pregnancy lossprevious breastfeedingcurrent medicationsexposure to harmful drugs or chemicalsthe menstrual cycledamage to the testes An exam This may involve a pelvic exam to check the reproductive organs. It can also include:semen analysis to look at sperm number and characteristicsblood tests to detect hormone insufficiencyultrasound to check for structural abnormalities, such as tumors, enlarged veins, or a blockage in the tube that carries the sperm out of the testes Treatment and fertility options Treatment may include: Fertility medications The main treatment for females with ovulation problems involves clomiphene (Clomid) as well as injections of follicle stimulating hormone and luteinizing hormone. Clomid induces ovulation, while the injections mature eggs and induce ovulation. Fertility medications like clomiphene and other hormonal medications may also help males with fertility issues due to hormone imbalances. Surgery Surgery for females may remove fibroids, endometrial growths, scarring, or uterine polyps. In some cases, doctors may consider surgery to open a blocked fallopian tube. Surgery for males may involve:repair of a blockage in the sperm transport systemreversal of a vasectomyrepair of enlarged veins in the spermatic cord, although this may not restore fertility Assisted reproductive technology If other treatment options do not work, people can consider conceiving with assisted reproductive technology. Some options include:inserting collected sperm into the uterusinjecting a single sperm into an eggmixing sperm with an egg outside of the body and later placing it in the uterusfreezing eggs How to cope with infertility Experiencing infertility can be emotionally challenging for both partners. The National Fertility Association recommends the following coping strategies:encouraging family members to educate themselves about fertility and letting them know how they can helpgiving a spouse or partner permission to feel differentlygiving oneself permission to cry or grievetelling a spouse or partner how one would like help or supportacquiring information about infertility to have an idea about what to expectjoining an infertility support group Summary Secondary infertility refers to a couple who cannot conceive or carry to term after having at least one successful birth in the past. It is not the same as primary infertility, which refers to a couple who has never conceived. Doctors base the diagnosis on a medical history, exams, blood tests, and, in some cases, ultrasound. Treatment depends on the cause, but a range of options is available. Infertility can take a toll on emotions, but coping strategies, such as joining a support group, may help. Sources:Al Subhi, T., et al. (2013). Prevalence of tubal obstruction in the hysterosalpingogram of women with primary and secondary infertility. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3911818/Benksim, A., et al. (2018). Difference between primary and secondary infertility in Morocco: Frequencies and associated factors. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5936612/CDC. (n.d.). https://www.cdc.gov/Coping techniques. (n.d.). https://resolve.org/get-help/helpful-resources-and-advice/managing-infertility-stress/coping-techniques/Katib, A. A., et al. (2014). Secondary infertility and the aging male, overview. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4132591/Polycystic ovary syndrome. (2021). https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndromeReproductive infertility. (2022). https://www.endocrine.org/patient-engagement/endocrine-library/infertility Last medically reviewed on June 30, 2022FertilityPregnancy / ObstetricsWomen's Health / GynecologyParenthoodGetting PregnantPregnancy ComplicationsPregnancy HealthFEEDBACK:Medically reviewed by Sanaz Ghazal, MD, FACOG — By Mary West on June 30, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageInfertility in males and femalesMedically reviewed by Amanda Kallen, MD Infertility or a person not being unable to conceive can cause significant stress and unhappiness. There are numerous reasons for both male and female…READ MOREAll you need to know about IVF IVF is the most common and effective type of assisted reproductive technology. Learn more about the procedure, success rates, risks, and ideal…READ MORESigns and symptoms of infertilityMedically reviewed by Holly Ernst, P.A. In this article, learn about possible signs of infertility in men and women, as well as about other risk factors, the treatment options, and when to…READ MOREInfertility and miscarriage may increase women’s risk of stroke, study shows New research published in the BMJ shows an association between women who've experienced infertility, miscarriage, or stillbirth and an increased risk…READ MORE11 of the best apps for fertility tracking and predicting for 2022Medically reviewed by Amanda Kallen, MD Fertility tracking apps can help people to monitor when they may be fertile and can help with conceiving or as a form of birth control. Learn more.READ MORE