Secondary Infertility- Causes, Signs, and Treatment

What is Secondary Infertility?

Secondary Infertility is defined as a condition where the body is incapable to conceive or become pregnant after giving birth to the first baby. In secondary infertility the mother is not able to conceive or not able to carry the baby to full-term despite having a successful first pregnancy. Secondary Infertility- Causes, Signs, and Treatment

Causes of Secondary Infertility in Men and Women

Secondary Infertility may occur in both men and women. Cause of secondary infertility can originate only to the mother or father or a combination of both. Causes of Secondary Infertility in Men and Women

Causes of Secondary Infertility in Women

The main causes for secondary infertility in women include

  • Quality and Quantity of Eggs: Women have a limited eggs supply and the number of eggs in the ovaries gradually decrease as they age. The remaining eggs are more likely to have chromosomal problems. Hence, it becomes more difficult to conceive after the first pregnancy.
  • Issue with fallopian tubes: Fallopian tubes carry the eggs to the uterus in the process of ovulation. Pelvic infections such as gonorrhea and Chlamydia can block the fallopian tubes and obstruct the flow of eggs.
  • Uterus problems: Several uterus related problems can be the reason for secondary infertility. Scarring can happen during a C-Sec delivery that can form adhesions in the uterus and further interfere with future pregnancies. Other uterine problems include retained placenta, polyps, and fibroids.
  • Endometriosis: This condition occurs when tissues that must grow inside the uterus grows elsewhere such as inside the ovaries or bowel surfaces. Endometriosis can be a common cause for secondary infertility.
  • PCOS: Polycystic Ovary Syndrome is a type of hormonal disorder causing irregular and longer menstrual periods. A woman suffering from PCOS produces more male hormones and fails to release eggs regularly.
  • Breastfeeding: Although not a very common cause, breastfeeding women who feed their babies’ breast milk for longer durations fail to ovulate and produce eggs regularly for conception.
  • Weight Gain: Sudden weight gain after the first pregnancy can alter the chances of conceiving again. The reason is weight gain causes ovary dysfunction in some women. Causes of Secondary Infertility in Women

Causes of Secondary Infertility in Men 

Most common causes of secondary infertility in men include

  • Less testosterone: Decline in testosterone levels can alter sperm production that has direct impact on fertility. Reduce testosterone levels are caused due to injury, age, or any medical condition.
  • Poor quality semen: The quality of semen is very important as it is the fluid that carries the sperms. As men age, the quality of the semen declines which impacts fertility.
  • Prostate enlargement: Enlargement of the prostate gland can lead to less ejaculation and lower sperm count.
  • Drugs that impact sperm count and quality: Certain medications and antibiotics can affect sperm quality thus directly having an impact on fertility.

Signs of Secondary Infertility

If the woman and man are younger than 35 and have unprotected sex for 12 months without getting pregnant, can be suffering from secondary infertility. Women and men less than age of 30 can also suffer from secondary infertility due to low sperm counts, irregular menstrual cycle, pelvic inflammatory diseases, and other hormonal disorders.

Treatment for Secondary Infertility

Secondary Infertility treatment may sound scary for couples who have had no issues with first pregnancy. Nevertheless, the treatment for secondary infertility is similar to primary infertility.

  • Medications: Certain medications like letrozole and clomiphene are prescribed to increase ovulation in women suffering from ovulation disorders.
  • Anti-oxidants: Anti-oxidants and anti-ageing medications are prescribed to men to improve semen quality and increase the chances of fertility.
  • Surgery: Those women suffering from uterine problems, surgeries are performed to remove polyps, fibroids, or scar tissues if any. In men, surgery is performed to repair testicular variocele.
  • In vitro fertilization: This is the most common treatment of secondary infertility advised by doctors. This is a surgical procedure where the eggs and sperms are retrieved and fertilized in the lab to form an embryo. The fertilized embryo is then transferred to the uterus where it implants and forms the baby.
  • Intrauterine insemination: This is a procedure which involves inserting the sperms artificially into the uterus to increase the chances of fertilization.


Depending on the medical condition and circumstances both the man and woman would need evaluation. Secondary infertility can be stressful and surprising. Do not cope with it alone. If you are suffering from secondary infertility, seek emotional support from your loved ones, family, and friends. Reach out for medical support at the right time to give a shot at all the chances you may have.



Yaamini Radhakrishnan
Yaamini Radhakrishnan:I am a clinic research professional, graduate in biotechnology and post graduate in biochemistry. Have also pursued freelance writing since the past 5 years I am married and have a daughter. I am a native and reside at Bangalore.