What is secondary infertility, and what causes it?

First-time parents aren’t the only ones who can struggle with infertility.

If you've already successfully brought a new life into the world, you might be surprised when your next attempt is significantly more difficult. It can be startling to discover that what once came easily to your body has mysteriously become a challenge. "I've done this before. Why isn't it working this time?" If you're struggling to conceive or carry a baby to term after already having done so, you may be one of the about 10% of couples experiencing secondary infertility. Secondary infertility can come from a number of causes, stemming from either parent. Thankfully, many are treatable with the help of fertility experts.

What causes secondary infertility in women?

Whether you're a first-time mother or otherwise, a birthing parent’s most stubborn foe is time. Female fertility begins declining at age 30, with the odds of conception decreasing significantly after age 40. Someone who had little difficulty becoming pregnant in their twenties may not find it so easy later in life, when their supply of eggs is less reliable. One way to counter age-related factors: If you have the resources and foresight to freeze your eggs during your most fertile years, you may have greater success with pregnancies down the road.
Age aside, you may develop medical conditions following your first pregnancy that make it harder to conceive additional children. For example, while endometriosis is generally diagnosed early in a woman's reproductive years, it can also develop after childbirth. If your endometriosis is not too severe, a minor surgery can increase the odds of conceiving naturally. You may also develop polycystic ovary syndrome (PCOS), a common condition that can occur following weight gain. Both of these conditions are treatable with the help of a fertility specialist.

What causes secondary infertility in men?

While men in general hear less talk about their “biological clocks,” getting older can still make it more difficult to make a baby. Sperm and semen quality declines after age 40, though it’s a more common obstacle after age 60. Hypogonadism, or low testosterone, also becomes more likely with age. This alone does not negatively affect sperm production, but the testosterone supplements used to treat hypogonadism can.

Just as with women, men may develop conditions later in life that were not an issue when trying to conceive the first time. Prostate issues are a common cause of secondary infertility. The risk of an enlarged prostate, which can restrict ejaculation and reduce sperm count, increases over time. If you've had your prostate removed as part of a cancer treatment, that can also inhibit fertilization. Even something as comparatively minor as a varicocele can reduce sperm count and motility.
While secondary infertility can be an unexpected detour in your family planning, it can be navigated with the help of a qualified expert. Start a conversation with a fertility specialist who can help you get back on track building the family of your dreams.