Secondary Infertility

We all know the drill. You say, “Let’s have a baby!” and BOOM, one baby, right on schedule. 

Okay. 

Maybe we don’t all know this drill.

Most of us don’t. 

But for those who do, you might also know the feeling of, “Oh wouldn’t it be nice to have another one?” And then it just…doesn’t happen. But you conceived the first time, why is this different? Enter ‘secondary infertility’.

Most of us are under the impression that if you conceive your first child relatively easily, the second won’t be an issue either. Sadly, this is not the case. Infertility – or in this case secondary infertility – is much more common than we often realise. Many couples have trouble conceiving their second, or even third, child and will have to see a fertility specialist. While some of these cases are attributed to age-related infertility, the problem is often much less black and white. While your toddler may be celebrating not having to share their toys – it can be truly devastating for many families. 

Causes

1 in 8 couples experience infertility issues and around 50% of these cases are secondary infertility. Most of the causes of infertility are universal across primary and secondary infertility. That being said, cesarean sections and age are widely thought to be the main contributors to secondary infertility.

Age-related infertility is more likely to affect sufferers of secondary infertility simply because they are more likely to be older since they’ve already had a child.

Cesareans are often blamed for secondary infertility however there is little evidence to back up this idea. Furthermore, the scaremongering this idea can place around caesareans is worrying.

After a cesarean, women are also advised to wait between eighteen and twenty-four months before trying for another baby and must not conceive during the first year, as their body has not had adequate time to heal.

Approximately 20% of women who gave birth via cesarean section have difficulties conceiving their second child. While this is often attributed to having a cesarean, there are multiple factors that could be the cause. It is important to note that most of this is speculation and there isn't enough research into the effect of cesareans on fertility to draw an accurate conclusion.

The majority of studies deliver more questions than answers when looking into the effect of cesareans on future fertility. Regardless of these questions, the causes of secondary infertility remain the same as primary: one-third female infertility, one-third male infertility, and one final third undiagnosed infertility.

Next steps

Seeking help for secondary infertility is a very similar process to that of primary infertility and – since most of the causes are the same – so are the treatment options. GPs are usually a good place to start if you’re unsure how to proceed and there are testing options available to help identify the cause. However, it can be more difficult for those experiencing secondary infertility to access NHS-funded treatments, since already having a child or children often disqualifies them from accessing any treatment options funded by their local CCG. For this reason, secondary infertility often bears a higher financial burden than its predecessor. Private clinics are an option, albeit an expensive one.