In short Secondary infertility occurs when a couple who already has a child experiences difficulty conceiving another pregnancy. It is not a rare problem. It is estimated that secondary infertility affects up to approximately 20% of couples undergoing fertility treatment who, without the help of a specialist, cannot conceive a sibling for their child.
– Infertility occurs when a couple, despite trying and having regular unprotected intercourse for 6–12 months, does not achieve pregnancy. This also applies to people who already have one or more children, as the fertility of both women and men can change. Achieving pregnancy once does not mean that problems in the area of reproduction cannot arise in the future, requiring the help of a fertility clinic and the support of a specialist, explains Grzegorz Sitkowski, M.D, Ph.D., obstetrician-gynecologist from the Bocian Clinic in Poznań.
Secondary infertility in women can be the result of:
It should be remembered that secondary infertility does not depend solely on the woman; it can also be the result of deteriorating partner health and semen quality. Poor working conditions, testicular overheating, unhealthy diet, poor physical condition, overweight, and excess stimulants all of this can translate negatively into sperm count and quality.
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– A couple that cannot achieve pregnancy again should seek help from a fertility specialist. It is crucial to conduct a detailed medical history during which the doctor will attempt to gather necessary information about the current health status of both partners, the course of the previous pregnancy and delivery, and any diseases. A gynecological examination and ultrasound of the woman's reproductive system are also performed, and selected hormones are checked, notes Grzegorz Sitkowski, MD, PhD, from the Bocian Clinic in Poznań.
In the case of a man, the basic step is a semen analysis, which provides a range of information about male fertility. Depending on the results of the basic tests, the doctor may also recommend extended diagnostics, such as:
The doctor begins secondary infertility treatment by attempting to eliminate the causes if they are known. In the case of hormonal disorders, pharmacological treatment is undertaken to restore the natural cycle. If mechanical causes are identified, e.g., in the form of polyps, blocked fallopian tubes, peritubal adhesions, or complications after a previous pregnancy, attempts are made to remove these causes using operative hysteroscopy or laparoscopy, during which corrections can be made. If these basic methods do not yield results, assisted reproductive technology can be considered, i.e., insemination, and as a last resort, if necessary, performing an in vitro fertilization program – in vitro.
