What is secondary infertility?

by Antonella Dési
Secondary infertility. Addressing the emotional and physical challenges of secondary infertility with compassion and understanding
Reading Time: 3 minutes

One and not done…The inability to conceive after having one or more children, also referred to as secondary infertility, is a challenging and often overlooked issue. Let’s explore the causes, emotional impact, and treatment options for couples facing this condition. By Antonella Dési

Secondary infertility is a topic that often goes unspoken of, yet it affects many couples around the world. Unlike primary infertility, where a couple has no prior history of pregnancy, secondary infertility occurs when a couple is unable to conceive after having had one or more children in the past, or there is a prior history of a previous miscarriage.

It can be a confusing and heart-breaking experience for couples who had no trouble conceiving their first child, and the emotional impact can be significant. Couples may feel guilt, shame, or frustration. They may also feel isolated, as secondary infertility is not as widely understood or discussed as primary infertility.

It’s important for couples experiencing secondary infertility to seek support from loved ones or a professional counsellor to help navigate this complex diagnosis.

Dr Yusuf Dasoo, fertility specialist and Director of the Bioart Fertility Clinic, explains that secondary infertility is more common than we realise: “Many people feel that if they have fallen pregnant before quite easily, that they are not going to have a problem falling pregnant for a second time. However, this may not always be the case. In fact, as many as 10% – 15% of couples trying to have their second child will have some form of difficulty in falling pregnant again.”

Age is a factor

There are various reasons why couples may experience secondary infertility. One common cause is age, notes Dr Dasoo: “Amongst the most common causes is advanced maternal age. We know that once a woman starts getting older than the age of 35, then it becomes a little more difficult to conceive. Certainly, if you have had your first child at 33 or 34 years old, and you decide to wait a while and have your second baby at the age of 37 or 38, you may experience this type of difficulty.”

Check out: All you need to know about freezing your eggs in SA

Myriad causes

However, aside from age, there are a myriad other causes too, including hormonal imbalances, ovulation disorders, and reproductive health issues, and many more. In some cases, lifestyle factors, such as stress, weight gain or loss, and certain medications, can contribute to secondary infertility.

Dr Goolam Mohamed, reproductive endocrinologist and the Director of the Sandton Fertility Centre at the Centre of Advanced Medicine in Johannesburg says, “The most common causes are very much the same as those that cause primary infertility. In the female, the causes can often be ovulatory or due to a tubal factor. Or it can be due to a disease occurring in the male, affecting his fertility. Many of these causes are treatable through medication and/or various fertility treatments.”

Also read: Why you shouldn’t wait to get fertility treatment

Treatment options

Depending on the underlying cause, treatment options may include fertility medications, intrauterine insemination (IUI), or in vitro fertilisation (IVF). Lifestyle changes, such as maintaining a healthy weight, reducing stress, and avoiding alcohol and tobacco, can also improve fertility. Dr Mohamed advises that if a couple has been battling to fall pregnant for more than a year, they should get assessed by a fertility specialist and seek treatment.

While secondary infertility can be a difficult journey, it’s important to remember that you’re not alone. With the right support and treatment, many couples are able to overcome this challenge and expand their families.

Dr Dasoo concludes by noting that when it comes to fertility treatment, time is of the essence: “Whether it is primary or secondary infertility, if you have had difficulty falling pregnant for over a year, then it would be prudent to start taking action in terms of getting to the root cause of the problem. If, however, you are over the age of 35 years old – due to time constraints, you should start taking action after only six months of having not achieved a pregnancy.”

Also read: The infertility blues

Visit: Joy after infertility


Have you had secondary infertility? Tell us your story in comments. 

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1 comment

Soraya June 11, 2024 - 12:48 am

Had my eldest daughter she’s 24 now had her at 18 than struggled with second but got pregnant 10years later natural didn’t know until I was 20 weeks pregnant she’s 13 now been struggling for more than 10 years now and it’s breaking be piece by piece


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