After having your first child, some may think that getting pregnant a second time and growing your family will be easy. But for many couples, this isn’t always the case.

According to The Center for Disease Control (CDC) as many as 11 percent of couples in the United States, or four million families, are shocked to experience secondary infertility. 

What is secondary infertility?

David Shin, M.D., chief of the Center for Sexual Health & Fertility at Hackensack Meridian Health Hackensack University Medical Center, explains that secondary infertility is the inability to carry a baby to term—despite trying for one year to achieve pregnancy—after previously giving birth. 

What causes secondary infertility?

Multiple factors can account for secondary infertility, according to Dr. Shin, for both men and women. “Many people tend to associate infertility with just women, but this is a misconception,” says Dr. Shin. “Male factors play a role in infertility up to 50 percent of the time.”

The latest research also shows that a sedentary lifestyle with too much time spent online, may also contribute to infertility.

For women, factors may include:

  • Age (anyone over the age of 35)
  • Irregular menstrual cycles
  • Endometriosis
  • Pelvic inflammatory disease
  • Unhealthy body weight
  • Tubal issues
  • Uterine abnormalities
  • Previous miscarriages

For men, factors may include:

  • Abnormal sperm production or function due to undescended testicles
  • Genetic defects such as Klinefelter syndrome or Y chromosome microdeletion
  • Sperm delivery problems such as a blockage in the ejaculatory duct, vas deferens or epididymis
  • Testis cancer
  • Varicocele, or dilated veins in the scrotum

For both males and females, factors may include:

  • Having recently undergone cancer treatment, such as radiation or chemotherapy
  • Lifestyle exposure to cigarette smoking, excessive alcohol and marijuana
  • Having taken selective antibiotics, anti-hypertensive medications and anabolic steroids
  • Exposure to certain environmental factors such as pesticides and chemicals
  • Diabetes
  • Infections such as chlamydia, gonorrhea or mumps
  • Genetic diseases such as cystic fibrosis
  • Any inadvertent injury to the reproductive organs

When to see a specialist

Dr. Shin encourages couples to seek the advice of a specialist after trying to conceive for at least one year. He advises, “However, if a couple has been trying for a few months and they don’t want to wait an entire year before undergoing an evaluation, I encourage them to start the process sooner rather than later.”

Treatment options for secondary infertility

Though dependent on the cause of infertility, length of infertility, age of infertile partner(s) and personal preferences, Dr. Shin says there are treatment options available for many couples.

Treatment for women may include:

  • Fertility drugs
  • Intrauterine insemination (IUI), or the insertion of semen directly into the uterus via catheter
  • Surgery such as the repair of blocked fallopian tubes
  • Altering lifestyle factors, such as diet and exercise

Treatment for men may include:

  • Medications to improve sperm counts
  • Surgery such as a varicocelectomy, a minor surgery frequently used to repair dilated scrotal veins
  • Altering lifestyle factors, such as diet and exercise

Other options a couple may consider include:

  • In vitro fertilization (IVF), or the procedure of fertilizing an egg with sperm outside of the body
  • Gestational carriers/surrogates
  • Donor eggs or sperm

“Although it may seem to be a very stressful period, couples can be reassured there are definitely both medical and surgical treatments available for men to help improve their chances of a second pregnancy,” comforts Dr. Shin.