Primary & Secondary Infertility

Having a more difficult time conceiving the second or third time around can be a sign of secondary infertility. Couples who have never been able to conceive are considered to have primary infertility, while couples who fail to conceive now despite having been able to do so previously are said to have secondary infertility - a problem that is much more common than you might expect. Unfortunately, having conceived easily and given birth without difficulty in the past is not a predictor of future fertility for women, nor is having fathered one or more children in the past necessarily a predictor of continued fertility for men. Simply aging naturally diminishes your fertility, but a number of different medical, environmental and lifestyle factors can also lead to decreased fertility. In the case of secondary infertility, more often than not there will be no one single cause but multiple contributing factors. The most common factors in secondary infertility include:

  • Age - Don't let the calendar fool you: your fertility can begin to decline naturally at a surprisingly young age. This is true to some extent whether you're in your 20s, 30s or 40s when you start trying to have another baby. Moreover, the effects of aging are not just limited to a natural decline in fertility. As you age you are also at increased risk of developing medical conditions that can accelerate that decline.
  • Medical Conditions/Medications - Diabetes, high blood pressure, depression, infections, and a host of other medical conditions can lead to decreased fertility. Antidepressants, beta blockers and other commonly-prescribed drugs can also play a role in decreased fertility
  • Environmental Toxins - Continued exposure to obvious toxins like pesticides, paint and chemical solvents can lead to decreased fertility. So can exposure to pollution as well as toxins and endocrine disruptors in foods, cosmetics and personal care products.
  • Lifestyle - Alcohol, tobacco and recreational drugs can lead to decreased fertility. So can weight gain and a sedentary lifestyle. Even hard training in certain endurance sports can be a problem; long-distance cycling, for example, can lead to testicular damage. Apparently harmless habits like sauna or hot tub use can reduce sperm counts. Stress can also be a factor.
    • Treatment Options The mechanisms of secondary infertility are much the same as for primary infertility. For men, the issue may be low sperm count or poor quality sperm. For women, the problem may be anything from hormonal imbalances and decreased ovarian function to conditions like endometriosis, pelvic adhesions or fibroids. Fibroids, in particular, are a frequent cause of secondary infertility. Excess estrogen can continue to circulate in a woman's body after a pregnancy, fueling the growth of the fibroids that may prevent another successful pregnancy. Treatment options are similar for primary and secondary infertility. They range from fertility drugs to help regulate erratic ovulation to assisted reproductive technologies (ART) like intrauterine insemination (IUI) or in vitro fertilization (IVF).