Secondary Infertility

“This was something my body was just supposed to know how to do,” says Amy M., a mother of three who faced secondary infertility following a more typical first pregnancy.

“I was confused,” she says. “Was there something wrong with me? Was it my husband? How could it work the first time and not now? Would we ever have another child?” The experience left her feeling frustrated, sad and angry, says Amy.
This situation is not uncommon. Around three million women in the United States face secondary infertility. According to a 2012 study, there seems to be a strong correlation to age. At age 25, around five percent of women face secondary infertility. By 40, that number climbs to over 20 percent of women.

Several factors can be potential causes for secondary infertility such as ovulation problems, endometriosis, hormonal issues, anatomic issues with fallopian tubes or the cervix and issues with sperm count and quality.

Allyson S., mother of two, dealt with a metabolic issue. Her endocrinologist described her pituitary system as “all out of whack” and said it could be difficult for her to conceive or maintain a healthy pregnancy. In fact, Allyson would experience two miscarriages before experiencing a successful pregnancy.

Fortunately a myriad of fertility treatment options are available. In addition to treatment for metabolic hormone problems or surgery for physical issues like Fallopian reconstruction, oral medications like Clomid and Femara are common. Injectable medications are sometimes used to address ovulation difficulties. More complex treatments include intrauterine insemination (IUI) and in vitro fertilization (IVF). This promising treatment has a high success rate for some couples.
Amy and her husband tried several options. “I went through seven inseminations. The first three were with Clomid. Then I had laparoscopy to clean out scar tissue. I had my final four IUI’s with injectables,” she explains. For Allyson, getting her metabolic issues under control was a major factor. For both women, these subsequent pregnancies felt a little different from their firsts.
“You can’t help but feel different after experiencing fertility issues,” Amy says. Once her twin pregnancy was confirmed, “I was paranoid it could all be taken away. Every appointment I was panicked we would not hear the heartbeats. I was sure every worst case scenario was going to happen to me.”
But, she adds, “I was more present.” She says she took time to sit and feel her babies move. “When I could quiet the doomsday voices in my head, I allowed myself to enjoy this pregnancy because I knew it could be my last. I didn’t complain as much. I slept in a chair for the final six weeks, but I woke up each day happy.”
Allyson describes feeling more anxious compared to her first, “easy” pregnancy. “After two miscarriages, there was lots of worry,” she says. “Being told my condition could make it difficult to carry to term was scary. I think my worry started before the pregnancy, with the previous miscarriages, but it hasn’t stopped. Unlike what you expect from a lot of first time moms, I was very laid back with my first child. But with this one I am much more anxious and cautious about everything.”

Both moms would assure other women facing secondary infertility that the experience is a common one. “A lot of people don’t realize that secondary infertility is a thing,” says Allyson, “but it is, and there are a multitude of reasons it might occur.”
For women concerned about secondary infertility, first talk with your OB/GYN. If the situation warrants, move on to a facility where more in-depth screening can be completed. Also, check
out the resources at the American Society for Reproductive Medicine ( and The National Infertility Association (, where patients can get a list of questions to ask their fertility specialist.

Finally, consider Amy’s advice: “You are not alone,” she says. “Do not be afraid to open up about your difficulties to friends, family and neighbors. You will be shocked how many others have experienced this. If a baby is something your heart desires, get a little pushy, and don’t let anyone tell you just to wait and see. The only timeline you need to follow is the one you are personally comfortable with.”

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