Secondary Infertility: What It Is and What You Can Do

Primary and secondary infertility share some of the same causes. And it’s important to note that those causes can come from both women and men. Fertility can change with time for both parties involved, too.

Regardless of sex, infertility is not always something you can control. And it is certainly not something to blame yourself or your partner for.

The best thing you and your partner can do is stay informed and avoid pointing any fingers.

Being aware of potential issues is key in navigating your infertility journey. Let’s do a refresh of the steps of conception and the potential issues that can crop up in each step.

Step 1: Egg/follicle formulation

Normally, the conception process starts in the female reproductive system. The beginning of your menstrual cycle is when the pituitary gland secretes follicle-stimulating hormone (FSH). This hormone stimulates the ovaries to develop multiple follicles, each of which contains an egg. One dominant follicle grows the largest.

In the case of associated conditions, things may look different.

• Age: As you age, your ovarian reserve decreases, which can lead to issues with fertility.
• Primary Ovarian Insufficiency (POI): Egg production can also be hindered by POI. This is when a woman’s ovaries stop functioning normally before the age of 40. They produce lower amounts of estrogen and struggle to release eggs regularly. This can lead to infertility.

POI can be caused by factors including:

• Chromosomal abnormalities
• Genetic conditions like Fragile X syndrome
• Treatments like chemotherapy and radiation
• The scarring of ovarian tissue can also cause issues with step 1 of the conception process. This can happen due to endometriosis, polycystic ovary syndrome (PCOS), past surgeries, infections, and multiple cysts.

Step 2: Ovulation

The next step of natural conception is ovulation. This is when the dominant follicle releases the egg due to a surge in luteinizing hormone (LH).

However, anovulation can disrupt this step. Anovulation is the absence of ovulation and it can happen due to:

• Polycystic ovary syndrome
• Thyroid disorders
• Hyperprolactinemia
• Being underweight
• Suffering from eating
• disorders

Learn more: Anovulation: Everything you need to know about the #1 cause of infertility

Not sure if you’re ovulating? Inito can help. This fertility monitor tracks your ovulation using four key fertility hormones — LH, estrogen, PdG, and FSH on a single test strip. It predicts your most fertile days and helps confirm whether you’ve ovulated.

Step 3: Fertilization

When things are running smoothly, fertilization happens next. This is when the egg travels down to the fallopian tube to meet the sperm. And fertilization happens.

However, various conditions can keep this from happening. These conditions include:

• Endometriosis
• Infections
• Scar tissue from
• surgeries (i.e. C-section)
• Uterine fibroids
• Polyps

These conditions can lead to blockages in the fallopian tubes or the uterus. This blockage keeps the sperm from reaching the egg. And in this case, fertilization can’t happen.

Step 4: Implantation

The final step in the conception process is when the fertilized egg (now a blastocyst) implants itself in the uterus. This happens around 6-12 days past ovulation (DPO).

But in the case of luteal phase defects, implantation can get tricky. These happen when the body doesn’t produce enough progesterone or can’t respond properly to it. And they can lead to implantation issues. This can increase the risk of miscarriage and an ectopic pregnancy.

Learn more: Your Guide to Luteal Phase Defects

Endometriosis can also present challenges during this step of the process. The inflammation and estrogen dominance associated with endo can interfere with normal implantation.

Now that you’re familiar with the potential challenges of conception, here are other factors that may cause secondary infertility.

• Age

As we talked about earlier, a woman’s fertility and ovarian reserve naturally decline with age. This can make it more challenging to conceive. Additionally, the risk of miscarriages and chromosomal abnormalities rises.

This is a normal part of aging, but we understand it can be difficult. Know that you’re not alone and that there is still hope for a healthy second pregnancy.

• Autoimmune conditions

Sometimes the body’s immune system malfunctions and attacks its own cells. These autoimmune conditions can interfere with fertility and lead to difficulty getting pregnant. These include Hashimoto’s thyroiditis, lupus, antiphospholipid syndrome (APS), etc.

• Unexplained infertility

Some people experience normal test results but still are unable to get pregnant. This is referred to as unexplained infertility.

Now, let’s look at male factors for secondary infertility.