Will you have any more? Secondary infertility treatment updates

Possibly one of the silliest questions to ask (unless you’re on super solid friendship ground), right after When will you guys have kids? The best answer, we think, is a straightforward You tell me. But secondary infertility is a much-misunderstood aspect of family building – one that, with expert support, is crucial to unpack. 

What do we mean by secondary infertility? Well, in simple definition terms, we’re talking about not being able to get pregnant – or carry a baby to term – after giving birth previously. Secondary infertility is thought to affect around 5 per cent of people in the UK – around one in 20 couples. 

Where do we ‘fit’?

Finding support for secondary infertility can be challenging, from seeking specific medical guidance to working out where you ‘fit’ in the parenting and fertility world. We have a child, but feel alienated from the parenting scene which is dominated by the two plus model. And, we have a child, so don’t feel quite able to connect into the (in)fertility scene, where so many people are struggling to begin their parenting journey. 

Are there any ‘signs’ of secondary infertility we can watch for?

Struggling to conceive again after having your first child can come as a surprise, but it’s more common than you might think – again, one in around 20 couples are thought to be affected.

Pinning down signs and symptoms is tricky, but we’d recommend seeking expert support if you’ve noticed:

• irregular periods
• unusual difficulty in tracking ovulation
• changes in your cycle which weren’t there before

Hormonal shifts, conditions like PCOS or endometriosis, or even health changes since your last pregnancy can play a role. For men, aspects like sperm health can also be a factor. If it’s been six months to a year of trying without success, it might be worth chatting with a fertility specialist to figure out what’s going on and explore your options.

Sorting out (and advocating for) expert support

Dare we say it, but secondary infertility is – from experience – one of the most complex areas of fertility and TTC. Working out that something is wrong is tough, especially when you’ve had a baby (often without any obvious difficulty) before. 

Sorting out and advocating for treatment is tougher. 

But toughest of all is the emotional rollercoaster that we can find ourselves on, with secondary infertility, and the feelings of confusion, disappointment, grief, guilt, isolation and shame which can surface. 

We’ve felt this. And we’re with you. Let’s unpack secondary infertility with a clinic at the top of their treatment game – TFP Fertility UK – with everything there is to know, right now, about this complex topic. Their nationwide network of expert clinics regularly treat patients for secondary infertility, while providing expert psychological support for the specific journey you’re on. 

Keep reading for their steer on: 

• causes, watch points and diagnosis 
• unexplained secondary infertility 
• the PCOS connection (a number one question from our community)
• secondary infertility in men (male factor)
• success rates

Before you jump in, bookmark a couple of our other resources in collab with the clinical team at TFP Fertility UK. From specific treatment plans to counselling support, pick and choose from: 

• Demystifying embryo transfer
• Your mental health during fertility treatment
• Egg & sperm donation in the UK Q&A
• BMI and fertility 
• Your endometriosis toolkit

Plus lots more. Wherever you’re at with secondary infertility or another question, head straight to TFP Fertility UK to connect with the team, and get a plan in place today. 

Over to TFP Fertility UK

What are the most common causes of secondary infertility?

When it comes to secondary infertility, the causes can seem numerous. Very often, this is because a previous pregnancy or birth can actually create issues for future conception – for example, you may have had a C-section which caused scarring, or a D&C (dilation and curettage) after miscarriage.  

In clinic, the most common causes we see are: 

• age-related fertility difficulties 
• uterine or fallopian tube scarring from a previous surgery 
• sperm count, production, quality and/or motility issues
• ovulation problems and/or PCOS
• blockages or issues in the uterus – e.g fibroids
• certain treatments or medications – e.g chemotherapy and cancer treatment 
• complications from a previous pregnancy or birth 
• Body Mass Index (BMI)-related issues (we’ve done a full round-up on BMI so do head there) 
• sexually transmitted infections (STIs), which can go unnoticed 

These are the key issues we see, and good starting points to unpack with your doctor or fertility support team. Egg quality and age are a significant part of the picture (just like for primary infertility), but so are issues with sperm and the ‘male factor’ (male infertility issues), and more structural problems, or health conditions. 

How do you go about diagnosis?

The first step is getting support – which TRB readers here are clearly making amazing strides with (we know it’s not easy!) – and keeping tabs on your menstrual cycle, changes in things like PMS symptoms, discomfort and whole body health. With all the info on the table, your team will be able to support your treatment much more efficiently. 

From there, at TFP Fertility UK we’ll use any and all of the following to support your diagnosis (do ask your treatment provider for their rationale, if they’re not looking into certain things): 

• medical/pregnancy history review
• menstrual cycle overview 
• semen analysis
• hormone testing
• transvaginal ultrasound
• hysterosalpingogram (an X-ray uterus and fallopian tube check)

Remember, infertility affects men and women equally, and 40 per cent of cases involve an issue with both the man and the woman.

The secondary infertility PCOS connection

We get asked about this a lot by patients, and they know their stuff – polycystic ovarian syndrome (PCOS) is a very common cause of secondary infertility. In fact, the CDC (Centers for Disease Control and Prevention) in the USA pins it as the number one cause. 

PCOS affects around 10 per cent of women of childbearing age. It’s also very normal to see patients presenting with PCOS after years with no symptoms, or cause for concern. And, of course, after getting pregnant and having a baby previously. 

Remember, PCOS is a genetic hormonal disorder, and one which you are born with. Symptoms do usually appear at around the same time as you start getting periods – usually in your teenage years – but some women don’t experience any until later on, right up until your 30s and even 40s. 

Because PCOS can show up well after you’ve already had a baby, the connection is often made to secondary infertility. But really, it’s just down to when those symptoms present. PCOS is also associated with a slightly higher rate of miscarriage, so do speak to your doctor and medical team, to get a proper diagnosis underway – and treatment plan. 

Head to TFP Fertility UK or call them at 0808 2234128 to connect with the amazing team, and build a plan that’s dedicated to your fertility and family-building journey.

What about unexplained secondary infertility?

‘Unexplained’ infertility – whether it’s secondary or primary – can be really challenging. Our approach is to support you on the journey you’re on, and work through every available option. The reality is that some patients don’t find the cause of their infertility, but this is unusual. Most do eventually conceive, either naturally or with support and treatment. 

Editor’s note – there are some really exciting tests available as we head into 2025, for leading causes of unexplained infertility. Read up on BCL6 testing, as a first stop, to rule out silent endometriosis (a common cause of primary or secondary unexplained infertility).