Secondary infertility occurs when you cannot get pregnant or stay pregnant in spite of having been pregnant earlier. For most couples, secondary infertility comes as a surprise, when earlier they were able to conceive naturally without facing any fertility issues. However, the causes of secondary infertility are quite similar to the causes of primary infertility. Keep reading to know more about it.

In most cases, being infertile is not your fault. The list below mentions some common causes of secondary infertility:

1. Age

According to science, age plays an important role in fertility, and there's no denying that as a woman ages, her capability to conceive starts declining.

A woman’s peak reproductive years range between their late teens to late 20s. By the time she becomes 30, their ability to get pregnant starts declining. This decline gets more rapid by the time she reaches her mid-30s. And, after menopause sets in at around 45, she is unlikely to get pregnant naturally.

2. Sexually Transmitted Diseases

Sexually transmitted diseases directly or indirectly can be a reason for secondary infertility in both men and women. If you don't treat an STD, it can develop over time and cause infertility by spreading in the woman's uterus, ovary, and fallopian tube. This can further result in more damage, scarring, and inflammation.

Furthermore, it can also be an infection of human papillomavirus (HPV), which majorly affects the cervical mucus and leads to a decline in fertility.

3. Reproductive Organ Issues

A blocked fallopian tube is a very common reason behind infertility. The fallopian tube is where the sperm and egg meet, thereby leading to fertilization. However, a blocked fallopian tube prevents them from meeting. If both the tubes are completely blocked, then getting pregnant without the help of science becomes impossible.

Furthermore, prevailing conditions of the uterus, like uterine scarring, uterine fibroids or polyps, endometriosis, or an abnormal shape of the uterus like a unicornuate uterus, also results in infertility.

4. C-sections and Scarring

Scar tissue grows and prompts the formation of large masses. This abnormality can cause endometriosis. Living with endometriosis is immensely painful, and it further leads to infertility. In most cases, doctors recommend removing the endometrial cells and tissues if the case is too critical.

Furthermore, if you had a Cesarean delivery previously, then scarring in the uterus is possible; this condition is common as isthmocele. It can further lead to inflammation in the uterus and cause infertility. However, through a surgical procedure, you can solve the problem of isthmocele. Thereafter, through IVF, you might conceive successfully.

5. Autoimmune Disorders

An autoimmune disorder can jointly affect your joints, thyroid glands, and ovaries. In case, the autoimmune disease attacks your ovaries then it can reduce the ovarian reserve, which means it can reduce the number of eggs left in your ovary. Furthermore, a drop in the ovarian reserve will result in early menopause and infertility.

Some common autoimmune disorders include lupus, rheumatoid arthritis, and Hashimoto's disease, which cause inflammation in the uterus and placenta. But, you can resolve this issue through proper and regular medication before it gets worse.

6. Ovulation Disorders

When we speak of infertility in women, ovulation disorder is one of the most common secondary infertility causes. The main reason behind this is problems with the regulation of reproductive hormones. This disorder is known to cause disturbances in egg production (a.k.a ovum or oocyte) during the menstrual cycle.

Other factors that can cause ovulation disorder include polycystic ovary syndrome (PCOS), a decline in egg formation due to age, thyroid issues, endocrine disorder, and primary ovarian insufficiency (POI). Other factors, like unhealthy lifestyle, overuse of alcohol and drugs, improper body mass, and insufficient nutrition can also cause ovarian disorder.

In addition to knowing what causes secondary infertility, there are situations when even doctors fail to understand what's causing secondary infertility. However, you or your partner should never lose hope as medical breakthroughs happen often and your body is constantly changing. Thus, keep trying until you become pregnant once again.

The treatment for secondary fertility is also quite similar to primary infertility treatments. It includes the following:

• In Vitro Fertilization (IVF): This is one of the most common treatment options for secondary infertility. Here, ovulatory process is stimulated in the female partner. An ovum is extracted from her ovaries, which then gets fertilized by a healthy sperm in a laboratory. The fertilized embryo is implanted back into the womb of the mother or a surrogate.
• Intra Uterine Insemination (IUI): This treatment involves artificial insemination. In the process of IUI, sperms are washed, concentrated, and then placed directly in the uterus. This procedure is done when the ovary is ovulating, i.e., releasing eggs for fertilization. The sperm swims inside the fallopian tube and fertilizes a waiting egg, resulting in pregnancy. IUI is done during the normal cycle or through fertility medications.
• Surgery: Another secondary infertility treatment involves surgery to repair uterine problems in the female. This surgery removes scar tissue, fibroids, and polyps from the woman's uterus. And in males, surgery for repairing testicular varicocele is done to improve sperm count and improve sperm quality.
• Medications: In general, it is the female partner who needs to pop some pills as a solution for their ovulation disorder. Some common medications include clomiphene and letrozole. These medicines help in inducing ovulation in females having an ovulatory disorder.
• Supplements: In case of male infertility, antioxidants and anti-aging supplements are also available to increase fertility. Another procedure for improving semen quality is through specific medications combined with supplements.

Irrespective of the major causes of infertility in your case and which treatment procedure you choose, neither of the treatments guarantee 100% pregnancy. Thus, it would be best if you kept trying and never lose hope when your dream is to add another member to your family.

It is not easy to deal with secondary infertility. You can experience feelings of sadness, stress and guilt; thus, here are some tips that can help you cope better:

• Try acknowledging your feelings openly with your partner and be there for one another. Avoid playing blame games, as the infertility was not directly anyone’s fault. These will only disrupt your mental peace.
• Stay positive to avoid feeling restless and thinking about the fertility all the time. You can seek help from family and friends if you feel a lack of positivity in your relationship with your partner.
• Spend as much time as you can with your other children and your partner. Practice checking on each other’s emotional conditions to avoid feelings of depression and stress.
• Try to understand that the situation is not completely out of your control. Practice self-care and try improving your lifestyle, weight, and eating habits to improve your chances of conceiving once again.

As a final takeaway, secondary infertility is a relatively common problem that couples often have to endure. Therefore, understand the cause of secondary fertility, plan your treatment at any reputed infertility clinic, and stay hopeful, as you never know what happens next.