Secondary infertility is a condition that affects at least one in five couples as they try to have their second child. Find out the common causes of secondary infertility and the treatments available to help with the condition.

What Is Secondary Infertility?

Secondary infertility is a term used to describe the inability to conceive after already having one or more children. It can be just as emotionally devastating as primary infertility, yet it’s often met with skepticism and even dismissal by family and friends.

If you’re dealing with secondary infertility, know that you are not alone. According to Resolve: The National Infertility Association, approximately 3 million Americans are affected by secondary infertility.

And while there isn’t nearly as much research on secondary infertility as there is on primary infertility, studies show it’s caused by many of the same things, including hormonal imbalances, uterine abnormalities, blocked fallopian tubes, and sperm problems.

The good news is that treatment options are available for women and men struggling with secondary infertility. 

See, Top 9 Best Herbs For Fertility and 9 Common Causes Of Infertility In Men

Common Causes Of Secondary Infertility

1. Advanced maternal age (age 35 and older)

The rate of secondary infertility has increased over the past few decades, likely due to an increase in the number of women delaying childbearing until later in life.

As a woman ages, her fertility declines. This is due to a decrease in the reproductive hormones, which decreases the number and quality of her eggs. 

Due to this, advanced maternal age is associated with a number of risks, including miscarriage, chromosomal abnormalities, and gestational diabetes. Women over the age of 35 may also have a harder time conceiving even with assisted reproductive technologies (ART), such as in vitro fertilization (IVF).

If you are over the age of 35 and trying to conceive, it is important to consult with a fertility specialist. They can help you understand your risks and make recommendations for treatment.

2. Impaired sperm production or low sperm count

Impaired sperm production or low-sperm count is one of the most common causes of secondary infertility in men. It can be caused by a variety of factors, including genetic defects, infections, hormone imbalances, and exposure to certain chemicals or medications. If you and your partner are having difficulty conceiving, your doctor may talk to you about this possible cause and treatment options.

In some cases, impaired sperm production can be improved with medication. If you have an infection, it can be treated with antibiotics. Hormone imbalances can often be corrected with medication. And if your fertility problems are due to exposure to certain chemicals or medications, your doctor may recommend avoiding those substances or using protective gear.

3. Damaged fallopian tubes

If your fallopian tubes are damaged, it may be difficult for you to get pregnant. 

The fallopian tubes are the tubes that carry eggs from the ovaries to the uterus. If they are damaged, it can be hard for the egg to travel to the uterus, and you may have trouble getting pregnant.

There are a few ways that your fallopian tubes can become damaged:

One way is through infection. Pelvic inflammatory disease (PID) is an infection of the reproductive organs that can cause damage to the fallopian tubes.

Ectopic pregnancies are another cause of damaged fallopian tubes. These are pregnancies that implant outside of the uterus, usually in the fallopian tubes. 

Ectopic pregnancy can damage the fallopian tubes, making it harder for an egg to travel down them and be fertilized. Additionally, scar tissue from the previous ectopic pregnancy can block the fallopian tubes or narrow them, making it difficult for an egg to pass through.

In addition, surgery on the fallopian tubes or surrounding area, such as a C-section, can sometimes cause damage.

4. Uterine conditions

There are a number of uterine conditions that can lead to secondary infertility. These may include:


Endometriosis occurs when the tissue that usually lines the inside of the uterus (the endometrium) grows outside the uterus. 

This misplaced tissue can attach to the ovaries, fallopian tubes, and other organs in the pelvis and abdomen.

There are many possible explanations for why endometriosis may lead to secondary infertility. Endometriosis creates an inflammatory environment in the pelvis that interferes with the implantation of a fertilized egg. 

Additionally, endometriosis can damage or block the Fallopian tubes, making it difficult for sperm to reach the egg or for the egg to travel down to the uterus. Endometriosis can also cause scarring and adhesions around the ovaries, which can interfere with ovulation or lead to early menopause.


Fibroids are one of the most common reasons why women experience secondary infertility. 

They are benign (non-cancerous) tumors that grow in the uterus. They can vary in size and number and can grow on the inside or outside of the uterus. 

While fibroids don’t usually cause any symptoms, they can sometimes cause heavy bleeding, pain, and pressure in the pelvic area.

Fibroids can interfere with fertility in several ways. They can block the fallopian tubes, making it difficult for the egg to travel to the uterus. They can also distort the shape of the uterus, making it difficult for the embryo to implant properly. Additionally, fibroids can produce hormones that can interfere with ovulation or implantation.

If you have fibroids and are having difficulty conceiving, there are several treatment options available. 

Medications can be used to shrink the fibroids or prevent their growth. Surgery can also be an option, depending on the size and location of the fibroids. 

If you have fibroids and are planning a pregnancy, be sure to speak to your doctor about your treatment options.


Adenomyosis is a condition in which the endometrial tissue, which normally lines the uterus, grows into the uterine muscle. This can cause the uterus to enlarge and can lead to pain and heavy bleeding during menstruation. Adenomyosis is often diagnosed in women who have had children, and it is one of the most common causes of secondary infertility, especially in women who have had prior uterine surgery.

While the exact cause of adenomyosis is unknown, it is thought to be related to hormonal changes or previous uterine surgery, such as a cesarean section. Adenomyosis can make it difficult to get pregnant because it can interfere with the implantation of the fertilized egg. In addition, adenomyosis can cause miscarriage or premature labor.

Primary ovarian insufficiency

Primary ovarian insufficiency (POI) is a condition in which the ovaries stop working properly before natural menopause (usually before the age of 40). This can cause problems with menstrual cycles and fertility.

POI can be due to a variety of factors, including genetic abnormalities, autoimmune diseases, or cancer treatments.

Symptoms of POI include irregular periods, hot flashes, night sweats, vaginal dryness, and difficulty conceiving. 

If you suspect you may have POI, it’s important to see your doctor for testing. There are treatments like hormonal therapy that can help improve your chances of conception.

5. Polycystic ovary syndrome

PCOS is a hormonal disorder that can interfere with fertility. If you have PCOS, your ovaries may produce too many male hormones than normal. This can lead to irregular periods or no periods at all, which can make it difficult to conceive. 

PCOS can also cause the formation of cysts on the ovaries, which can further disrupt fertility. 

In addition to making it difficult to get pregnant, PCOS can cause pregnancy complications, such as miscarrying or delivering a baby prematurely. 

If you have PCOS and are trying to conceive again, be sure to talk to your doctor about your risks and how best to manage them.

6. Excessive weight gain in both men and women

While there are many causes of secondary infertility, excessive weight gain is a common contributing factor in both men and women. 

Being overweight can lead to insulin resistance, which can interfere with fertility hormones and make it difficult to conceive.

In men, being overweight can cause low testosterone levels, which can lead to reduced sperm production and decreased semen quality. 

Additionally, excess weight can lead to the development of fat deposits around the testicles, which can raise the temperature of the testes and impact sperm production. 

If you are struggling with secondary infertility and are overweight, losing weight may improve your chances of conceiving. 

To achieve weight loss, first, focus on eating healthy foods. This means avoiding processed foods, sugary drinks, and excessive amounts of fat and calories. Instead, opt for fresh fruits and vegetables, healthy fats, and whole grains. Additionally, make sure to get plenty of exercise.

Exercise not only helps you maintain a healthy weight, but it also improves your overall health, both of which are important for fertility.

On top of that, work on controlling your stress levels.

7. Lifestyle factors

There are many lifestyle factors that can contribute to secondary infertility, including smoking and heavy alcohol use. 

Smoking cigarettes can damage the reproductive system in both men and women, leading to problems with fertility. 

In men, smoking can damage the sperm and decrease sperm count. In women, smoking can damage the eggs and lead to early menopause. 

Heavy alcohol use can also damage the reproductive system and lead to fertility problems. 

Alcohol abuse can cause problems with ovulation in women and decreased testosterone levels in men. 

Both smoking and heavy alcohol use can also lead to other health problems that can affect fertility, such as obesity and diabetes. 

If you are struggling with secondary infertility, it is important to talk to your doctor about lifestyle changes that may help improve your chances of conceiving.

8. Certain medications

Birth control pills

Birth control pills work by preventing ovulation, and they can continue to do so even after you stop taking them. This can make it difficult to conceive because there is no egg to be fertilized. 

If you plan to conceive in the future and are using birth control pills, you should talk to your doctor about switching to a non-hormonal method of contraception. 

Hormone therapy, such as the kind used to treat conditions like PCOS or endometriosis, can also interfere with ovulation and make it difficult to conceive. If you are having difficulty conceiving while on hormone therapy, speak to your doctor about alternative treatments. 


Some antidepressants can reduce the production of hormones needed for ovulation. If you are taking antidepressants and having difficulty conceiving, talk to your doctor about switching medications. 

Certain cancer treatments, 

Treatments like chemotherapy and radiation therapy can damage the eggs and make it difficult to conceive. If you are undergoing cancer treatment and hope to have children in the future, talk to your doctor about fertility preservation options before starting treatment.

How is a secondary infertility diagnosis made?

There are a few different ways that secondary infertility can be diagnosed. First, your medical history will be taken, and you will be asked about your previous pregnancies or ability to get a woman pregnant. You will also have a physical exam.

Your doctor may also order tests, such as a pelvic ultrasound, to check for any abnormalities in your reproductive organs. Blood tests may also be done to check hormone levels.

Additionally, men may need a semen analysis to help analyze the number, shape, and movement of the sperm.

Another way to diagnose secondary infertility is through a laparoscopy. This is a surgery where a small incision is made in the navel, and a thin, lighted tube called a laparoscope is inserted through this incision. The laparoscope allows the doctor to see the ovaries, Fallopian tubes, and uterus to check for any abnormalities.

Final Thoughts

If you’re facing secondary infertility, you’re not alone. Many couples struggle to conceive a second (or third, or fourth) child, and it can be an emotionally and physically difficult journey. 

However, there are things you can do to improve your chances of success. 

The very first one is to find out the cause. This will determine the next step you take. 

You may want to visit a fertility specialist to help ascertain your cause of secondary infertility and provide the way forward.

Nonetheless, living a healthy lifestyle and maintaining a healthy weight will boost your odds of getting pregnant or fathering a child, as well as increase your overall health and well-being

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