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. According to Dr. Jeremy Groll, Medical Director at SpringCreek Fertility, around three million women in the United States face secondary infertility. He points to a strong correlation to age: “At maternal age of 25 years, approximately five percent of women experience secondary infertility,” he explains, citing a 2012 study. By age 40, that number climbs to over 20 percent of women.

Groll says potential causes for secondary infertility include age-related ovarian decline, female hormonal imbalances, uterine abnormalities or polyps, and low/declining sperm counts.

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 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. Groll says beyond treatment of underlying metabolic hormone problems or surgery for anatomic problems, oral medications like Clomid and Femara are often prescribed. More complex treatments include intrauterine insemination (IUI) and in vitro fertilization (IVF). “These are so effective now,” he says, “especially IVF, where pregnancy rates may be over 60 percent in some instances, that these may be appropriate to consider as first line treatments for many couples, particularly when timeliness is a higher priority.”
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 issue 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, she remembers, “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.”

Both moms would assure other women facing secondary infertility that this 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, Groll suggests initial testing with an OB/GYN. From there, consider moving on to more in-depth screening at an appropriate facility. At his practice, they focus solely on fertility issues. He suggests women “let their providers know they are actively attempting to achieve a pregnancy. If people have a concern about secondary infertility, they should seek treatments sooner, not later – particularly after six months of unsuccessful attempts.”

Groll also recommends 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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