Nessa BallAre you wanting to expand your family, but finding it harder to conceive this time around? Regardless of how easy or difficult your journey to motherhood has been so far, secondary infertility can be a discouraging and often misunderstood topic for many couples who may not have initially questioned the likelihood of conceiving after having one child.
So what is secondary infertility, and how does it differ from primary infertility? In this informative and compassionate guide, we’ll delve deep into the world of secondary infertility causes, symptoms, and natural treatment options—leaving you equipped with the knowledge and actionable steps to confidently pursue conception beyond conventional medical approaches.
What Is Secondary Infertility?
Secondary infertility refers to the inability to conceive or carry a pregnancy to term after having previously birthed one or more children. While primary infertility – conceiving your first child—is more widely acknowledged and discussed, secondary infertility statistically affects as many couples as primary infertility and can be just as challenging.
Is it harder to conceive a second time?
Unfortunately, it can be. It is a complex issue influenced by various factors, including age, overall health, prior pregnancies and lifestyle choices. Its prevalence might surprise you: despite having successfully conceived in the past, 11% of couples face unexpected hurdles when trying for another child.
Secondary Infertility Awareness—from first signs to treatment strategies.
In this section, we’ll explore the intricacies of secondary infertility, beginning with secondary infertility symptoms all the way to potential treatments. We’ll address common questions and provide practical insights for anyone grappling with this fertility challenge.
Recognizing the Symptoms
While primary infertility is often accompanied by overt signs, like anovulation (the absence of a released egg), hormonal imbalance, or autoimmune disorders, secondary infertility can manifest more subtly.
If you conceived before, are not currently breastfeeding, and have been trying for more than 4 cycles, it’s time to be proactive and investigate what may be happening. Taking charge of your fertility begins by identifying if you are indeed experiencing secondary infertility, or if you are simply missing the mark with timing by not accurately charting your cycle.
Step one is gauging the health of your ovulatory system each cycle by starting to chart following the Fertility Awareness Method (FAM). Once you get a base level to work from, you will be able to easily recognize imbalances and disruptions that could be preventing you from becoming pregnant—by gaining understanding first, you will have the tools to pinpoint and address the root cause.
Having struggled with secondary infertility myself while conceiving our second child (who was born in November of 2023!), I know first-hand the importance and practical application of this powerful knowledge.
Causes of Secondary Infertility
Secondary infertility can arise from a multitude of factors, ranging from age-related decline in fertility to underlying health conditions. Unfortunately, many doctors are quick to throw in the towel and give a diagnosis of “unexplained secondary infertility”, without offering much guidance other than referring patients for invasive fertility techniques.
Not surprisingly, a disproportionate amount of the focus and pressure is placed on the woman. So I want to start with an all too often overlooked component of secondary infertility—the male partner:
Male Infertility Factors
Get ready for this major truth bomb: More than 50% of infertility is caused by the male partner… What?!? Let’s examine the factors that can negatively impact your chances of getting pregnant on the male’s behalf:
-Sperm issues
- Sperm Production – Age, medications, and lifestyle choices can decrease sperm production, increasing the potential for a low sperm count (Oligospermia)
- Poor Sperm Motility (Asthenozoospermia) – Motility refers to the sperm’s speed and its ability to swim in a straight line. Both of these traits are essential to natural conception
- Abnormal Sperm Morphology (Teratozoospermia) – In every sperm sample, there is a large percentage of abnormally shaped sperm. But if the number is higher than 96% it is considered a condition that can affect fertility
-Hormonal Imbalances
Hormonal issues can significantly impact sperm production and quality. Conditions such as hypogonadism (low testosterone), hyperprolactinemia (high prolactin levels), and thyroid disorders can interfere with sperm production and function.
-Testicular Issues
Varicocele – A varicocele is an enlargement of the veins within the scrotum, which can lead to increased temperature and reduced sperm production. Surgical intervention is often required to correct this condition.
-Infections
⅓ of these cases are related to asymptomatic infections in the reproductive tract, such as epididymitis (inflammation of the curved tube at the back of the testicle) or orchitis (general inflammation of one or both testicles), either of which can damage sperm production and function.
Sexually transmitted infections (STIs) can also impact fertility. Asymptomatic STIs like gonorrhea and chlamydia can go unnoticed and untreated, potentially causing long-term damage—making infections like these THE most preventable cause of infertility! Regular screening for STIs is cheap, effective and crucial for sexual and reproductive health.
-Physical Trauma
Any trauma to the testicles can potentially affect sperm production and quality. This can be due to sports injuries, accidents in general, or various surgical procedures (including scrotal, testicular or prostate surgery, and surgeries to remove malignant cells in the testicles or rectum).
Female Infertility Factors
Now, we’ll look at the known secondary infertility causes associated with the woman:
-Hormonal Imbalances
Thyroid Disorders like hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid) can develop or intensify after a prior pregnancy, disrupting menstrual cycles and ovulation
Elevated levels of prolactin (the hormone responsible for lactation) can interfere with ovulation. This condition, known as Hyperprolactinemia, can be caused by medications, pituitary gland disorders, changes in hormonal balance after a previous pregnancy, OR breastfeeding while trying to conceive (more on this later).
-Ovulation Disorders (can be identified with charting!)
Polycystic Ovary Syndrome (PCOS) remains a significant cause of secondary infertility. Hormonal imbalances associated with PCOS can disrupt ovulation, even if it was not an issue during a previous pregnancy. Symptoms include irregular menstrual cycles, acne, and excessive hair growth.
Factors such as stress, significant weight changes, or extreme exercise routines can lead to Hypothalamic dysfunction (disruption of the hypothalamus’s regulation of ovulation), resulting in irregular or absent ovulation despite prior successful pregnancies.
-Fallopian Tube Damage or Blockage
- Pelvic Inflammatory Disease (PID) – Often resulting from STIs, PID can lead to scarring and blockages in the fallopian tubes. This condition can appear or worsen after an initial pregnancy, preventing the sperm from reaching the egg
- Endometriosis – A disease that occurs when uterine-like tissue grows outside the uterus, causing inflammation and scarring in the fallopian tubes, ovaries, and pelvic tissues. This can develop or become more severe after a previous pregnancy
- Previous Surgeries – Surgeries such as C-sections, fibroid removal, or treatments for ectopic pregnancies can cause scarring and blockages in the fallopian tubes
Can breastfeeding impact Secondary Infertility?
The hormonal changes brought on by breastfeeding play a significant role in a woman’s fertility. Prolactin (the milk hormone) suppresses the release of ovulation hormones, leading to a natural form of birth control known as lactational amenorrhea. This effect is especially pronounced with frequent and intensive breastfeeding sessions, and particularly night feedings.
As breastfeeding frequency decreases, as when solids are introduced or the baby is partially to fully weaned, hormone levels gradually return to normal, and fertility resumes. Signs like spotting, changes in cervical mucus, and mild ovulation pain indicate the return of fertility. Initial menstrual cycles may be irregular, making it challenging to predict ovulation accurately. If you are trying to conceive while breastfeeding, consider gradually reducing nursing sessions and monitor menstrual cycles and ovulation signs.
Treatment of Secondary Infertility
Navigating secondary infertility involves exploring a range of treatment options, both conventional and natural—from assisted reproductive technologies to holistic approaches.
Can you overcome secondary infertility holistically?
Yes! This is made possible by focusing on natural treatment modalities for enhancing fertility and optimizing chances of conception that prioritize overall health and well-being. Encompassing the mind, body and soul, my comprehensive approach leaves no stone unturned:
Fertility Awareness Method
The Fertility Awareness Method (FAM) enables you to accurately determine when your fertile window occurs during your cycle using biomarkers like cervical mucus and body temperature. FAM is a crucial element in timing intercourse for a better chance at conceiving each cycle, and charting your cycle using this method can quickly alert you to any hormonal imbalances.
Nutrition & Supplements
It might seem daunting at first, but understanding the potentially critical impact diet can have on fertility will pave the way to food liberation. As with many health issues, what we eat is AS important as any other factor. In my course, we will focus on a whole foods, ancestral approach to eating—emphasizing protein and fat—to support your fertility goals.
Lifestyle
Prioritizing conception means making lifestyle choices that optimize your fertility – centering your life around your desires rather than perceived problems. Stress-inducing circumstances may arise, but you don’t have to live in a constant state of stress. Incorporating mindfulness techniques and practices, even (especially!) amidst the hard times, can drastically alter your relationship to your fertility.
Other key areas to consider making lifestyle changes include:
- Medication use – Examine medications taken by you AND your partner for any interference with fertility—including decreased sex drive!
- Overexercising – Exercise affects a multitude of female hormones that influence ovulation. Determining a healthy level of exercise can keep you from unintentionally interfering with pregnancy outcomes
- Over or undereating – Being either significantly above or below your ideal BMI can repress ovulation: this is why it’s important to focus on eating the right amount of the right foods
Mindset
It’s easy to get caught up in all the ways your fertility journey ISN’T going as planned, but scientific evidence tells us that visualizing the future you want is not just about cultivating a positive attitude—it can literally make that future a reality! Believing in the divine timing of the arrival of your little one is a soothing balm to quiet the anxiety, worry, and hopelessness that can accompany secondary infertility.
Beyond Secondary Infertility: Next Steps
Remember, you do not have to face infertility alone. Whether you’re just beginning to explore fertility options or seeking support after experiencing secondary infertility, know that resources and solutions are available.
If you’re ready to take control of your fertility journey and explore natural treatment options, it’s time to explore The Conscious Conception Course. This is the course I wish existed during the years I struggled with secondary infertility. It’s my heart’s passion: connecting the sacredness of your cycle and inner wisdom to science-backed methods to improve your chances of achieving a healthy pregnancy.
Join me, and together we’ll chart a personalized path towards realizing your dream of expanding your family.
