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Problems for a second pregnancy? May be secondary infertility

By Dr. Jesús Alberto Félix Atondo

Have you been a mom once and no matter how hard you look for a younger sibling for your child, you can’t get pregnant again? Many women were able to conceive and carry a pregnancy to term without problems when they were younger, only to find it difficult to conceive years later when planning a second pregnancy. This is known as secondary infertility. Next, we will tell you what secondary infertility is, why it occurs and how to treat it.

What is secondary infertility?

As we mentioned, secondary infertility consists of difficulty conceiving and carrying a pregnancy to term after having previously become pregnant, naturally and without problems. This comes with both problems to achieve pregnancy, as well as different forms of miscarriages.

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Secondary infertility causes a lot of confusion as people often think that having gotten pregnant once, the second time will be just as easy. However, the situation is more complicated.

How common is secondary infertility?

It is estimated that 3 million women in the United States experience secondary infertility at some point in their lives. The combination of female, male, mixed factors, in addition to age at the time of looking for a new pregnancy should be considered when evaluating the difficulty of becoming pregnant.

Secondary infertility Causes

The following conditions are associated with secondary infertility:

  • Advanced age. People over 35 years of age may have more difficulty achieving pregnancy and carrying it to term naturally.
  • Conditions of the uterus. Polycystic ovary syndrome, uterine myomatosis, adenomyosis or fibromas.
  • Damage to the fallopian tubes. A blockage in this area can prevent the egg from traveling to the uterus to be fertilized, or the sperm from reaching the uterus.
  • Endometriosis. This condition causes adhesions or scarring in the uterus due to the growth of tissue that lines the inside of the uterus, but which expands and encompasses other pelvic organs.
  • Hormonal imbalances. Problems with menstruation can cause ovulation disturbances.
  • Anovulation. It is a condition in which the egg is not expelled from the ovary.
  • Male factors. Poor quality or low sperm count, as well as mobility problems.
  • Uterine scars. Scars caused by surgery, pregnancy, curettage, or other procedure performed on the uterus before seeking pregnancy.
  • Risk factors such as being overweight, taking some medications, having received cancer treatments.

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Secondary infertility Treatment

Fertility specialists should evaluate the couple in order to identify the cause of secondary infertility. Conditions such as polycystic ovary syndrome, endometriosis, uterine myomatosis or any other condition that may prevent conception will be treated.

In some cases, other conditions such as type 2 diabetes mellitus are related to secondary infertility, both in men and women. Insulin resistance often causes ovulation disturbances and is often part of polycystic ovary syndrome. Furthermore, body weight is also a factor to consider in secondary infertility.

In general, it is recommended to exercise, have a healthy diet, control glucose levels, and avoid tobacco, alcohol or drugs consumption. All this is part of a healthy lifestyle, which will help you have better control of diabetes.

Now, when conditions such as low sperm count are diagnosed, the treatment options are the same as in primary infertility, such as:

  • Artificial insemination
  • In vitro fertilization (IVF)
  • Egg or sperm donors

In cases where repeated miscarriages occur, or the risk of pregnancy loss is very high, couples can consider surrogate motherhood, which consists of resorting to fertility specialists so that a woman other than the couple is inseminated and can carry a pregnancy to term.


In general, the diagnosis of secondary infertility is the same as in primary infertility. Tests include hormone and thyroid profile, basic clinical tests (blood chemistry and blood count), ultrasound and hysterosalpingography in women, seminogram or spermiogram in men.

These studies will give the specialist a broad overview in order to detect the cause of secondary infertility. In some cases, you may request another complementary test to confirm your diagnosis and provide the most appropriate treatment for your needs.

Visit The Fertility Center

If you have been trying to get pregnant for more than a year and you have not succeeded, come to us. Our fertility specialist Tijuana at The Fertility Center we will help you find the cause and the most appropriate treatment to fulfill your dream of having another baby at home. Feel free to check out our treatments, such as the IVF process, timed intercourse cycle, IUI, the sperm and egg donation treatments, even the egg donor requirements, and more. Schedule your appointment through our contact form, we will gladly assist you. Receive the benefits of the cost of IVF in Tijuana!

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Dr. Jesús Alberto Félix Atondo

Gynecology, Obstetrics and Biology of Human Reproduction Surgeon at the Autonomous University of Guadalajara, specialist Biologist of Human Reproduction by the Mexican Institute of Infertility.

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