Secondary Infertility Causes and Treatments

Couple on beach with child, secondary infertility preventing them from having another
Secondary infertility has the same causes and treatments as primary infertility. VisitBritain/Daniel Bosworth / Britain On View / Getty Images

Secondary infertility is when a couple has had at least one child, is trying to get pregnant again, but doesn’t conceive after at least one year of trying. This diagnosis can be confusing and mind-boggling. You had no trouble getting pregnant last time. So, why isn’t it happening now?

Many people assume primary infertility is more common than secondary infertility. Primary infertility is when a couple has never had children and can’t conceive. However, according to a review published in 2018, secondary infertility is the most common form of female infertility.

Couples experiencing secondary infertility may be more likely to put off seeking help. They may also find that friends, family, and even doctors downplay their fertility struggles. After all, they have one kid. (Or two kids, or more...) Isn’t that enough?

The truth is that whether you’re struggling for child number one, number two, or number five, there is anxiety and grief to confront.

Coping with secondary infertility has its own challenges.

You have an image of what you thought your family would be. Your child may be asking for a sibling. And the medical causes of secondary infertility aren’t any less difficult to treat and diagnosis than primary infertility.​

Reasons for Secondary Infertility 

Secondary infertility is caused by the same problems that lead to primary infertility.

Those causes include:

About one-third of infertility cases are related to male infertility, another third are related to female infertility, and another third are related to problems in both the man and woman or remain unexplained.

Risk Factors for Secondary Infertility

The biggest question in the minds of those who experience secondary infertility is why conception isn't happening this time around.

Secondary infertility may strike when...

You’re older: if you had your first child at 35, and you’re trying for a second at 38, your fertility has naturally declined significantly.

Age is a major cause of secondary infertility.

You’re with a new partner: it could be your new partner has an undiagnosed infertility problem. But it’s also possible the one with kids from a prior relationship has developed a fertility problem.

Either situation can occur.

An underlying fertility problem has worsened: it’s possible you always had endometriosis, or you always had subclinical PCOS. Maybe your ovarian reserves were already on the downslide, but you had no idea.

Time has passed, and things have worsened. It happens.

You’ve gained weight: fertility is affected by weight. Being over or underweight can cause ovulation problems in women, and possibly impact sperm health in men.

New parents often gain weight (partially from the pregnancy, partially from the stress and lack of sleep.) This may be enough to push you to the infertile side.

You have a new health problem: perhaps you or your partner has developed diabetes. Maybe he's taking medication for high blood pressure. Or, perhaps you’re suffering from depression.

Any of these illnesses may impact your fertility or require medication that can impact your fertility.

The last pregnancy or birth caused a fertility problem: pelvic infection or multiple D&C procedures may cause uterine adhesions or blocked fallopian tubes.

If you had a C-section, you may develop scar tissue, which can impact your fertility.

There’s no clear reason why this time is different: many times, no one can tell you why your particular fertility issue didn’t stop you from conceiving last time.

There’s a lot about fertility that we don’t understand. No one has all the answers.

When to Seek Help

If you are under 35 years old, you should seek help if you don’t conceive after one year of trying. If you are 35 years old or older, you should get help after six months. Also, no matter how old you are, if you experience two consecutive miscarriages, you should get help.

Some couples think they should keep trying even after the year mark passes. Didn’t they conceive last time? Clearly, if they just keep trying, they will succeed this time. Right?

Unfortunately, this may not be the case. So, please don’t put off getting help. Some causes of infertility worsen over time. Delaying help may reduce your odds of pregnancy success.

The fact that you got pregnant in the past doesn’t guarantee you’ll conceive again on your own. Sadly, there are no fertility guarantees, for anyone.


Testing for secondary infertility is the same as testing for primary infertility. Both the man and woman need to be checked.

Maybe you’re with a new partner, and one of you has had a child and the other has not. Does the “proven fertile” partner really need fertility testing?

The answer is yes. They do.

Having had a child doesn’t mean you can’t experience infertility.

How Is It Treated?

Treatments for secondary infertility are the same as for primary infertility. Treatments may include:

  • Fertility drugs, often starting with the most commonly prescribed fertility drug Clomid
  • Injectable fertility drugs, known as gonadotropins
  • IUI
  • IVF, sometimes in combination with other assisted reproductive options
  • Surgery, usually laparoscopic surgery, to repair blocked fallopian tubes, or to remove fibroids or endometriosis deposits

A Word From Verywell

As you seek out a solution for your fertility problems, you may have friends and family that don’t approve of your decisions. They may wonder why you’re “trying so hard.” Why don’t you “just relax?” It happened last time, it’ll happen again.

These friends and family are wrong. Be assured that your need for treatment is the same as someone with primary infertility. It is not an "extreme measure" to use medical treatments that may help you have the child you desire.

10 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Vander Borght M, Wyns C. Fertility and infertility: Definition and epidemiology. Clin Biochem. 2018;62:2-10. doi:10.1016/j.clinbiochem.2018.03.012

  2. The National Infertility Association. Secondary Infertility.

  3. National Institute for Child Health and Human Development. What are some causes of infertility?

  4. National Institute for Child Health and Human Development. How common is infertility?

  5. Benksim A, Elkhoudri N, Addi RA, Baali A, Cherkaoui M. Difference between Primary and Secondary Infertility in Morocco: Frequencies and Associated FactorsInt J Fertil Steril. 2018;12(2):142–146. doi:10.22074/ijfs.2018.5188

  6. NHS. Infertility - Causes.

  7. American College of Obstetricians and Gynecologists. Evaluating Infertility.

  8. Conforti A, Alviggi C, Mollo A, De Placido G, Magos A. The management of Asherman syndrome: a review of literatureReprod Biol Endocrinol. 2013;11:118. doi:10.1186/1477-7827-11-118

  9. Centers for Disease Control and Prevention. Infertility FAQs.

  10. American College of Obstetricians and Gynecologists. Treating Infertility.

By Rachel Gurevich, RN
Rachel Gurevich is a fertility advocate, author, and recipient of The Hope Award for Achievement, from Resolve: The National Infertility Association. She is a professional member of the Association of Health Care Journalists and has been writing about women’s health since 2001. Rachel uses her own experiences with infertility to write compassionate, practical, and supportive articles.