You've had one successful pregnancy, so why is it difficult to have another? For many women, secondary fertility can be a frustrating and confusing condition. At Penn Fertility Care - Lancaster General Health, we offer comprehensive testing and state-of-the-art treatments to help you overcome this challenge and grow your family.

What Is Secondary Infertility?

Secondary infertility is the inability to get pregnant or carry a pregnancy to full term after you've had one or more healthy pregnancies and births. You may be surprised to know that secondary infertility is fairly common. In fact, up to 14% of women have trouble getting pregnant a second time. Some women with secondary infertility also have recurrent pregnancy loss.

Why Can't I Get Pregnant Again?

There are a variety of reasons you may be having trouble getting pregnant again. Secondary infertility causes can include:

  • Endometriosis (endometrial tissue that grows on other pelvic organs, including the ovaries)
  • Older age (over 35, when ovarian reserve declines)
  • Polycystic ovary syndrome (hormone disorder that affects how the ovaries work)
  • Blocked or damaged fallopian tubes (sperm may not be able to reach the egg)
  • Smoking or heavy alcohol use (in either partner)
  • Uterine conditions, such as fibroids or an abnormal uterus shape
  • Weight gain (in either partner)

Some conditions specific to men can also result in secondary infertility, such as:

  • Erectile dysfunction (inability to get or maintain an erection for sexual intercourse)
  • Older age (over 40, when testosterone levels and sperm quality decline)
  • Prostate enlargement or prostate surgery (prostate problems can affect semen production and ejaculation)
  • Reduced testosterone, a male sex hormone (low levels can affect sperm production)
  • Varicocele (enlarged scrotal veins that can affect sperm production)

How Do We Evaluate Secondary Infertility?

Since secondary infertility can have so many causes, it's important for us to get a complete picture of your health when diagnosing the condition. The more we know about your lifestyle and medical history, the more information we have to build an effective treatment plan.

The diagnostic tests for secondary infertility are similar to those for primary infertility. You can expect a thorough physical exam and blood tests to measure hormone levels and check for health conditions. Basic fertility testing for women includes ultrasound imaging of the reproductive organs and tests to measure ovarian reserve. Fertility testing for men includes a semen analysis to evaluate the quantity and quality of sperm.

When Should You See a Fertility Specialist for Secondary Infertility?

If you've been trying to get pregnant for 6 or 7 months after previously having a full-term pregnancy (with or without fertility treatments) and giving birth, we recommend scheduling an appointment with our fertility specialists.

Our Treatments for Secondary Infertility

Sometimes infertility testing uncovers a clear cause of secondary infertility. In other cases, the condition remains unexplained. Depending on what we find out during your evaluation, we may recommend:

  • Ovulation induction: Ovulation induction uses fertility drugs to help your ovarian follicles grow and release an egg each month. You may benefit from this treatment if you have abnormal periods, PCOS or another condition that affects ovulation.
  • Intrauterine insemination: During intrauterine insemination (IUI), we use a catheter (long, thin tube) to deliver sperm directly into your uterus. We might recommend IUI if your male partner has a low sperm count, poor sperm quality or erectile dysfunction.
  • In vitro fertilization: In vitro fertilization fertilizes an egg with sperm in a lab. We grow the fertilized egg into an embryo and transfer it to your uterus. There are variations of IVF that can be tailored to your needs and situation, such as using donor eggs or sperm.
  • Reproductive surgery: Surgery can treat some conditions, such as uterine fibroids or varicocele, and improve the chances of pregnancy. But fertility surgery does carry risks, so we typically recommend conservative (non-surgical) treatments first.

Make an Appointment

Call 717-544-0107 or request an appointment to schedule your fertility consultation.

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