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What is Secondary Infertility?
Secondary infertility refers to the inability to conceive a child after having already conceived one or more children. It is to be distinguished from primary infertility, or the inability to conceive at all. Approximately sixty percent of all cases of infertility in this country are attributable to secondary infertility. The causes of secondary infertility are legion and, apart from the possibility of advancing age, are basically identical to the causes of primary infertility. These causes can reside in the woman alone, the man alone, or possibly in both partners.
On the side of the female partner, the most common causes of secondary infertility are endometriosis, ovulatory dysfunction, and uterine or cervical problems. Endometriosis is a condition in which some of the tissue that lines the uterus and is shed each month during menstruation is present in the abdominal cavity outside of the uterus. This tissue can interfere with the passage of released eggs into the fallopian tubes. Ovulatory problems, such as anovulation, or the failure to release an egg during the menstrual cycle, can also be a factor. A condition in which the blood contains an excess amount of the hormone prolactin can bring about an ovulation. A woman can also be anovulatory if she has developed diabetes or thyroid disease in the interval since her last successful pregnancy. Uterine and cervical factors can also be a cause of secondary infertility. Uterine tumors and fibroids that bulge into the uterine cavity can preclude conception. Cervical polyps, generally benign growths that protrude from the mouth of the cervix, can sometimes impair fertility.
In the male partner, the prime causes of secondary infertility are low sperm count, or complete absence of sperm in the semen, and sperm abnormalities. All of these problems are actually resultant conditions that reflect underlying problems as the root causes of the infertility. For example, an insufficient sperm count can be the result of a scrotal temperature that is too high. Wearing clothing or briefs that are too tight can also reduce sperm concentration. Occasionally, varicose veins around the testes can be responsible. Sperm abnormalities, such as irregularities in the shape of the sperm that can render it nonmotile, can result from infections, overindulgence in alcohol, tobacco, or marijuana, the use of prescription drugs, radiation therapy, and even exposure to environmental toxins such as solvents and pesticides.
