Secondary Infertility

Q. I have a three year old little boy and had no trouble getting pregnant the first time. Now that my husband and I have started trying for a second child nothing is happening. What is going on?

A. Infertility after a previous successful pregnancy is called secondary infertility. Even though you may be in great health, subtle anatomic and hormonal issues, as well as age factors could be contributing to your difficulty. For example, up to 40% of women in their reproductive years develop fibroid tumors in their uterus. Fibroids are benign muscle tumors that can distort the shape of the uterus and prevent embryos from implanting. Others may have hormone issues, like an underactive thyroid gland (hypothyroidism), that can affect the ovaries’ ability to release eggs and make hormones.

One of the most silent causes of secondary infertility is reproductive aging. As women get older, their ovaries contain fewer eggs that require stronger signals from the pituitary gland to ovulate. When the eggs are released, they tend to not fertilize as easily and may produce embryos that stop growing. Outwardly, this may be show up as infertility. Aging factors seem to become more important as women approach the age of 40 and beyond.