14th January, 20225 min read

Secondary infertility: symptoms, causes and treatment

Medical reviewer:Dr Ann Nainan
Author:Judith Ozkan
Last reviewed: 14/01/2022
Medically reviewed

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What is secondary infertility?

Secondary infertility is when you’ve had a pregnancy in the past, but you can’t get pregnant again. It’s thought to affect about 5% of people in the UK.

Some people will have given birth to at least 1 baby, while others may have had a miscarriage or termination in an earlier pregnancy.

Secondary infertility can be very distressing. You may feel a mix of emotions – shock that your fertility has changed, sadness that an existing child won’t have a brother or sister, or even guilt about being upset, when there are some people who can’t have any children.

You may also find it difficult to talk about what you’re going through, or feel like you can’t get the same support or help as someone who has primary infertility.

But it’s important to know that there is help available. Read on to learn more about the symptoms, causes and treatment options for secondary infertility, so you can get the support you need.

Signs and symptoms of secondary infertility

Not getting pregnant despite having regular sex without contraception is the most obvious sign of secondary infertility. It’s usually only diagnosed if you’ve been trying to get pregnant for more than 1 year.

There are some other signs that may suggest you have fertility issues. In females, these can include:

  • changes to your menstrual cycle – irregular or infrequent periods can be a sign of ovulation problems
  • heavy or painful periods – this can be a sign of growths in the womb called fibroids, or a condition called endometriosis, when tissue similar to the lining of the womb grows in other parts of the body
  • pelvic pain – this could be a sign of an infection or endometriosis

In males, there aren’t usually obvious signs of infertility. You may need tests to check for possible fertility problems, such as issues with your sperm production or delivery.

Things that could lead to secondary infertility in males include:

  • ageing – sperm quality reduces as you get older
  • obesity and weight gain – linked to lower testosterone and sperm quality
  • varicocele – enlarged veins in your scrotum, which can affect sperm production
  • reduced testosterone – due to ageing, injury or certain medical conditions
  • prostate problems or removal – can lead to lower sperm count or fertility issues

Read more about male infertility.

Secondary infertility

Causes of secondary infertility

As with primary infertility, there are several possible causes of secondary infertility. Common causes include:

  • problems with ovulation (when an egg is released from an ovary)
  • damaged or blocked fallopian tubes
  • endometriosis
  • low-quality semen

Read more about causes of infertility.

However, in about 25% of cases of infertility, there’s no known cause – this is called unexplained infertility.

When to speak to a doctor about secondary infertility

Generally, if you’ve been trying to get pregnant for more than a year, you should speak to a doctor for advice, whether or not you’ve been pregnant before.

If you’re female and over 35, or you have any underlying conditions, it’s a good idea to get advice earlier than this, as you may be less likely to get pregnant naturally.

Your doctor may be able to refer you for fertility treatment, as well as offering advice about support and counselling, if needed.

There is also online support available. Join Fertility Network UK’s Secondary Infertility Group, or see other people talk about their experiences at Healthtalk.org.

Treatment options for secondary infertility

Any fertility treatments you may be offered will depend on your situation and the reason for your infertility. Possible treatment options include:

  • medicines or hormone injections to stimulate ovulation
  • artificial insemination – when sperm is put directly into the womb
  • in vitro fertilisation (IVF) – when an egg is fertilised by sperm in a laboratory, then placed in the womb
  • intracytoplasmic sperm injection (ICSI) – sometimes used as part of IVF, where sperm is injected directly into the egg
  • surgery

Read more about treatments for infertility.

Having infertility treatment can be emotional, and sometimes physically demanding. There’s no guarantee that it will work, but the treatments are safer than ever, and success rates are improving. You may find it helpful to talk to a fertility counsellor before making any decisions.

Your health questions answered

Can you become infertile after having a miscarriage?

“Having a miscarriage doesn’t make you infertile, or mean that you won’t be able to get pregnant again in the future. Even in cases of recurrent miscarriage – meaning 3 or more in a row – most people are able to have a healthy pregnancy afterwards.”

What are the signs of infertility after abortion?

“Having an abortion doesn’t usually affect your chances of getting pregnant in the future. There’s a very small risk to fertility if you get an infection during the operation and it isn’t treated, but this can usually be treated with antibiotics.”

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