Secondary infertility is the inability to conceive in women who have previously had a pregnancy, after having regular unprotected intercourse for one year in women under age 35, or for six months in those aged 35 or older.
Secondary infertility can occur for many reasons. Sometimes, it is due to increased age and the associated decline in egg quality and quantity, making conception more difficult. Other times, it can be due to pregnancy-related complications, damage to the uterus or fallopian tubes, ovulation disorders, sperm problems, or other changes in medical history since the prior pregnancy was achieved. It is a common diagnosis, and treatment depends on the potential cause. Secondary infertility is evaluated in a similar way to primary infertility. Common tests to perform are a hysterosalpingogram (HSG) to confirm that the fallopian tubes are open and the uterine cavity is normal, a semen analysis to check the quantity and quality of the sperm and blood tests to assess a woman’s reproductive hormones and ovarian reserve.