Initial Trouble Getting Pregnant
Primary infertility refers to the inability of a woman or couple to conceive after at least 1 year of unprotected intercourse without ever having had a previous pregnancy. There are many causes of primary infertility, including older maternal age, some exposures, hormonal imbalances, and various reproductive health issues. In the United States, about 1 in 5 women of reproductive age struggle with primary infertility.
Difficulty getting pregnant again
The term secondary infertility explains the inability to conceive after having 1 or more previous pregnancies. About 1 in 20 women will struggle with secondary infertility. Secondary infertility shares many of the same causes as primary infertility but can also be influenced by factors that develop after the previous pregnancy. For example, if a woman experiences a uterine rupture or scarring during an initial pregnancy, subsequent implantation may be more difficult. Older age also plays more of a role in second pregnancies. Lastly, attempting to get pregnant again with a new male partner could be the cause of secondary infertility.
Infertility testing
Identifying the cause of both primary and secondary infertility often requires the same initial testing. Bloodwork will be performed to check hormone levels for progesterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, and others. Bloodwork can also identify any vitamin deficiencies that may affect fertility. An ultrasound can be used to evaluate the health of the uterus and look for reproductive problems such as fibroids, while a hysterosalpingogram (HSG) may be used to check for any blockages in the fallopian tubes. If the woman’s results come back normal, a semen analysis may be ordered to further evaluate the male partner.
Treating primary and secondary infertility
Women diagnosed with infertility have different options for getting pregnant. Infertility makes conception much more difficult but not impossible, and some women who continue to try naturally will have success. Medication, such as ovulatory stimulants, can also help women with both primary and secondary infertility achieve a pregnancy. For couples who want to take a more aggressive approach, assisted reproductive technology (ART) treatments like in vitro fertilization (IVF) are available. With IVF, an egg is retrieved and combined with sperm in a lab to create an embryo, which is then transferred into the uterus to implant.
Staying emotionally strong
Infertility can be an emotional, financial, and physical journey. Women with primary infertility may struggle with the idea of not being able to have children, while individuals with secondary infertility may feel judgment and societal misconceptions due to already having a child. Staying emotionally strong while navigating both primary and secondary infertility is important. With proper testing and treatment, many women with infertility go on to have a healthy pregnancy or second pregnancy.
