Struggling to Get Pregnant a Second Time?

June 10, 2019

Clinical Contributors to this Story

David Shin, M.D. contributes to topics such as Urology.

Causes and Treatment Options for Secondary Infertility

By Brianna McCabe

After having your first child, some may think that getting pregnant a second time and growing your family will be easy. For many couples, though, this isn’t always true.

An overview of secondary infertility

David Shin, M.D., chief of the Center for Sexual Health & Fertility at Hackensack University Medical Center, explains that secondary infertility is the inability to carry a baby to term—despite trying for 1 year to achieve pregnancy—after previously giving birth. The Center for Disease Control (CDC) estimates that 11% of couples in the United States, or 4 million families, experience secondary infertility.

Possible causes of secondary infertility

According to Dr. Shin, multiple factors can account for secondary infertility for both men and women. “Many people tend to associate infertility with just women, but this is a misconception,” says Dr. Shin. “Male factors play a role in infertility up to 50% of the time.”

For women, factors may include:

  • Age (anyone over the age of 35)
  • Irregular menstrual cycles
  • Endometriosis
  • Pelvic inflammatory disease
  • Unhealthy body weight
  • Tubal issues
  • Uterine abnormalities
  • Previous miscarriages

For men, factors may include:

  • Abnormal sperm production or function due to undescended testicles
  • Genetic defects such as Klinefelter syndrome or Y chromosome microdeletion
  • Sperm delivery problems such as a blockage in the ejaculatory duct, vas deferens or epididymis
  • Testis cancer
  • Varicocele, or dilated veins in the scrotum

For both males and females, factors may include:

  • Having recently undergone cancer treatment, such as radiation or chemotherapy
  • Lifestyle exposure to cigarette smoking, excessive alcohol and marijuana
  • Having taken selective antibiotics, anti-hypertensive medications and anabolic steroids
  • Exposure to certain environmental factors such as pesticides and chemicals
  • Diabetes
  • Infections such as chlamydia, gonorrhea or mumps
  • Genetic diseases such as cystic fibrosis
  • Any inadvertent injury to the reproductive organs

When to see a specialist

Dr. Shin encourages couples to seek the advice of a specialist after trying to conceive for at least one year. He advises, “However, if a couple has been trying for a few months and they don’t want to wait an entire year before undergoing an evaluation, I encourage them to start the process sooner rather than later.”

Treatment options for secondary infertility

Though dependent on the cause of infertility, length of infertility, age of infertile partner(s) and personal preferences, Dr. Shin says that there are treatment options available for many couples.

Treatment for women may include:

  • Fertility drugs
  • Intrauterine insemination (IUI), or the insertion of semen directly into the uterus via catheter
  • Surgery such as the repair of blocked fallopian tubes
  • Altering lifestyle factors, such as diet and exercise

Treatment for men may include:

  • Medications to improve sperm counts
  • Surgery such as a varicocelectomy, a minor surgery frequently used to repair dilated scrotal veins
  • Altering lifestyle factors, such as diet and exercise

Other options a couple may consider include:

  • In vitro fertilization (IVF), or the procedure of fertilizing an egg with sperm outside of the body
  • Gestational carriers/surrogates
  • Donor eggs or sperm

“Although it may seem to be a very stressful period, couples can be reassured that there are definitely both medical and surgical treatments that are available for men to help improve their chances of a second pregnancy,” comforts Dr. Shin.

Dr. Shin is located in Hackensack and is a physician at Hackensack Meridian Health Medical Group, a network of more than 1,000 physicians and advanced providers at over 300 practices throughout New Jersey. Our care network can help you better manage your health. Visit to find a practice near you.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.

Centers for Disease Control and Prevention: Infertility
U.S. Department of Health & Human Services: Infertility