What Is Secondary Infertility? Explaining Why It Can Sometimes Be Difficult to Have Another Baby
April 25, 2019
By Jen Juneau
“Infertility” is a term that many women who have experienced it will tell you is not discussed enough, and secondary infertility may be talked about even less — but what exactly is it?
According to Mayo Clinic, secondary infertility is defined as “the inability to become pregnant or to carry a baby to term after previously giving birth to a baby,” and “shares many of the same causes of primary infertility.”
In honor of National Infertility Awareness Week, PEOPLE spoke to Dr. Colby Previte, an obstetrician-gynecologist at the University of Rochester, about the phenomenon and what could be the underlying cause, if any.
“Perhaps one of the most challenging things about infertility is that ‘infertility’ is a broad category,” she says. “This category includes all of the many diagnoses (reasons) that make it challenging for couples to get pregnant. As a result, treatments and interventions vary depending upon the diagnosis and/or cause.”
“When I see patients in the office who are thinking about conceiving their second or third pregnancies, they often ask me if it will be ‘as easy’ or ‘as difficult’ as the last time they attempted to get pregnant,” Dr. Previte tells PEOPLE. “As we get older, our eggs age with us, and this makes getting pregnant harder.”
“Time makes a huge difference when you’re a woman,” Dr. Jaime Knopman, a board-certified reproductive endocrinologist at CCRM Fertility in N.Y.C., told GMA. “And male age is not insignificant too. We recognize that sperm quality and quantity decrease with age as well, though not as severely as with females and eggs.”
Aside from age, other causes of secondary infertility, Mayo Clinic explains, could be “impaired sperm production, function or delivery in men,” damaged Fallopian tube(s), ovulation abnormalities and uterine conditions such as scarring and endometriosis, as well as medication usage or weight change.
“There are interventions that can help improve pregnancy rates in some patients. For example, in patients who are overweight or obese, weight loss has been shown to improve their chances of getting pregnant significantly,” Dr. Previte explains to PEOPLE.
Many moms and moms-to-be have been searching for information surrounding secondary infertility this week after Dylan Dreyer announced on the Today show Monday that she has been struggling with the condition and suffered a miscarriage while she and husband Brian Fichera were trying to give their son Calvin Bradley, 2, a sibling.
One apparent issue, Dreyer revealed, was that her uterus “was two-thirds scarred shut” as a result of the emergency cesarean section she’d had with Calvin, which resulted in a surgery where the doctor removed the scar tissue. Then, she got pregnant immediately before the couple suffered the tragic loss.
Dreyer, 37, admitted she “didn’t know secondary infertility was a thing” until her experience, and that the couple are looking at in vitro fertilization for their next steps.
Co-host Jenna Bush Hager announced her third child on the way the same day, in another segment of Monday’s episode, and revealed she had “fertility issues” with her younger daughter Poppy Louise, 3½, before she and husband Henry Hager conceived their little boy on the way.
Bush Hager, 37, also revealed she had suffered an ectopic pregnancy before having her now-6-year-old daughter Margaret “Mila” Laura, calling the experience “very isolating” and remarking, “There is joy and there is pain.”
Of Dreyer’s case, Dr. Previte, who has not treated Dreyer, tells PEOPLE, “If scar tissue in her uterus was the only identifiable challenge to her conceiving a pregnancy, then the studies show that successful break-up of this scar tissue would generally enable her to have successful pregnancies in the future.”
She also emphasizes that both miscarriage and infertility are much more common than many would be led to believe, due to the fact that they aren’t openly discussed as often as they occur. In reality, “roughly one-third of pregnancies will end in miscarriage in the first 12 to 14 weeks of pregnancy,” Dr. Previte shares.
“Most Americans know little about it, and therefore incorrectly think that both are rare,” she adds. “Sadly, most patients and their partners who experience miscarriage and/or infertility report feeling isolated from friends, family and sometimes from each other as they go through these emotional and challenging times.”