As India surpasses China to become the most populous country in the world, a growing concern in reproductive health has emerged—infertility rates are on the rise. According to the National Family Health Survey (NFHS), the overall infertility rate in India increased from 22.4% in 1992-93 to 25.3% in 2005-06, and again to 30.7% in 2015-16. While infertility is often discussed in terms of primary infertility—when a couple has never been able to conceive—secondary infertility, a largely hidden issue, is gaining prevalence and deserves more attention.
What is Secondary Infertility?
Secondary infertility refers to the inability to conceive or carry a pregnancy to full term after previously having a child or experiencing one or more successful pregnancies. This condition is often emotionally challenging, as couples who have successfully had children in the past may struggle to understand why they are now facing difficulties.
As Dr. R Uthra, a consultant in obstetrics and gynecology at DHEE Hospitals, Bengaluru, explains, “Secondary infertility occurs when a couple who has had a child or children in the past experiences difficulty conceiving again.” Despite its significant impact, secondary infertility remains underdiscussed compared to primary infertility.
Why Is Secondary Infertility Underrecognized?
A major reason secondary infertility is not as well known is the misconception that because a couple has already had one child, they should be able to conceive again without issue. This assumption often leads to delays in seeking medical help, as couples may feel that infertility is not an option for them. Additionally, there is a lack of awareness around the condition, both among the general public and healthcare professionals.
Dr. Rajendra Shitole, IVF Consultant at DPU Super Speciality Hospital in Pune, highlights that societal pressures and emotional challenges may prevent couples from openly discussing their struggles. “Many couples feel guilty or hesitant to seek help for secondary infertility because they already have a child and fear judgment for wanting another,” says Dr. Shitole.
The Causes of Secondary Infertility
Secondary infertility can arise from a variety of factors, some of which are similar to those that cause primary infertility. However, other issues may develop after a previous pregnancy or childbirth.
In Women:
- Age: Women over 35 may face a decline in fertility due to natural age-related changes.
- Polycystic Ovary Syndrome (PCOS): This hormonal condition can affect ovulation, making it more difficult to conceive again.
- Previous Surgeries: C-sections, fibroid removals, or other reproductive surgeries can lead to scarring or damage to reproductive organs, hindering conception.
- Chronic Health Conditions: Issues like thyroid disorders, diabetes, and endometriosis can cause hormonal imbalances, disrupt ovulation, and decrease fertility.
- Lifestyle Changes: Significant weight fluctuations, high stress, smoking, and alcohol consumption can all negatively impact fertility.
Dr. Navina Singh, IVF Specialist at Birla Fertility & IVF, Mumbai, emphasizes that these factors, combined with age and lifestyle habits, can complicate attempts to conceive after the first child.
In Men:
Fertility issues in men often stem from the quantity and quality of sperm. A decline in sperm motility, count, or overall quality can severely impact fertility. Age, along with factors like weight gain, stress, smoking, excessive alcohol consumption, and underlying health conditions such as diabetes, can all affect male fertility.
The Need for Awareness and Early Intervention
Secondary infertility affects nearly 50% of all infertility cases worldwide, yet it remains far less discussed than primary infertility. This gap in awareness can lead to delayed medical intervention. Often, couples may wait years of unsuccessful attempts before seeking help, assuming that because they’ve successfully conceived in the past, they must just be facing a temporary issue.
As Dr. Shitole points out, “Because of the history of a successful pregnancy, couples and even healthcare providers may delay fertility evaluations. This delay can lead to more complications, making the treatment process more challenging.”
The Emotional Toll
The emotional impact of secondary infertility is often underestimated. Couples who previously conceived with ease may feel frustration, guilt, or even shame when they encounter difficulty in trying for a second child. These feelings are compounded by societal expectations, which often place undue pressure on individuals and families to expand their family without understanding the difficulties involved.
Conclusion
Secondary infertility is a common and growing issue that requires more open discussion and awareness. Couples experiencing secondary infertility may struggle to understand why they are having trouble conceiving again, but with the right support and medical intervention, there is hope. Dr. Uthra encourages couples to seek help early: “Understanding the causes of secondary infertility, seeking timely medical intervention, and fostering open conversations can help normalize the issue and provide much-needed support.”
As we work toward destigmatizing infertility in all its forms, it’s crucial to include secondary infertility in these conversations, ensuring that those affected feel seen, heard, and supported throughout their journey to conception.
Related topics:
Poland’s Infertility Law Raises Ethical and Legal Concerns Over Embryo Donation
HnRNPK’s Vital Role in Male Fertility Revealed Through PiRNA Regulation
