Secondary Infertility


The face of infertility is changing. Commonly believed to affect only childless couples, infertility can be experienced by parents who effortlessly got pregnant in the past. This struggle, called secondary infertility, accounts for nearly half of those who seek fertility treatment today. MONICA PITRELLI spoke with Dr Kelly Loi from the Health & Fertility Centre for Women.

Understanding Secondary Infertility

The causes of primary and secondary infertility are almost identical: that is, problems arise in either the female or the male reproductive system, or in both. In women, infertility is largely caused by ovulation disorders, endometriosis, tubal disease, and age. In men, the quantity and quality of sperm is affected by age, poor diet, lifestyle habits and chronic illnesses, such as diabetes and high blood pressure.

How does age affect a woman’s fertility?

Women are born with a fixed number of eggs. As a woman ages, the number of functioning eggs in the ovaries decreases. The quality of the eggs also declines, resulting in an increased risk of genetic abnormalities and miscarriage. The likelihood of conceiving falls from 20 percent a month for a woman in her late 20s to 8 percent a month for a women in her late 30s. This means that the likelihood of conceiving in one year falls from 86 to 65 percent, respectively.

Even the success rate of artificial reproductive treatment is affected – women under the age of 35 have a 40 percent success rate as compared with just 10 percent in women over 40.

Most people understand the heartache surrounding primary infertility, but parents struggling to conceive a second or third baby often face a lack of understanding from friends and family. How traumatic is secondary infertility?

The psychosocial impact of secondary infertility can be every bit as devastating as primary infertility, and in some cases even more so. It often affects the entire family. Children of parents trying to conceive through reproductive technology may be affected by the changes in their parents’ emotional and physical state. Also, discussing the topic of infertility with a child can be daunting, due to the emotional pain felt by the parents and the uncertainty about how to best explain the situation to a child.

When should a woman seek help from a fertility specialist?

Early diagnosis and treatment of secondary infertility is especially important in older couples. Women over the age of 35 should make an appointment after trying unsuccessfully for six months to conceive. Also, women with a history of infrequent periods, pelvic inflammatory disease (PID), or previous reproductive surgery should seek specialist advice sooner rather than later. eL

Trying to Conceive? Heed the following advice:


  • Limit coffee intake to one cup a day; high levels of caffeine are associated with decreased fertility and an increased risk of miscarriage.
  • Take folic acid to prevent certain birth defects


  • Wear loose-fitting undergarments.
  • Avoid extremely hot temperatures, such as hot tubs and saunas.


  • Maintain a normal weight, exercise, and eat a diet rich in fruit, vegetables and antioxidants.
  • Stop smoking! Smoking impairs sperm quality and female smokers are 1.6 times more likely to be infertile.
  • Limit alcohol intake to two drinks per day.
  • Use lubricants that are conducive to conceiving.

For more information,
call 6235 5066 or visit

3 Mount Elizabeth, #15-16,
Mount Elizabeth Medical Centre
Singapore 228510
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