Primary and secondary infertility: what can affect fertility and when to seek medical help

Infertility affects as many as 1 in 8 couples trying to conceive, according to a study from the World Health Organization (WHO). However, it’s important to remember that if you and your partner are experiencing challenges with conception, you do have options.

While most medical conditions affect a single individual, infertility is unique as it involves a pair. Medically, infertility is defined by the inability to conceive following 12 months of regular intercourse without conception, or after 6 months in women 35 years and older.

What may not be common knowledge is the presence of two distinct types of infertility: primary infertility and secondary infertility. Primary infertility refers to infertility issues when a person has never been pregnant before, whereas secondary infertility occurs in individuals that have become pregnant in the past, regardless of the outcome of that pregnancy. Approximately 50% of infertility cases are secondary infertility.

Identifying the cause of infertility can be difficult, as there are several potential issues that can cause infertility to occur. Genetic factors or reproductive disorders such as Mullerian agenesis and endometriosis are a few of the reasons that some may experience infertility. For others, the factors may be as simple as a lack of viable eggs for fertilization due to age. In men, hypogonadism, adult mumps, testicular trauma, or a number of other factors could lead to infertility.

“Age is a very important factor affecting a woman’s fertility,” said Dr. Malvina Elmadjian, an obstetrician-gynecologist with Northwell Health Physician Partners/Westchester Health. “The probability of achieving a pregnancy decreases with aging, especially after 35 years. This is likely due to a decrease in both the quantity and quality of the eggs. The rate of follicle loss accelerates after the woman reaches her mid-thirties.”

Ultimately, one member of the couple is no more to blame than the other for infertility issues. The same WHO study found that female infertility was reported in 37% of infertile couples, male infertility in 8% and both male and female infertility in 35% of cases.

If you and your partner are experiencing infertility issues, Dr. Elmadjian recommends seeking medical help early. A lot of factors surrounding infertility are out of our control but seeking help from a healthcare professional can help identify causes earlier. Additionally, one can lower their odds of infertility by avoiding sexually transmitted diseases, achieving a healthy body mass index, and quitting smoking.

There are options available for couples’ experiencing infertility. Sperm donors and egg donors are viable options for some couples, as well as in vitro fertilization (IVF). The best option for you can be determined by a gynecologist or infertility specialist.

While infertility may be difficult to discuss, seeking early help is critical to increasing your odds of conception. If you and your partner would like to schedule an initial fertility evaluation, you can reach Dr. Elmadjian’s office by calling (914) 241-4900.

By Malvina Elmadjian, MD, FACOG, Obstetrics and Gynecology, Northwell Health Physician Partners/Westchester Health