Treating secondary infertility, like primary infertility, will depend largely on any underlying medical conditions. Through the Couples Clinic at UW Health's Generations Fertility Care, both members of the couple undergo a routine evaluation. Since infertility is not simply a woman's problem, evaluating both members ensures the most effective treatments can be recommended.  
I had a wonderful experience at CHA Fertility Clinic and got pregnant on my first cycle.  My son will turn two this year and I immediately contacted them when we were thinking of having a second child.  The doctors and staff are so kind, informative, and helpful, and they really put my mind at ease.  We had looked at other fertility clinics … Read More
Progesterone elevation on the day of induction of final maturation is associated with lower pregnancy rates in IVF cycles in women undergoing ovarian stimulation using GnRH analogues and gonadotrophins.[23] At this time, compared to a progesterone level below 0.8 ng/ml, a level between 0.8 and 1.1 ng/ml confers an odds ratio of pregnancy of approximately 0.8, and a level between 1.2 and 3.0 ng/ml confers an odds ratio of pregnancy of between 0.6 and 0.7.[23] On the other hand, progesterone elevation does not seem to confer a decreased chance of pregnancy in frozen–thawed cycles and cycles with egg donation.[23]

Artificial insemination, including intracervical insemination and intrauterine insemination of semen. It requires that a woman ovulates, but is a relatively simple procedure, and can be used in the home for self-insemination without medical practitioner assistance.[171] The beneficiaries of artificial insemination are women who desire to give birth to their own child who may be single, women who are in a lesbian relationship or women who are in a heterosexual relationship but with a male partner who is infertile or who has a physical impairment which prevents full intercourse from taking place.
A woman normally produces one egg during each menstrual cycle. However, IVF requires multiple eggs. Using multiple eggs increases the chances of developing a viable embryo. You’ll receive fertility drugs to increase the number of eggs your body produces. During this time, your doctor will perform regular blood tests and ultrasounds to monitor the production of eggs and to let your doctor know when to retrieve them.

Nope, infertility is not only about you: about one-third of all infertility cases treated in the United States are caused by a male problem. Varicocele is one of them, and it’s when the veins that drain the testicle become enlarged, similar to the varicose veins you get in your leg. It may cause the scrotum to swell or form a weird, twisted mass on the surface (kind of like a small bag of worms). The condition may decrease the quality of sperm, as well as how much is produced—thus impacting fertility. The good news: varicocele can be surgically repaired, which may improve sperm numbers and function or cure the infertility.
Because not each IVF cycle that is started will lead to oocyte retrieval or embryo transfer, reports of live birth rates need to specify the denominator, namely IVF cycles started, IVF retrievals, or embryo transfers. The SART summarised 2008–9 success rates for US clinics for fresh embryo cycles that did not involve donor eggs and gave live birth rates by the age of the prospective mother, with a peak at 41.3% per cycle started and 47.3% per embryo transfer for patients under 35 years of age.
IVF may be used to overcome female infertility when it is due to problems with the fallopian tubes, making in vivo fertilisation difficult. It can also assist in male infertility, in those cases where there is a defect in sperm quality; in such situations intracytoplasmic sperm injection (ICSI) may be used, where a sperm cell is injected directly into the egg cell. This is used when sperm has difficulty penetrating the egg. In these cases the partner's or a donor's sperm may be used. ICSI is also used when sperm numbers are very low. When indicated, the use of ICSI has been found to increase the success rates of IVF.
However, the more you understand about what's coming next, the more in control you'll feel. While every clinic's protocol will be slightly different and treatments are adjusted for a couple's individual needs, here is a step-by-step breakdown of what generally takes place during in vitro fertilization, as well as information on the risks, costs, and what’s next if your IVF treatment cycle fails.
Bachelor of Arts in Translation and Interpreting (English, Spanish, Catalan, German) from the University of Valencia (UV) and Heriot-Watt University, Riccarton Campus (Edinburgh, UK). Postgraduate Course in Legal Translation from the University of Valencia. Specialist in Medical Translation, with several years of experience in the field of Assisted Reproduction. More information about Sandra Fernández
Many people have never heard the term "secondary infertility"; fewer understand it. I discovered it a year into my struggle to conceive a second child and fell on it, amazed. What I was undergoing had a name! I wrote it down and immediately felt better, as if the phrase exuded a talismanic power that might protect me from the likes of my neighbour.
In IUI, this natural sequence of events is given some assistance. A sample of sperm is prepared in the laboratory so that only the best moving sperm are concentrated together. This sperm is then deposited directly into the uterus without having to swim there on its own, which can be challenging, especially if the sperm do not swim well. IUI places a higher concentration of moving sperm closer to the ovulated egg. Often a woman will have taken medication prior to the IUI procedure to ensure she will ovulate around the time of the procedure, so egg and sperm can meet.

Fertilization. An embryologist (a scientist who specializes in eggs, sperm, and embryos) will examine your eggs before combining them with your partner's sperm and incubating them overnight. Fertilization usually happens during this time, but eggs that aren't normal may not be fertilized. (If sperm quality is poor, or if fertilization was unsuccessful during previous IVF cycles, your doctor may recommend using a technique called intracytoplasmic sperm injection (ICSI). With ICSI, a single sperm is injected directly into each mature egg.)
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In egg donation and embryo donation, the resultant embryo after fertilisation is inserted in another woman than the one providing the eggs. These are resources for women with no eggs due to surgery, chemotherapy, or genetic causes; or with poor egg quality, previously unsuccessful IVF cycles or advanced maternal age. In the egg donor process, eggs are retrieved from a donor's ovaries, fertilised in the laboratory with the sperm from the recipient's partner, and the resulting healthy embryos are returned to the recipient's uterus.
4. IVF or In-Vitro Fertilization - IVF means eggs are collected and fertilized outside the body, in a laboratory. This is followed by transferring the embryos into the uterus. This advanced technology has resulted in many successful pregnancies in women who had lost hope. During IVF - In-Vitro Fertilization, women can choose to freeze their healthy eggs for future use.
If a physician believes infertility is a concern, a number of tests will be administered. For women, these may include ovulation testing, ovarian reserve testing, hormone testing, and hysterosalpingography (X-rays of the fallopian tubes) or other imaging tests. Assessing male infertility involves semen analysis, which examines the number of sperm, as well as their motility and morphology (shape). Other tests for men may include hormonal and genetic testing, testicular biopsy, and additional imaging.
Because not each IVF cycle that is started will lead to oocyte retrieval or embryo transfer, reports of live birth rates need to specify the denominator, namely IVF cycles started, IVF retrievals, or embryo transfers. The SART summarised 2008–9 success rates for US clinics for fresh embryo cycles that did not involve donor eggs and gave live birth rates by the age of the prospective mother, with a peak at 41.3% per cycle started and 47.3% per embryo transfer for patients under 35 years of age.
However, the more you understand about what's coming next, the more in control you'll feel. While every clinic's protocol will be slightly different and treatments are adjusted for a couple's individual needs, here is a step-by-step breakdown of what generally takes place during in vitro fertilization, as well as information on the risks, costs, and what’s next if your IVF treatment cycle fails.
Problems with your periods or menstrual cycle is a sign of ovulation problems – and if you aren’t ovulating, you won’t get pregnant. Menstrual problems are the most obvious sign of infertility in women – but they don’t necessarily mean you’re infertile. Most women have some type of problem with their period: light flow, heavy flow, clotting, irregularity caused by stress or weight fluctuations, hormonal changes, etc.
Undergoing fertility treatment requires precise scheduling of frequent tests and procedures—a tricky proposition when you're a parent. "I've had to go to the doctor early in the morning three times a week for testing," says Bozinovich. "Who can you find to babysit at 7 a.m. on a weekday?" (The answer: a grandparent or, when all else fails, a nurse at the doctor's office.) Your instinct might be to keep your treatment a secret, but it can make your life easier to enlist a friend or relative to help with child care. Also, choose a doctor's office you're comfortable with. You'll be spending a lot of time there; a compassionate staff can make treatment easier.
IVF has many steps, and it takes several months to complete the whole process. It sometimes works on the first try, but many people need more than 1 round of IVF to get pregnant. IVF definitely increases your chances of pregnancy if you’re having fertility problems, but there’s no guarantee — everyone’s body is different and IVF won’t work for everyone.
Secondary infertility is a secret club and one, I've discovered, with permanent membership. I was in a supermarket the other day and ahead of me in the cereal aisle was a woman with a boy of about nine and twin babies in the trolley. As I passed, she turned and looked at us. I saw her clocking my children and their age-gap and she saw I was doing the same with hers. We looked at each other for a moment; she smiled and I smiled back and then we walked on.
Studies show that sperm count and sperm movement decrease as men age, as does sexual function. But there isn't a cutoff age that makes a man too old to father a child. One study found that it took men age 45 or older longer to get a woman pregnant once the couple started trying. If your partner is older, you may want to talk to your doctor about ways to boost your chances.
The percentage of cycles cancelled between egg retrieval and embryo transfer is an indication of failed fertilization. This figure is halved with ICSI as compared to conventional IVF, indicating that it can indeed improve fertilization when the sperm is at fault. However, there are no differences in pregnancy, miscarriage or live birth rates between conventional IVF and ICSI, indicating overall similar success rates1.
Ovarian reserve testing. To determine the quantity and quality of your eggs, your doctor might test the concentration of follicle-stimulating hormone (FSH), estradiol (estrogen) and anti-mullerian hormone in your blood during the first few days of your menstrual cycle. Test results, often used together with an ultrasound of your ovaries, can help predict how your ovaries will respond to fertility medication.
^ Tersigni C, Castellani R, de Waure C, Fattorossi A, De Spirito M, Gasbarrini A, Scambia G, Di Simone N (2014). "Celiac disease and reproductive disorders: meta-analysis of epidemiologic associations and potential pathogenic mechanisms". Hum. Reprod. Update. 20 (4): 582–93. doi:10.1093/humupd/dmu007. PMID 24619876. Physicians should investigate women with unexplained infertility, recurrent miscarriage or IUGR for undiagnosed CD. (...) CD can present with several non-gastrointestinal symptoms and it may escape timely recognition. Thus, given the heterogeneity of clinical presentation, many atypical cases of CD go undiagnosed, leading to a risk of long-term complications. Among atypical symptoms of CD, disorders of fertility, such as delayed menarche, early menopause, amenorrhea or infertility, and pregnancy complications, such as recurrent abortions, intrauterine growth restriction (IUGR), small for gestational age (SGA) babies, low birthweight (LBW) babies or preterm deliveries, must be factored. (...) However, the risk is significantly reduced by a gluten-free diet. These patients should therefore be made aware of the potential negative effects of active CD also in terms of reproductive performances, and of the importance of a strict diet to ameliorate their health condition and reproductive health.
In vitro fertilisation (IVF) is a process of fertilisation where an egg is combined with sperm outside the body, in vitro ("in glass"). The process involves monitoring and stimulating a woman's ovulatory process, removing an ovum or ova (egg or eggs) from the woman's ovaries and letting sperm fertilise them in a liquid in a laboratory. After the fertilised egg (zygote) undergoes embryo culture for 2–6 days, it is implanted in the same or another woman's uterus, with the intention of establishing a successful pregnancy.

That’s about the time frame women between the ages of 35 and 40 should give themselves, before discussing fertility concerns with their doctor. For women under 35, experts recommend trying for about a year—really trying, as in unprotected, well-timed intercourse—before having any testing or treatment; women over 40 may want to consult an obstetrician/gynecologist right away. See your doctor sooner than later if you’ve suffered multiple miscarriages, have a history of pelvic inflammatory disease (a serious complication of some STDs), or experience any other symptoms of infertility. Meanwhile, learn these infertility myths you don’t have to worry about.
Fertility is often something people do not consider until they are actively trying to start a family, or in many cases after they have started having trouble conceiving. What many don’t realize is that couples ages 29-33 with normal functioning reproductive systems only have a 20-25% chance of conceiving in any given month. Add in any number of infertility factors from either gender and those chances can decrease significantly.
In the United States, women seeking to be an embryo recipient undergo infectious disease screening required by the U.S. Food and Drug Administration (FDA), and reproductive tests to determine the best placement location and cycle timing before the actual Embryo Transfer occurs. The amount of screening the embryo has already undergone is largely dependent on the genetic parents' own IVF clinic and process. The embryo recipient may elect to have her own embryologist conduct further testing.
Another major cause of infertility in women may be the inability to ovulate. Malformation of the eggs themselves may complicate conception. For example, polycystic ovarian syndrome is when the eggs only partially develop within the ovary and there is an excess of male hormones. Some women are infertile because their ovaries do not mature and release eggs. In this case synthetic FSH by injection or Clomid (Clomiphene citrate) via a pill can be given to stimulate follicles to mature in the ovaries.

The treatment options for unexplained infertility are several and the treatment results are promising. Expectant management can be recommended if the woman is under 28-30 years of age and the infertility duration is less than 2-3 years. In vitro fertilization (IVF) has revolutionized the treatment of infertile couples, as well as profoundly increasing the basic understanding of human reproduction. IVF can be used as both a diagnostic and a therapeutic tool in couples with unexplained infertility. The pregnancy rates with IVF are good, at 40% per treatment cycle. In addition, the outcome of pregnancies among women with unexplained infertility is generally comparable to that of spontaneous and other pregnancies using assisted reproductive technologies.

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