What is Secondary Infertility?

Secondary sterility refers to a woman who has had a pregnancy before and has not been contraceptive for 1 year.

Basic Information

English name: Secondary Sterility
Visiting department: Obstetrics and Gynecology
Common locations

Common causes: Women have uterus, fallopian tubes, ovaries, vagina, immunity and other factors, and are affected by abortion and systemic diseases; men have reproductive infections and environmental pollution
Common symptoms: Have had a pregnancy and have not had a contraception for more than 1 year

Causes of secondary infertility

Among the causes of secondary infertility, female factors account for about 50%, male factors account for about 40% of infertility, and other comprehensive factors account for about 10%.

Female factor

(1) Uterine factors: uterine fibroids, uterine malformations, intrauterine adhesions, endometriosis, endometrial polyps, and endometritis are not conducive to conception. Cervical inflammation and abnormal position can cause infertility.

(2) Fallopian tube factor: It is impossible to conceive because of the fallopian tube. Common reasons include fallopian tube inflammation, fallopian tube spasm, fallopian tuberculosis, fallopian tube fluid, fallopian tube adhesion, etc.

(3) Ovarian factors: Ovarian tumors, premature ovarian failure, and abnormal ovarian function can cause infertility.

(4) Inflammatory factors of the lower genital tract: Trichomonas, mold, bacteria and other infections destroy the natural defense function of the vagina, causing vaginal inflammation, which can reduce the ability of sperm to move and shorten the sperm's survival time, causing temporary infertility.

(5) Immune factors: As a heterologous protein-antigen, men's sperm can cause antibodies in women. Some women's immune response is particularly strong, and anti-sperm antibodies are positive, which makes the sperm condensate lose activity and leads to infertility.

(6) Psychological factors: mental abnormality, excessive mental stress, and can become a spiritual "crazy" in severe cases, which can cause endocrine disorders and infertility.

(7) Factors of induced abortion: due to repeated or excessive curettage damage to the endometrium basal layer, resulting in amenorrhea or low menstrual flow, it may also cause endometritis, endometrial damage and intrauterine adhesions, which may affect the implantation of pregnant eggs Infertility.

(8) Chemical and physical factors: such as lead and mercury poisoning, smoking, drinking, radioactive factors, environmental changes, lack of trace elements and vitamins, etc., also affect pregnancy.

(9) Systemic diseases: including hypothalamic-pituitary diseases, diabetes, thyroid and adrenal dysfunction.

(10) Others: such as pelvic inflammatory disease, pelvic peritonitis, tuberculous peritonitis, peritoneal endometriosis, etc. can cause infertility.

2. Male factors

Mainly reproductive system infections, such as orchitis, epididymitis or tuberculosis, seminal vesiculitis, prostatitis, urethritis, etc. These bacteria, viruses, protozoa and other infections can directly damage the testes; environmental pollution, direct contact with harmful substances and excessive tobacco and alcohol Both can affect sperm formation, severely affect spermatogenesis and reduce sperm activity, leading to infertility. Abnormal ejaculation in men, including premature ejaculation, non-ejaculation and retrograde ejaculation.

Clinical manifestations of secondary infertility

Women of childbearing age have not had a contraceptive pregnancy during normal sexual life. Those who have been pregnant and have not been pregnant for more than 1 year.

Secondary infertility test

Physical examination

In addition to the general examination, attention should be paid to the development of secondary sexual characteristics. Gynecological examination should pay attention to the development of internal and external genitals, whether there are developmental deformities, inflammation and pelvic mass.

2. Ovarian function test

Female hormone measurement, basal body temperature measurement, cervical mucus crystallization examination, endometrial biopsy before menstruation.

3. Fallopian tube patency test

Tubal drainage, uterine tubal lipiodolography, and fallopian tube ultrasound contrast.

4. Examination of thyroid and adrenal function

5.B-ultrasound, hysteroscopy, laparoscopy

6. Reproductive immunological examination

Diagnosis of secondary infertility

Diagnosis is based on medical history, infertility and auxiliary examinations. A medical history check includes a history of marriage, infertility and sexual history.

Marriage history

The age of marriage, the availability of contraception, the health status of the spouse, and occupations.

2. History of infertility

What kind of tests and treatments were performed at what time and place after suffering from infertility, and how effective were the treatments.

3. Sex life history

Frequency of sexual life, whether there is physical discomfort during sexual life. Also understand the history of abortion in detail.

Treatment of secondary infertility

1. Treatment for the cause.

2. Patients with secondary infertility with gynecological inflammation should be treated promptly and thoroughly.

Prevention of secondary infertility

First of all, to avoid unplanned pregnancies, try to have as little abortion as possible. If you need an abortion, go to a regular medical unit. Change bad living habits, reduce exposure to toxic and harmful substances, actively do good reproductive health care, and prevent and treat reproductive tract infections.