Secondary Infertility Causes, Diagnosis & Treatment: Everything You Need to Know

Secondary infertility affects millions of women — and yet it remains one of the most isolating diagnoses in the fertility space. You already have a child, so you feel like you can't complain. But the confusion, grief, and frustration are completely real. In this solo episode, Dr. Sasha Hakman breaks down exactly what secondary infertility is, why it happens, and what to do about it — including causes that will genuinely surprise you. If you've been pregnant before and are struggling to get pregnant again, this episode was made for you. In this episode, we cover: What secondary infertility actually is by definition — and why pregnancy loss counts too, even if you never brought a baby home Ovulatory dysfunction: why it's the #1 cause of secondary infertility, how PCOS, thyroid disease, and high prolactin play a role, and how postpartum weight changes can quietly shut down ovulation How to track your cycle and confirm ovulation at home — including Dr. Sasha's favorite tools (Inito, LH strips, and progesterone testing) The age factor no one talks about enough: what the statistics actually say about childless-not-by-choice rates for women 35–40 and 40+ Premature ovarian insufficiency (POI): why some women enter early menopause between babies — and why waiting too long between pregnancies can dramatically change your options Tubal disease and endometriosis: how tubes that were once open can become blocked between pregnancies, and what an HSG actually involves Uterine factors: fibroids, polyps, Ashman syndrome, and why a saline infusion sonogram catches what a regular ultrasound misses Male factor infertility: why "he already has kids" is not a reason to skip the semen analysis, and how sleep deprivation, weight gain, and lifestyle changes after baby can tank sperm quality Unexplained secondary infertility: why it's the most frustrating diagnosis, and how Dr. Sasha expands her workup to look for hidden endometriosis, insulin resistance, and sleep disruption C-sections and fertility: what a meta-analysis of 600,000 women found about C-section's impact on subsequent pregnancy and live birth rates Isthmocele explained: what it is, how a C-section scar defect can trap fluid and create a hostile environment for embryos, and how it's diagnosed and treated Why Dr. Sasha pursued a VBAC after her first C-section — and the fertility reasoning behind that decision The full diagnostic workup for secondary infertility: what your doctor should be evaluating and what to ask for if they're not Treatment options: from super ovulation with IUI to IVF, to surgical correction of structural issues — and how the approach depends entirely on what the workup reveals Why breastfeeding may be the simplest thing standing between you and your next pregnancy Follow Dr. Sasha! TikTok: @sashahakmanmd Instagram: @sashahakmanmd @tryingpod YouTube: @sashahakmanmd Want to receive my weekly newsletter? Sign up at sashahakmanmd.com/newsletter for updates, Q&A answers and more! If you haven't already, please rate, review, and follow the podcast to be notified of new episodes every week. If you're interested in becoming a patient go to sashahakmanmd.com to learn more! Thank you to our sponsors! If you're in the infant stage or know someone who is, check out the Momcozy Night Pro Bottle Warmer or the DeepClean Bottle Washer D8. They're offering 20% off if you go to momcozy.com and use code TRYING. For a limited time, our listeners get $20 off to unlock their new health intelligence. Head over to Superpower.com and use code TRYING for $20 off your $199 Superpower membership. Learn more about your ad choices. Visit megaphone.fm/adchoices