Which of the following represents secondary infertility?

Explanation

Core Concept: Secondary infertility is defined as the inability to conceive or carry a pregnancy to term after having had at least one previous successful pregnancy and live birth.

Clinical Presentation:

• Symptoms: Failure to conceive after 12 months of unprotected intercourse (or 6 months if the female partner is >35 years old) despite a history of prior conception.
• Complications: Emotional distress, relationship strain, and underlying acquired medical conditions (e.g., pelvic inflammatory disease, endometriosis, or secondary male factor infertility).

Diagnosis:

• First-line: Semen analysis for the male partner, ovulation tracking, and pelvic ultrasound.
• Gold Standard: Hysterosalpingography (HSG) or laparoscopy with chromopertubation to evaluate tubal patency and pelvic anatomy.

Management:

• Acute: Identify and treat underlying causes (e.g., ovulation induction, treating infections, or surgical correction of anatomical defects).
• Definitive: Assisted reproductive technologies (ART) such as In Vitro Fertilization (IVF) or intrauterine insemination (IUI) if conservative measures fail.