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You have one child, and you’re excited about adding another baby to your family. But sometimes, it’s hard to get pregnant a second time. And if you didn’t have trouble conceiving your first baby, it can be a shock when you don’t easily become pregnant again.

What Is Secondary Infertility?

Secondary infertility is the medical term for not being able to get pregnant again after the birth of one or more children. It refers to women who have already had at least one healthy pregnancy without fertility treatments.

Doctors usually diagnose secondary infertility after a couple tries to conceive for 6 to 12 months without success.

How common is it?

Secondary infertility occurs at about the same rate as primary (first-time) infertility. According to the Centers for Disease Control and Prevention, about 12% of women trying for another child have trouble conceiving.

When should you see a doctor?

If you’re having no luck getting pregnant again, schedule an appointment with your ob-gyn. They may refer you to a fertility specialist.

You should see a doctor if:

• You’re under age 35 and have been trying to conceive for a year or more.
• You’re age 35 or older and have been trying to conceive for 6 months or more.
• You’re age 40 or older and want immediate evaluation and treatment.

If you’re age 35 or older, it’s important to see a doctor quickly. Fertility rates drop rapidly each year after age 35. The sooner you get treatment, the more likely it is that you’ll be able to conceive.

Causes of Secondary Infertility

A woman’s age is a major cause of secondary infertility.

More women today put off having children until their 30s and 40s. However, women experience a rapid decline in fertility in their mid-to-late-30s. If you have your first child after age 35, your odds of getting pregnant again become lower each year.

But doctors don’t always know why a woman can’t get pregnant a second time.

Risk factors in women

Secondary infertility may stem from a combination of factors. These risk factors may play a role:

• Obesity.
• Smoking.
• Adhesions and scarring of reproductive organs.
• Blocked tubes.
• Previous pelvic infections.
• Endometriosis.
• Thyroid conditions.
• Undiagnosed celiac disease.
• Polycystic ovary syndrome.

Risk factors for male infertility

Secondary infertility isn’t only a woman’s issue. It can result when a man has reproductive problems. Low sperm count or poor sperm motility (movement) can cause infertility in men.

Risk factors for male infertility may include:

• Steroid use.
• Obesity.
• Injuries to the reproductive system.
• Age.
• Illness.
• Medicines.
• Environmental factors.

Symptoms of Secondary Infertility

The signs of secondary infertility are the same as for primary infertility. The obvious sign is that you haven’t gotten pregnant despite having 6 to 12 months of unprotected sex.

Women may also notice:

• Irregular periods.
• Long, heavy, or painful periods.
• Unusually dark menstrual blood.
• Premature menopause.
• Severe acne, thinning hair, or unexplained weight gain from hormonal changes.

How Does it Affect Families?

Secondary infertility can have emotional and psychological impacts. It can be a lonely and isolating experience. Friends and family may not be as sympathetic to couples who already have one child.

Couples may experience:

• Depression and anxiety over not being able to conceive.
• Feelings of guilt.
• Jealousy of other families.
• Frustration at not knowing what the future holds.

Couples experiencing secondary infertility need emotional support. They may want to think about getting counseling or joining a support group.

When looking for support groups, try to find those focused on secondary infertility. That way you’re with other people who truly understand your challenges. Plus, you won’t have to feel uncomfortable talking about your struggles with couples who’ve never been able to have a child.

Treatment for Secondary Infertility

In general, doctors treat secondary infertility the same as primary infertility. An appointment with a fertility specialist may include:

• Review of medical and sexual history.
• Semen analysis.
• Blood tests.
• Imaging tests of reproductive organs.

Treatment may include:

• Medicine.
• Surgery.
• Intrauterine insemination (IUI), also known as artificial insemination.
• In vitro fertilization (IVF).

The good news is that many couples can conceive and carry another child with a little medical help. And sometimes, the situation resolves on its own.