If getting pregnant the first time around was a cinch, you may have expected that you’d be able to score a second pregnancy just as easily. But because many couples have secondary infertility, that’s not always the case.
What is secondary infertility?
Secondary infertility is the inability to become pregnant or carry a pregnancy to term after you’ve already had a baby.[1] It's more common than you might think, accounting for about 50 percent of infertility cases.
In fact, more couples experience secondary infertility than primary infertility (infertility the first time around). It’s especially common in women in their late 30s or 40s who are trying to have their second babies.
What causes secondary infertility?
Sometimes problems getting pregnant for a second or subsequent time are related to a complication that occurred in a prior pregnancy or prior to delivery, such as uterine scarring or damage to the fallopian tubes.
But most often, secondary infertility is caused by the same factors that would cause primary infertility — issues like age and ovulation problems.[2]
What can I do about secondary infertility?
Before you enlist the help of a doctor for secondary infertility, see if there’s something you can do on your own to give your fertility a boost. Remember, even in the healthiest (and youngest) of couples, there’s only a 20 to 25 percent chance of conceiving each cycle — which means there’s a 75 to 80 percent chance of striking out each month.
Here are a few things you can do:
Assess your preconception prep
It’s not easy for wannabe second-time parents to devote as much time and energy to TTC as they likely did on the first go-around. So take a step back and ask yourself if your cycles are still regular, or whether there have been any changes that might be interfering with your chances of conceiving.
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For instance, have you been able to pinpoint ovulation with accuracy, or are you just having sex whenever (which would make conception less likely)? Getting back on track with tracking your fertility — or even using an ovulation predictor kit — may be enough to put you back in the game.
Reexamine your diet
If your eating habits have changed since you conceived baby number one — especially if they've changed for the worse — shoring up your diet may help you close in faster on conception. For example, has your caffeine consumption gone up now that you’re a mom? That’s understandable, but too much caffeine isn’t great for fertility and might even be contributing to your secondary infertility.
Losing or gaining weight since your last baby was on board may also have something to do with it. Your weight can impact your fertility, so getting as close as possible to a healthy BMI can also help get you closer to that second pregnancy you’re hoping for.
Take stock of your lifestyle habits
Has the stress of a new baby caused your smoking habit to return? If yes, it’s time to kick butt, since smoking decreases fertility. Or, are you getting way too little sleep? While understandable, skimping on sleep can mess with your hormones — and possibly your fertility.
If any new unhealthy habit has slipped into your lifestyle, now’s the time to put the brakes on it. And it’s not just about you. If your partner is kicking back one too many beers or has started smoking, that could be affecting his sperm quality too.
Consider your health status
Have you started any medications that might be interfering with conception? Has a new chronic condition that’s cropped up since your first baby was born?
Changes to your health could be responsible for secondary infertility. The good news is that some simple health modifications — like switching to a more fertility-friendly medication, for instance, or getting your chronic condition under control — could bring you closer to the second baby of your dreams.
What's the difference between primary infertility and secondary infertility?
Primary infertility is trouble conceiving your first baby, whereas secondary infertility is trouble getting pregnant the second time around, after you've already had a baby.
When should I visit the doctor?
Wondering if it’s time to seek help for secondary infertility from a specialist? Your age can help clue you in to the answer.
If you’re younger than 35, it’s perfectly normal for it to take six months to a year to conceive. If you haven’t accomplished your conception goal after a year, you’ll want to talk with your practitioner and/or get a referral to a fertility specialist.[3]
If you’re older than 35, experts recommend that you seek help from a fertility specialist after six months of regularly trying to conceive without birth control — and you may even want to go after three months.
If you’re over 40, you’ll probably want to start off your quest for a second pregnancy with a fertility evaluation from your doctor. Ditto if your partner is over 40, since 35 to 40 percent of fertility problems can be traced back to the man, and a guy’s age affects the quality of his sperm.
Of course, if you have a history of infertility or any factors that might impede fertility, it makes sense to arm yourself with the right help right from the start.
Once you make that appointment with a fertility specialist, you and your doctor will follow the same treatment plan for secondary infertility that would be put into place if you were dealing with primary infertility.
Tips for coping with secondary infertility
When you face secondary infertility, you’re dealing not only with the typical ups and downs of trying to conceive, but also with the additional emotional fallout that is unique to those having difficulty getting pregnant with baby number two.
In addition to feeling disappointed and upset, you may also be feeling shock ("I got pregnant so easily the first time, there’s no way I could have infertility problems"), guilt ("I already have a child, so I should be happy") and even isolation ("I can’t connect with the people facing primary infertility, and I can’t connect with my friends who have multiple kids").
How do you reconcile these conflicting emotions — and how do you tackle them while trying to raise the child you already have? Here are some tips:
Acknowledge your feelings
When dealing with secondary infertility, it’s very common to feel shock or denial. After all, making one baby might have been a piece of cake for you, so you probably assumed that having a second one would be easy, too. Your friends and even your doctor may also downplay your current infertility problems (telling you not to take it so hard or to "just keep trying") since you had no trouble before.
But secondary infertility is much more common than most people realize. So allow yourself the chance to accept the idea that you may be battling secondary infertility — because once you do, you can tackle the problem head-on.
Let go of any guilt
While you probably feel disappointed and sad about your infertility problems, you may feel guilty giving in to those emotions. Parents facing secondary infertility often feel they don’t have the "right" to feel upset because they should be grateful for the child they already have.
But if you want more children and are having trouble getting pregnant again, you're just as entitled as anyone else to feel depressed or angry. The last thing you need when you’re coping with secondary infertility is to let guilt weigh you down even more.
Talk it out
Once you realize you’re entitled to your emotions, find an outlet for them. Talking about your feelings can be a huge release and allow you to receive the support you need.
If your family or friends don’t understand your sadness (or you find it hard to contain your baby envy around friends with more than one child), seek out people in your same situation. Find a support group for people with secondary infertility — online or in your area. And consider joining What to Expect's Secondary Infertility group to find moms who are also coping with the same thing.
Spend quality time with your child
In the midst of your secondary infertility problems, you may feel especially upset about shifting your focus from the child you already have to the child you’re longing to have in the future. You may even feel guilty about your inability to give your little one a sibling or about the sadness that may be spilling over into her life.
The best thing you can do for your child is to keep life as normal as possible, and ideally, find some quality time to be together. Whether it’s a chat about her day before you tuck her into bed or an afternoon romp in the park, those rituals will go a long way toward keeping your tot’s world stable and happy — even if yours feels anything but.
If you fear that you may have a hard time handling your true emotions in front of your child (say, your pregnancy test just came up negative for the zillionth time in a row), see if you can arrange to send her to a friend’s house, or enlist your partner or a family member to take over for a bit. Allowing yourself the time to compose yourself can make it much easier to face your little pride and joy with a smile.
Connect with your partner
Remember that you aren't the only one coping with secondary infertility, and while your partner may be dealing with it differently, it can be extremely helpful to check in with each other emotionally. Set aside some time to talk about how your secondary infertility problems are affecting each of you.
If you're tired of talking about it, plan a date night that's totally unrelated to any baby-making duties. Since secondary infertility problems can take a toll on any relationship, date nights are needed now more than ever to keep the love and fun flowing. An added bonus: Since lowering your stress levels could also improve your fertility, enjoying just being a couple could even increase your odds of achieving that second pregnancy.
If you decide to seek out a fertility specialist, know that there are technologies available — including artificial insemination (AI) and in vitro fertilization (IVF) — that can help boost the odds of a successful pregnancy.
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