Why Can’t I Get Pregnant Again? The Truth Behind Secondary Infertility

If you already have one child, or more, and are struggling to get pregnant again, this may come as a surprise. Unfortunately, it’s not uncommon to face challenges the second time around. In this article, we’ll explore the possible causes of what is known as secondary infertility and when to seek support.

What is Secondary Infertility?

Secondary infertility is defined as the inability to conceive after having previously conceived and carried a pregnancy to live birth. While it isn’t as often discussed, secondary infertility is as common as primary infertility affecting 1 in 8 couples.

Potential Causes of Secondary Infertility:

To properly treat secondary infertility, it’s important to understand what’s behind it. Often, the causes of secondary infertility mirror those of primary infertility including:

• Endometriosis
• Fibroids or scarring
• Polycystic ovarian syndrome
• A low amount of eggs in your ovaries (also known as diminished ovarian reserve)
• Certain autoimmune disorders
• Male infertility such as issues with sperm count, shape, or movement

Factors like age or increased weight gain can also impact one’s fertility. Unfortunately, in many cases, the cause can be unexplained, meaning there is no definitive underlying medical cause. It can be frustrating not to have answers. While there is still a lot we don’t know about infertility, we have come a long way in terms of treatment and support.

Medical Help and Support

Fortunately, through advancements in science there are now a variety of treatments available to help couples achieve their goals of parenthood. The treatment options are similar to primary infertility including:

• Intrauterine Insemination (IUI), where sperm is inserted into the uterus at the time of ovulation.
• In Vitro Fertilization (IVF) where sperm and egg are fertilized outside the woman’s body. A resulting embryo is then placed back into the uterus in hopes of implantation.
• Medications, such as Clomid, can balance out hormones and help you ovulate.

If you are under 35 years old, you should seek help if you don’t conceive after one year of trying. If you are 35 years old or older, you should get help after six months. Couples may be hesitant to seek help if they were able to conceive before, but it’s important to know that you don’t have to wait.

Just like primary infertility, secondary infertility can bring with it a unique and complex set of emotions. Feelings of guilt, sadness, grief, and fear of judgement are all common. It’s important to remember that no matter what you’re experiencing, your feelings are valid. Just because you had success in your first pregnancy, doesn’t make the pain of secondary infertility any less impactful. It’s also important to remember that you’re not alone.

A reproductive endocrinologist trained in supporting couples with infertility can help you to explore your options. Our fertility partners are here to help you through each step!

In addition to medical support, caring for your emotional wellbeing is just as critical. Some may find it helpful to join an online forum to connect with others experiencing secondary infertility. Organizations like Resolve have support groups specific to those with secondary infertility. It can be helpful for some couples to find support through therapy and the support of a licensed mental health professional.