What You Should Do if You're Facing Secondary Infertility

Causes + Testing and Treatment + Why It's Emotionally So Difficult

Couple on beach with child, secondary infertility preventing them from having another
Secondary infertility has the same causes and treatments as primary infertility.. VisitBritain/Daniel Bosworth / Britain On View / Getty Images

Secondary infertility is when a couple has had at least one child, is trying to get pregnant again, but doesn’t conceive after at least one year of trying.

Secondary infertility can be confusing and mind-boggling. You had no trouble getting pregnant last time. So, why isn’t it happening now?

Many people think primary infertility is more common than secondary infertility. Primary infertility is when a couple has never had children and can’t conceive.

However, the truth is the numbers are half and half.

According to the Center for Disease Control, 11% of couples who already have a child go on to experience secondary infertility. That's approximately 4 million families, or about half of all infertility cases.

Couples experiencing secondary infertility may be more likely to put off seeking help. They may also find that friends, family, and even doctors downplay their fertility struggles.

After all, they have one kid. (Or two kids, or more...) Isn’t that enough?

The truth is that whether you’re struggling for child number one, number two, or number five, there is anxiety and grief to confront. Coping with secondary infertility has its own challenges.

You have an image of what you thought your family would be. Your child may be asking for a sibling. And the medical causes of secondary infertility aren’t any less difficult to treat and diagnosis than primary infertility.

What Causes Secondary Infertility?

Secondary infertility is caused by the same problems that lead to primary infertility.

Those causes include:

  • Male infertility due to low or absent sperm count, problems with sperm shape (also known as sperm morphology), or problems with sperm movement (also known as sperm motility)

About one-third of infertility cases are related to male infertility, another third are related to female infertility, and another third are related to problems in both the man and woman, or remain unexplained.

Why Can’t I Conceive This Time Around?

This is the biggest question in the minds of those experience secondary infertility.

Secondary infertility may strike when...

You’re older: if you had your first child at 35, and you’re trying for a second at 38, your fertility has naturally declined significantly.

Age is a major cause of secondary infertility.

You’re with a new partner: it could be your new partner has an undiagnosed infertility problem. But it’s also possible the one with kids from a prior relationship has developed a fertility problem.

Either situation can occur.

An underlying fertility problem has worsened: it’s possible you always had endometriosis, or you always had sub clinical PCOS. Maybe your ovarian reserves were already on the down slide, but you had no idea.

Time has passed, and things have worsened. It happens.

You’ve gained weight: fertility is affected by weight. Being over or under weight can cause ovulation problems in women, and possibility impact sperm health in men.

New parents often gain weight (partially from the pregnancy, partially from the stress and lack of sleep.) This may be enough to push you to the infertile side.

You have a new health problem: perhaps you or your partner has developed diabetes. Maybe he's taking medication for high blood pressure. Or, perhaps you’re suffering from depression.

Any of these illnesses may impact your fertility or require medication that can impact your fertility. 

The last pregnancy or birth caused a fertility problem: pelvic infection or multiple D&C procedures may cause uterine adhesions or blocked fallopian tubes.

If you had a C-section, you may develop scar tissue, which can impact your fertility.

There’s no clear reason why this time is different: many times, no one can tell you why your particular fertility issue didn’t stop you from conceiving last time.

There’s a lot about fertility that we don’t understand. No one has all the answers.

When Should You Seek Help?

If you are under than 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.

Also, no matter how old you are, if you experience two consecutive miscarriages, you should get help.

Some couples think they should keep trying even after the year mark passes. Didn’t they conceive last time? Clearly, if they just keep trying, they will succeed this time. Right?


Please don’t put off getting help. Some causes of infertility worsen over time. Delaying help may reduce your odds for pregnancy success.

The fact that you got pregnant in the past doesn’t guarantee you’ll conceive again on your own.

Sadly, there are no fertility guarantees, for anyone.

Testing for Secondary Infertility

Testing for secondary infertility is the same as testing for primary infertility. Both the man and woman need to be checked.

Maybe you’re with a new partner, and one of you has had a child and the other has not. Does the “proven fertile” partner really need fertility testing?

The answer is yes. They do.

As mentioned above, having had a children doesn’t mean you can’t experience infertility.

Secondary Infertility Treatments

Treatments for secondary infertility are the same as for primary infertility. Treatments may include:

  • Fertility drugs, often starting with the most commonly prescribed fertility drug Clomid
  • Injectable fertility drugs, known as gondotropins
  • IUI
  • IVF, sometimes in combination with other assisted reproductive options
  • Surgery, usually laparoscopic surgery, to repair blocked fallopian tubes, or to remove fibroids or endometriosis deposits

As you seek out a solution for your fertility problems, you may have friends and family that don’t approve of your decisions.

They may wonder why you’re “trying so hard.” Why don’t you “just relax?” It happened last time, it’ll happen again.

These friends and family are wrong. Be assured that your need for treatment is the same as someone with primary infertility.

It is not an "extreme measure" to use medical treatments that may help you have the child you desire.

More on infertility symptoms and getting help:


Chandra A, Martinez GM, Mosher WD, Abma JC, Jones J. Fertility, family planning, and reproductive health of U.S. women: Data from the 2002 National Survey of Family Growth. National Center for Health Statistics. Vital Health Stat 23(25). 2005. http://www.cdc.gov/nchs/data/series/sr_23/sr23_025.pdf

Secondary Infertility. RESOLVE: The National Infertility Association. http://www.resolve.org/diagnosis-management/infertility-diagnosis/secondary-infertility.html Accessed July 29, 2010.

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