Everything you need to know about so-called "secondary infertility".

If your first child came on the first try and without effort, you surely believed that the same would happen with the second one. But you have found that you are struggling more than you expected. Maybe you've never heard the term before, but it exists and it's called "secondary infertility" and unfortunately it's a phenomenon whose rates are increasing. But don't get worried! There are explanations and solutions for everything.

What is secondary infertility?
• What is the difference between primary and secondary infertility?
• What can I do about secondary infertility before seeking help?
• Some tips you can apply
• When to seek help

What is secondary infertility

Secondary infertility is defined by doctors as the inability to conceive or give birth to a second or subsequent child. An American study revealed that in 1995, 1.8 million women experienced secondary infertility, while in 2006 the number rose to 3.3 million! Secondary infertility now accounts for 6 out of 10 infertility cases..

What is the difference between primary and secondary infertility?

Primary infertility is a problem in conceiving your first baby, while secondary infertility is a problem in your second pregnancy, when you already have a child.
When you're dealing with secondary infertility, you're not only dealing with the typical ups and downs of trying to conceive, but also the additional emotional consequences that are unique to those who struggle to conceive their second baby. In addition to feeling in denial, frustrated and upset, you may also feel guilty and even isolated.
If you have said the following phrases, then you have to keep reading this article:
"I got pregnant so easily the first time, there's no way I'm having infertility issues"
"How to get pregnant with the second child"
"Maybe I should consider IVF for the second child"
"But why did I get my period again when I did everything right on my fertile days?"
"I already have one child, so I should be happy even if I don't have a second one"
"I can't hang out with my friends who have kids."
Let's analyze things in more detail:
You've had your first baby and you think getting pregnant for a second time will be just as easy. But you find that this is not the case…
We will explain why this might happen and suggest ways to have a successful pregnancy if you're having trouble conceiving after your first child. While many couples have no problem conceiving for the second time, millions of couples are facing secondary infertility for the first time, according to the National Center for Health Statistics. This includes couples who experienced infertility but eventually had a successful pregnancy.

As we said, secondary infertility is the inability to conceive or conceive after the birth of the first child. There are many moms who wonder: "why can’t I have a second child, when I already have one?".

Read eight possible reasons why you may be having trouble getting pregnant again - and when you should seek help:
1. You are a woman over 35 years old
Perhaps unsurprisingly, one of the most important factors affecting a woman's chance of getting pregnant is age. Changes in hormones and the risk of certain diseases also increase as we age, so both can affect fertility, especially in women over 35 years old. But if you're in your 30s and still wanting a second child, don't despair. It might take longer, but that doesn't mean you won't get pregnant again - it just means you have less time in your hands.
2. You are a man whose sperm count is low
You probably know that age, health, or medications sometimes affect sperm quality or quantity. Men often are surprised to learn that some common practices can reduce sperm production, such as: taking testosterone supplements, exposing the testicles to heat (tight clothing, using electronic devices, etc.). You can check your sperm at home with the fertilitySCORE male fertility test.
3. You are a woman with polycystic ovary syndrome
Polycystic ovary syndrome (PCOS), a hormonal imbalance that can disrupt ovulation, is a common cause of secondary (and primary) infertility. If your period is irregular or absent, talk to your doctor to see if you have PCOS.
4. You are overweight
For both men and women, excess (or extremely low) weight can cause obstacles to conception. In women, extra pounds (or less than normal) can contribute to insulin resistance and elevated testosterone levels, which can suppress ovulation. Also, implantation (of the fertilized egg) rates are lower for those who are overweight (or underweight) than for those of a healthy weight. For men, being overweight can increase estrogen levels, leading to a lower sperm count.
5. Alcohol consumption
For both men and women, drinking too much alcohol can cause problems with conception. What does "moderate to heavy" drinking mean? More than two drinks a day or more than seven drinks a week. This will increase the time it will take you to conceive.
6. Smoking
We all know that smoking is generally not good for health. But did you know it can ruin your fertility? Women who smoke are more likely to experience infertility. Smoking can damage eggs and cause problems with ovulation. Also, research has shown that smoking can damage sperm DNA.
7. Injuries to the uterus
Sometimes there are other problems related to a complication that occurred in a previous pregnancy or before delivery, such as scarring of the uterus or damage to the fallopian tubes. These should be considered in depth before trying for a second child.
8. Anxiety about the second child
When dealing with secondary infertility, it's natural to be overwhelmed by a variety of emotions. The most common of these are:
Anxiety that you will not succeed, especially every month when your period comes and you feel like you have not succeeded.
Disappointment, because for the second child you understand that you are having a lot of difficulty, while the first one came very easily.
Jealousy, when you see friends or relatives having children.
Isolation, as your desire is not fulfilled and you feel like you don't want to socialize with groups, especially those that include children.
Guilt, since you cannot give your existing child a sibling.

All of the above create stress that is manageable for some women and not for others. Through stress, however, there must be a little hope every month that you will succeed, since each cycle means a new beginning!


What can I do about secondary infertility before seeking help?

Before seeking help from a specialist, try to improve your fertility yourself.
Just a reminder - even for the healthiest of couples there is only a 20-25% chance of conceiving in each cycle – which means there is a 75-80% chance you won't make it every month!

See some tips you can apply:

• Assess preconception preparation. Take a step back and review your cycles. See if they are still regular or if there have been changes after having your first child. Do you pinpoint your ovulation each month or do you just have intercourse when you assume you're on your fertile days? To get back in the game, you need to track your ovulation with ovulation tests and have intercourse as soon as you get a positive result.
• Review your diet. If your eating habits have changed since you conceived your first baby—especially if they've changed for the worse—improving your diet can help you get to conception faster. See e.g. the possible high consumption of caffeine, which may contribute to secondary infertility.
• Assess your health status. Have you started any medications that may prevent conception? Have you developed a chronic condition after your first baby was born? Changes in your health may be responsible for secondary infertility.
• Get on the scale. Have you lost or gained weight since your last baby? Your weight can affect your fertility, so being close to a healthy Body Mass Index (BMI) can also help you get closer to that second pregnancy you so desire.
• Take stock of your current lifestyle. If you smoke, it's probably time to throw away your cigarettes. Smoking is known to age eggs and reduce fertility. Also, see if you get a few hours of sleep. Neglecting your sleep can cause hormonal problems, as well as potential fertility problems. Finally, if a new unhealthy habit has crept into your lifestyle, now is the time to get rid of it. This of course also applies to your partner. A healthy lifestyle positively affects the quality of his sperm.

When to seek help

Wondering if it's time to seek help for secondary infertility by an expert?
If you're trying to get pregnant again, try to relax and not worry too much — at least at first. Your age, of course, can help you understand the answer.
If you're under 35, it's perfectly normal to take six months to a year to conceive. If, after a year, you have not reached your goal, you should talk to your doctor and/or be referred to a fertility specialist.

If you are over 35, you should seek help from a fertility specialist after six months of regular trying.
If you're over 40, you'll probably want to start right away with a fertility evaluation by your doctor. So does your partner, if he's over 40, it's a good idea to have his sperm quality assessed.

In general, the diagnosis and treatment in this case are the same as those for infertility. However, there is a theoretical advantage as women with secondary infertility in several cases are more likely to see an effect with treatment than women who have not had a child. Even if you didn't face any problems in your first pregnancy, if you see time passing by and you can't get pregnant again, don't hesitate to consult your doctor.