Secondary infertility: Why getting pregnant again isn’t always easy—and what to do if you’re struggling

“Secondary infertility is defined as the inability to conceive after previously having one or more successful pregnancies. Research indicates that approximately 10–15% of couples experience it.”

However, don’t just assume you’re experiencing secondary infertility if you’ve been trying for longer than you did first time, as there could be many other reasons, and secondary infertility is only diagnosed after a set period of time.

“A couple would be diagnosed with secondary infertility if they haven’t conceived after trying naturally for at least 12 months,” says Dr Carole.

“That 12-month timeframe is a bit arbitrary and really depends on the couple. We’d always recommend getting a fertility check-up—or MOT—if the woman is 35 or older, as fertility does decline with age. It’s also worth checking in sooner if either partner has a medical condition that could affect fertility—like recent surgery to the ovaries, uterus or testicles, irregular periods, or complications from a previous pregnancy or delivery that could have affected the fallopian tubes or uterus.”

What causes secondary infertility?

If your first baby came easily, it can feel confusing—and frustrating—when the second takes longer. But if there’s a big age gap, or you’re trying again later in life, it could be down to changes in your fertility.

“A woman’s egg genetic health declines with age over 35, and a man’s sperm genetic health declines over the age of 45,” explains Dr Carole Gilling-Smith. You’re also more likely to develop fibroids as you get older, which can interfere with conception.

And it’s not just age.

Lots of women are having babies later in life, so they’re in a rush to fit them all in.

“This rush can mean they’re not giving their bodies a full 18 months to recover from the first birth, which could be affecting things,” explains Zita.

There’s also a difference in mindset the second time around. “Before trying for the first baby, many parents have eaten healthily, watched their weight, and avoided drinking or smoking—but second time around, complacency may have set in,” Zita adds.

Dr Carole agrees: “Lifestyle factors such as obesity, smoking, excessive alcohol consumption, and high stress levels can all impact fertility.”

Then there’s the emotional and physical toll of parenting itself. “There’s also the tiredness and stress of looking after your first, which may interfere,” says Zita. “Especially if it stops you having sex as regularly as you did before becoming parents.”

Sometimes, complications from your previous birth may be part of the picture too. “Previous pregnancy complications such as miscarriages or complications during delivery can play a role in future fertility,” says Dr Carole.

Underlying health issues may also affect your chances. “Medical conditions such as polycystic ovary syndrome, endometriosis, thyroid disorders and pelvic infection can affect female fertility, while in men, varicocele or sexually transmitted diseases—and even taking antidepressants—can impact sperm health,” she adds.

And if you’re still breastfeeding, that could be a factor too. “The prolactin hormone interferes with ovulation and may also stop you conceiving,” says Zita. “However, reducing feeding times, especially at night, may help regulate things again.”

Could it be PCOS?

Polycystic ovary syndrome (PCOS) is a common condition where small cysts develop on the ovaries, which can affect ovulation and make it harder to conceive. And while it’s often talked about in relation to first-time fertility issues, it can also be the reason you're struggling to get pregnant again.

“Sometimes it goes undetected in a first pregnancy and only causes problems when a woman tries again,” says fertility expert Zita West.

One of the key symptoms of PCOS is weight gain, which can make other symptoms worse—including irregular periods, acne and excess hair growth. All of these can impact your chances of conceiving naturally.

Where to get help if you think you have secondary infertility

Unfortunately, there’s less support available for secondary infertility, as priority is given to childless couples.

After one to two years of trying for a second baby, without a pregnancy, a GP will normally agree to start testing for abnormalities.

Couples will be tested to check the woman is ovulating properly and that the man’s sperm is normal.

If you’re over 35 you may be tested sooner because the longer you wait the less chance you have of being successful.

Treatment options for secondary infertility

If tests show you have a problem, you will need to look into the four main fertility treatment options.

These are Clomid, tablets to stimulate your ovaries, IUI, when your partner’s best sperm is selected and placed in your uterus, IVF, injections to stimulate egg production, which are then collected and mixed with your partner’s sperm, and ICSI where a single sperm is injected into each egg collected.

Your treatment will differ depending on the reason for your infertility, but the majority of primary care trusts won’t fund treatment for couples that already have a child. Check out the Fertility Network for info on what funding is available to you.

“For women with polycystic ovary syndrome, hormone treatment can help to regulate ovulation,” says Dr Carole.

“In vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) are often advised to overcome issues such as blocked fallopian tubes, male factor infertility and unexplained infertility (when no cause is found). And surgery is sometimes advised for conditions like endometriosis or uterine fibroids.

“Success rates for treatments depend on numerous factors including age, the specific cause of infertility, and overall health. There is no compelling evidence to show that success rates are lower in secondary infertility and, many couples achieve successful pregnancies through these interventions.”

At-home tips that could make a difference

Making a few lifestyle changes can go a long way in supporting your fertility—and often, it’s the best place to start. Eating a balanced diet, exercising regularly, and avoiding smoking, alcohol and recreational drugs can all boost your chances of conceiving.

“Lifestyle modifications such as weight management, stopping smoking and recreational drugs, and dietary changes can all improve fertility,” says Dr Carole Gilling-Smith. “But you need to work on these consistently for at least three to six months to see an effect.”

Timing matters too. Having regular sex—ideally every couple of days—can help maximise your chances, as sperm can survive for up to four days in the Fallopian tubes, waiting for the egg to be released.

And don’t underestimate the impact of stress. Secondary infertility can be emotionally draining, so anything that helps you feel calmer—whether it’s acupuncture, aromatherapy, meditation or yoga—might be worth exploring.

Where to get support with secondary infertility

The emotional toll of secondary infertility is often underestimated. Many parents struggling to conceive again feel isolated, frustrated—and even guilty.

Susan Seenan, former chief executive of leading fertility charity Fertility Network UK, says these feelings are incredibly common, but no less valid than those experienced by first-time hopefuls.

“Secondary infertility can be every bit as painful and difficult to deal with as primary infertility, and couples suffering from secondary infertility deserve support and understanding, just as much as anyone who is trying to conceive for the first time,” she says.

Just because you have a child doesn't mean you can switch off the longing to have another baby.

There’s also a unique emotional layer that comes with already having a child. “There is often a sense of guilt about this—a feeling that you should simply be grateful for the child you have when others are still trying for a first.”

Existing children may also add unintentional pressure. “Often, there can be the added pressure of existing children asking why they can’t have a brother or a sister. This can exacerbate the emotional impact felt when trying for a second baby: not only is there the pain and longing for another child, there is the feeling of guilt that you can’t provide a brother or sister and that your only child may be missing out.”

And for couples who conceived quickly the first time, the change can feel jarring. “It may be incredibly difficult to deal with the fact that it's not happening for them in the same way again,” she adds.

Pics: Getty

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