What is secondary infertility?

We look at what causes secondary infertility, get advice from experts and hear what our mums have to say on the issue

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Not being able to conceive when you’ve had a previous pregnancy is called secondary infertility. It affects about 5% of the population and, as it comes pretty much out of the blue (especially if baby number one came pretty quickly) it can be really hard to deal with.

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Fertility advisor Emma Cannon says you can only truly say you have secondary infertility “if you’ve been trying for a year and are having sex 2 or 3 times a week without seeing any results”.

With this in mind, she says that nearly half the women she sees who suspect secondary infertility actually don’t have a problem at all.

“Expectations are really high after conceiving quickly the first time, so women often panic when it doesn’t happen as soon the second time around,” she says.

What’s causing it?

You may have conceived your first child quickly, but if there’s a big gap between your first and second, the fact is, your fertility levels may have dropped.

Your egg quality declines after you turn 35 and your egg quantity goes down year by year, also you’re more at risk of getting fibroids, which can interfere with fertility.

“Lots of women are having babies later in life, so they’re in a rush to fit them all in,” says fertility expert Zita West. “This can mean they’re not giving their bodies a full 18 months to recover from the first birth, which could be affecting things.”

“Another possible explanation is that before trying for the first baby, many parents have eaten healthily, watched their weight, not drank or smoked, but second time around complacency may have set in.”

Then there’s the tiredness and stress of parenting your first, which may interfere, especially if it stops you having sex as regularly as you would before you and your partner had children.

“The previous birth could also play a part,” says Emma. If there are any problems with scarring or a womb infection after delivery or a c-section, this might make it more difficult for the egg to implant due to a tube blockage.

“And if you’re still breastfeeding, the prolactin hormone interferes with ovulation and may also stop you conceiving,” says Zita. However, reducing feeding times, especially at night,
may rectify this.

Could it be PCOS?

Polycystic ovary syndrome, or PCOS, when a woman has small cysts in her ovaries and may not release eggs regularly, can also be a cause.

“Sometimes it goes undetected in a first pregnancy and only causes problems when a woman tries again,” says Zita. One symptom of PCOS is weight gain and being overweight can aggravate other symptoms, which include an irregular menstrual cycle, acne and hair growth.

Where to get help

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

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.

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Try-at-home tips

Having a healthy lifestyle with regular exercise and a balanced diet that doesn’t include smoking or drinking will give you the best chance of conceiving.

Regular intercourse will increase your chances too. Sperm can stay alive for four days in your Fallopian tubes, so if they’re ready and waiting for when the egg is released you’re increasing your chances.

“Secondary infertility can be a stressful journey, so anything that can calm the mind, like acupuncture, aromatherapy, meditation or yoga might be worth trying,” says Emma.

“Yoga and acupuncture are good for helping the blood flow in the uterus, promoting fertility and yoga helps to regulate your brain, which controls hormones.”

Chatting to other women going through the same thing can help, too -check out our forum to see other mum’s stories.

Asking for support

Susan Seenan, chief executive of leading patient fertility charity Fertility Network UK says, reveals that a lot of parents feel guilty about being so sad not to conceive again: “[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, but 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.

“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.

“In addition, for couples who have conceived naturally first time around it may be incredibly difficult to deal with the fact that it’s not happening for them in the same way again.”

Mums’ stories

“It only took me a month to conceive my first child Jacob, so when it didn’t happen so quickly the second time, I started to worry,” says Nicola S. “I just couldn’t understand why it wasn’t happening, as Jacob being there showed that I was able to conceive.

“Although I felt completely blessed to have one baby, in some ways I wonder if it’s harder than primary infertility – I knew how fantastic being a mum was and was terrified I’d never get the opportunity again. People kept saying to me, ‘At least you’ve got Jacob,’ and although they were right, and I was so grateful for him, I couldn’t settle with just one, despite feeling guilty for complaining.

“After seven months of trying without any luck, I started to get concerned and went to see my GP. I’d noticed my periods had become a bit erratic when they were normally very regular and after a series of tests he diagnosed me with polycystic ovary syndrome (PCOS) and referred me to a consultant for further tests.

“After checking my Fallopian tubes were clear, they put me on the fertility drug Clomid, which stimulated my ovaries, and metformin, which helped with the side effects of PCOS. Two months later I was pregnant.

“The doctors thought I could have developed PCOS after my first pregnancy, but because I went on the pill after having Jacob I wasn’t able to tell if my periods were irregular or not until I came off it and decided to try for another baby.

“Theo arrived nearly two years after I first started trying for him. My advice to other couples is to never give up, as he’s proof that it’s worth every ounce of effort and patience you put in.”

“Second baby took 7 years. Totally worth the wait though. She’s perfect ❤️  ” says Maryanne C.

“First baby, I got pregnant straight after coming off the pill, 2nd took 3 yrs and ended in me having fertility treatment (clomid) got pregnant on the 4th attempt,” says Katy A.

And Michelle B says: “First I’m not sure [how long we took to conceive] – she was a complete surprise. 2nd – 4 years. Been 9 years and counting for our 3rd…”

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