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What Is Secondary Infertility? 6 Ways to Manage

05.26.2023 / Melissa Wallace
What Is Secondary Infertility? 6 Ways to Manage

So, you’ve already had a baby and you’re ready for another — but things aren’t coming as easily the second time around. You might be experiencing a phenomenon called "secondary infertility."

If you’re having trouble conceiving a second time, you’re not alone. Secondary infertility is just as common as primary infertility, affecting about one in ten women. Yet unlike primarily fertility, it can be an emotionally difficult condition to navigate as you raise your first child. Here’s how to manage.

What it is     Causes     Diagnosis     Treatment   How to manage

What is secondary infertility?

According to the Mayo Clinic, secondary infertility is defined as the inability to become pregnant or to carry a baby to term after previously giving birth. The National Center for Health Statistics (NCHS) estimates that there are more than three million women in the US with one child that have had a difficult time getting pregnant again, or carrying another baby full-term.

But we need to talk beyond the statistics, because secondary infertility is emotionally difficult on both us and our partners. Because we already have a child, it’s difficult to not be immersed in a world where you’re constantly reminded of your inability to conceive. 

“When my wife and I had our first child, we got pregnant pretty easily. Honestly, as I look back on it, it had to have been the very first or second cycle we were trying. Unfortunately, today, we are here two years into working on our second and no luck. We constantly talk about whether or not it's too late now. It's the single biggest strain on our relationship." - Jerome, CTO & Co-Founder at OOVA  

>>RELATED: How Infertility Can Affect Your Relationship — And What To Do About It

Infertility vs. secondary infertility

What’s the difference between infertility and secondary infertility? Secondary infertility is a type of infertility that occurs when a person has trouble conceiving their second child. When someone has second infertility, they’ve already been able to become pregnant once. Primarily infertility is when someone hasn’t been able to conceive and carry a pregnancy to term.

Causes of secondary infertility

The causes of secondary infertility are often similar to the causes of primary infertility, with the main difference being that the couple has already been able to conceive once before. Partners of any gender can contribute to secondary infertility.

Some causes of secondary infertility include:

  • Increased age: It can be more difficult to conceive as you age — so if you’re a few years older than when you first conceived, age may be a factor. (Learn what to know if you’re trying to conceive after 35.) 
  • Hormonal imbalances: Hormonal imbalances can disrupt your menstrual cycle and ovulation window, making it harder to conceive. Changes like irregular cycles, shorter or longer cycles, or heavier or lighter flow, can indicate that you may have hormonal imbalances that affect your cycle. 
  • Changes in sexual health: Signs of secondary fertility can come from either partner! If you or your partner is having changes in sexual health like erectile dysfunction or difficulties with ejaculation, it can affect the ability to conceive and therefore increase chances of secondary infertility.
  • Lifestyle factors: Factors like excessive alcohol consumption, smoking, drug use, poor diet, and even stress can impact fertility in partners of any gender.
  • Reproductive disorders: Reproductive disorders like polycystic ovarian syndrome (PCOS) and endometriosis can affect ovulation and therefore make it more difficult to conceive.


          How is secondary infertility diagnosed?

          For a professional to give a secondary infertility diagnosis, they’ll need to evaluate both partners’ medical history and current physical state. Before diagnosis, a doctor will likely go through:

          • Medical history, including information about previous pregnancies, or changes in health and lifestyle
          • Physical examination, to assess overall health
          • Ovulation assessment, to assess if ovulation is occurring
          • Semen analysis, to assess a male partner’s sperm count, motility, and morphology
          • Hormone testing, to identify an hormone imbalances

          Secondary infertility treatment

          Is secondary infertility treatable? Just like primary infertility, secondary infertility can be navigated and there is hope for conceiving a second time. Some common secondary fertility options include addressing underlying health conditions, medication, assisted reproductive technology, and lifestyle modifications.

          Addressing underlying health conditions

          First, a doctor may recommend treating underlying health conditions like hormonal imbalances, infections, or inflammation that can be contributing to infertility. They may also help you manage conditions like endometriosis or work with you on PCOS treatments.


          If you’re ovulating irregularly — or not at all — medications like clomiphene citrate or letrozole can help induce ovulation.

          Assisted reproductive technology (ART)

          Assisted reproductive technologies like intrauterine insemination (IUI) or in vitro fertilization (IVF) can help increase the chances of conception and help overcome fertility challenges like low sperm count and age-related decline in fertility.

          Lifestyle modifications

          Certain lifestyle changes can potentially have a positive impact on fertility in both partners. Both partners may aim to maintain a healthy weight, eat a balanced diet, reduce stress, get enough sleep, exercise regularly, and avoid smoking and excessive drinking.

          >>RELATED: Oova 101: How to Reduce Stress

          How to manage secondary infertility

          Now that we know what causes secondary infertility and treatment options, we can start to try to manage it emotionally. When we begin to recognize the pain we're going through, understand it, deal with it, and get the support we need, we really can get through secondary infertility.

          1. Make time for yourself. 

          It can seem absolutely impossible to find time for ourselves. And let’s not forget the guilt that comes with not dedicating every moment to our current child. But here’s what we need to remember — when we take care of ourselves, we're able to better take care of others. 

          Start with just 15 minutes a day. Each week, add a little more time to that. If your child is under three years old, it’s possible you are not getting a good night's sleep. It’s okay to accept that it’s going to be tough to get an hour at the gym if you're tired. So start with just enough time for some stretching, a brisk walk, meditation — time dedicated to you.

          As we dedicate more time to ourselves, we can be more in tune with our bodies. Once we know what our stressors are, we're able to manage unexpected changes that come from them.

          2. Identify what's changed.

          Life moves so fast, and the stressors we had the first time we got pregnant are not the same as they were in the past. Factors ranging from age to diet can have an impact on fertility. We go back to work and things are never the same, especially now we’ve got a little one at home to get back to.

          The best thing we can do is pinpoint the areas in our lives that are causing that stress. Here are a few things to consider. 

          • Recent life changes
          • Surgery or new medications
          • Diet, exercise and routine
          • Lack of sleep

          3. Have a plan.

          Especially if getting pregnant the first time was easy, we may not know what's ahead for us as we manage through secondary infertility. Planning can help address things in advance and avoid stressful, last-minute decisions.

          How can you get ahead? Try planning by:

          • Creating a fertility roadmap
          • Learning what treatments are available to you
          • Understanding which treatments are you willing to consider and when should you undergo them
          • Tracking your budget and how much are you willing to spend

           >>RELATED: Infertility is Expensive. Here Are 7 Ways To Save Money When Trying to Conceive.

          4. Ask for support.

          We should never feel like we have to fight infertility alone. There are so many emotions we go through, like the feeling of inadequacy that seeps in, or the guilt you feel because you already have a beautiful child, while others struggle to have their first.

          It can be so hard to discuss with your partner, family and friends about any and all of this. But it’s really important to talk about how we’re feeling and lean on the support of others to help us cope

          In addition to those close to you, seek a community to connect with on Facebook or through sites like RESOLVE. When we say “we are not alone,” just remember: three million women have faced secondary infertility. We can help one another.  

          5. Reach out to your doctor or a fertility specialist.

          It’s never too soon to get support from a medical professional, like a reproductive endocrinologist. There are a few guidelines to follow to determine when it’s time to call the doctor:

          • If you are under the age of 35, and have been trying to conceive for at least one year
          • If you are over 35 and you have been trying to conceive for at least six months without success
          • If you have ovulation concerns, have missed or irregular periods, have a history of pelvic infection or have tubal damage or endometriosis
          • If you have had two or more miscarriages

          6. Track your ovulation cycle.

          Tracking your fertile window through your ovulation cycle is a great way to understand your fertility. Oova’s test kit will not only show you if and when you’re ovulating, but also give you a personalized view of your luteinizing hormone and progesterone levels so you can identify any potential hormonal imbalances. 


          Managing secondary infertility: the bottom line

          Secondary infertility is just as common as primary infertility, but it’s a uniquely difficult emotional experience to navigate as you take care of your first child. Secondary fertility can be caused by a variety of factors from partners of any gender, but there are numerous treatment options depending on your situation. When managing secondary infertility, know that you’re far from alone, and that the right support and medical knowledge can help you through your fertility journey. 

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