Secondary Infertility: “Why Can’t I Get Pregnant Again?”
You may have already had a child without difficulty, but now that you’re trying again, it’s just not happening.
If this feels puzzling, you’re not alone—one in ten couples who already have at least one child are unable to conceive another. This condition is known as secondary infertility, and it affects an increasing number of couples who suddenly face the unexpected challenge of struggling to conceive again after one or more successful pregnancies.
In light of World Fertility Day on June 15, we explore what secondary infertility is, its causes, available treatments, and why it’s essential to talk openly about it.
What is secondary infertility?
Secondary infertility refers to the difficulty a couple faces when trying to conceive a child after one or more previous successful pregnancies. It is not primary infertility—which refers to never having conceived—but rather the inability to conceive again, which often comes as a shock and brings emotional stress to parents. In some cases, women may have had a prior pregnancy that didn’t result in the birth of a healthy child and now face infertility, defined as the inability to conceive after 12 months of regular, unprotected intercourse.
What causes it?
The causes of secondary infertility are often multifactorial and may involve either partner:
- Age: The most common cause, particularly due to the natural decline in female fertility after age 35 and reduced sperm quality in men.
- Hormonal imbalances: Such as Polycystic Ovary Syndrome (PCOS) or thyroid disorders.
- Medications and health conditions: Including hypertension, diabetes, and depression.
- Gynecological issues: Like endometrial polyps, fibroids, or endometriosis.
- Complications from previous pregnancy or birth: Such as infections, adhesions, or scar tissue from a cesarean section.
- Male factor infertility: Low sperm count or reduced sperm motility.
- Lifestyle factors: Obesity, smoking, excessive alcohol intake, or chronic stress.
- Delayed attempts to conceive: Some couples postpone trying for a second child, underestimating the impact of age.
What tests diagnose secondary infertility?
The tests for secondary infertility are similar to those for primary infertility and may include:
- Semen analysis
- Ovarian function assessment
- Fallopian tube function and patency tests
- Hysteroscopic examination
- Hormonal profiling
How is it treated?
- Secondary infertility can often be reversible, especially if the cause is identified early. Treatment options may include:
- Hormonal therapies: To regulate the cycle and stimulate ovulation.
- Surgical interventions: To treat blocked fallopian tubes or intrauterine abnormalities.
- Assisted reproductive technologies (ART): Such as intrauterine insemination (IUI), in vitro fertilization (IVF), or use of donor eggs or sperm, if needed.
- Lifestyle changes: Improved nutrition, physical activity, and stress management.
Today’s options for couples
The most important step is to seek medical advice after 6–12 months of unsuccessful attempts to conceive. Reproductive medicine today offers more options than ever before, and success rates are high—especially in cases where a prior pregnancy has occurred.
The importance of emotional support
Secondary infertility is often not acknowledged socially with the same seriousness, since the couple “already has a child.” However, the grief and worry about a child that doesn’t come are real and painful. Mental health support is crucial for the well-being of both partners.
