Secondary infertility: Why can't I get pregnant again?

What is secondary infertility?

There are 2 types of infertility:

• Primary: Primary infertility means that a couple finds it difficult to become pregnant or carry a pregnancy to term and has not conceived a child before.
• Secondary: Secondary infertility means that a couple who has already had one or more children has trouble becoming pregnant or carrying a pregnancy to term.

As such secondary infertility only refers to couples that have previously had babies but are struggling to fulfil their wish for another.

How common is secondary infertility?

Secondary infertility is just as common as primary infertility. According to WHO, approximately 15% of couples trying to have child number two suffer from secondary infertility.

If you want to know more about the causes of infertility, we can recommend our article on the most common fertility problems or our blog post on the subject of male infertility.

Causes of secondary infertility

Conceiving a child is a complex process and there can be numerous causes of infertility. The most common cause of secondary infertility is reduced fertility because of ageing. When you already have conceived a child, it is normal to wait a couple of years before trying again. During this period, your fertility will decrease and may cause you to experience signs of secondary infertility. The majority of causes for secondary fertility however resemble those found in primary infertility. These are:

• Ageing (as a woman's fertility declines with age, this may make it more difficult to conceive a second child)
• Changes in the reproductive system (such as endometriosis or fibroids)
• Ovulation disorders
• Polycystic ovary syndrome (PCOS)
• Male infertility (such as low sperm count or motility)
• Previous pregnancy complications (such as miscarriage)
• Infectious diseases such as CMV, listeria and malaria can also lead to a miscarriage.

There are other reasons for you not getting pregnant, follow the link to our blog post Why am I not getting pregnant - 10 reasons why.

Testing why you cannot get pregnant the second time

Often, there are no signs of secondary infertility. Therefore, if you are struggling to conceive it would be a good idea to have your fertility tested. If the test results are negative and your fertility levels are low, it does not mean that you will not be able to have a sibling for your child. You might just need a little help. Many people suffering from secondary infertility must rely on fertility treatment to have their dream of a second child fulfilled.

Secondary infertility treatments

There are different fertility treatment options available, depending on your situation. The most common types of fertility treatments are:

• IUI treatment: In IUI treatment the sperm is injected into the woman’s uterus through a thin plastic tube.
• IVF treatment: IVF is a treatment for infertility in which eggs and sperm are combined in a laboratory dish, and the resulting embryos are then transferred to the uterus.
• ICSI treatment: ICSI treatment is used for cases with low sperm quality and involves using a needle to inject a single sperm into an egg.

Treatments like IVF and ICSI are recommended for men with low sperm motility or quality because the sperm cells are either injected straight into the egg or placed in a petri dish next to the egg. By doing that, the sperm has optimal chances of fertilizing the egg. Another possibility to fulfil your dream of another child is through the use of donor gametes. Donor sperm and donor eggs are a great option for couples who are not able to conceive using their own sperm or eggs.

How to cope with secondary infertility?

Coping with secondary infertility is similar to dealing with primary infertility, but there is a key difference. Since you already have conceived a child, there are a lot of different emotions couples suffering from primary infertility do not experience. It is normal to feel pressure when trying to conceive another child for a variety of reasons:

• You always pictured yourself having a large family. Many people dream of a large family with multiple children or maybe children close to each other in age. When you struggle to conceive another child, this type of dream can put a lot of pressure on your body.
• Pressure from friends and family. A common assumption regarding families with one child is that it should be easy to conceive another child. But a lot of people do not know that secondary infertility is just as common as primary infertility.
• You want to give your child a sibling. A lot of people think that children deserve a sibling, someone close to their age to share their upbringing with. Wanting to provide a sibling to your child, can put even more pressure on yourself when experiencing signs of secondary infertility.

A way to cope with both primary and secondary infertility is to connect with others who experience fertility problems. Therefore, we have created a Facebook group called 'Family Dreams', where people dealing with infertility can support each other. Another way is to acknowledge your feelings of grief and find ways to manage the stress caused by infertility. If you are suffereing from infertility and want to learn more about the 5 stages of grief, then follow the link.

One way to manage the stress is to talk to about the feelings of infertility. You could talk to your partner, a family member, or a therapist. It is important to work through the emotions because infertility will often have a big impact on your everyday life.

If you want to read our tips on how to cope with infertility, follow the link to our blog post on the subject.

FAQ's on secondary infertility

What are the symptoms for secondary infertility?

There are a variety of symptoms associated with secondary infertility, which may differ from one person to another. Some common symptoms include:

• Difficulty conceiving
• Irregular menstrual cycles
• Abnormal uterine bleeding
• Unexplained infertility

Why am I not getting pregnant the second time?

There could be many reasons why you might not be getting pregnant the second time around. This could be due to a medical issue, such as a problem with the ovaries or fallopian tubes. It could also be a problem with your partners sperm if you are a heterosexual couple.