When you’ve already had a successful pregnancy, it seems hard to believe that you may have difficulty getting pregnant again. But in the United States, nearly half of all cases of infertility are classified as secondary infertility. Secondary infertility is defined as the inability to become pregnant —despite engaging in unprotected intercourse—following the birth of one or more biological children who were born without the aid of fertility treatment or medications.

Causes of Secondary Infertility

Maternal Age
One of the leading causes of secondary infertility is the female partner’s age. As a woman gets older, the quality and quantity of her eggs decreases. While she may have had her first child without a problem, she could encounter a change in egg quality or quantity if she tries to conceive again several years later. While every individual woman is different, Shady Grove Fertility provides age-based recommendations for when you should see a fertility specialist if you are having difficulty conceiving.

Internal Complications
In some women, there may have been complications from their previous pregnancy and/or delivery that could have affected the uterus and the ability of an embryo to implant and grow. If an infection occurred and went untreated, adhesions may have developed within the uterus or around the Fallopian tubes.

Irregular or absent menstrual cycles can often reveal an underlying ovulation disorder, even if previous conception occurred.

Recurrent miscarriage, also known as recurrent pregnancy loss, is defined as two or more consecutive, spontaneous pregnancy losses. It is often unknown why miscarriages occur, even when a previous pregnancy has been successful.

Male Factor Infertility
As with women, male aging can have an effect on reproductive health, potentially affecting sperm quality and quantity. But while these changes may be due to age, they could also be due to new medications or lifestyle changes like weight gain or a new smoking habit (which can also affect female fertility). Learn how you can improve sperm quality.

Weight Gain
For both men and women, weight gain can have a significant impact on the ability to conceive, sometimes leading to ovulatory dysfunction in women or reduced sperm quality in men. However, weight loss can reverse these conditions. In many men and women with a body mass index (BMI) that is above normal, diet, exercise, and lifestyle changes have been shown to make a vast difference in fertility potential. Studies have shown that for women, losing as little as 5 to 10 percent of their body weight can improve the chances of pregnancy occurring.

Available Treatment Options

If you have had a successful pregnancy before and are now trying to conceive without success, we recommend making an appointment to see a fertility specialist.

After your physician establishes a diagnosis, he or she will discuss with you the recommended treatment approach. As with other types of infertility, many patients with secondary infertility are able to start with low-tech treatment like intrauterine insemination (IUI). In some instances though, secondary infertility may need to ultimately be treated with in vitro fertilization (IVF) or donor egg treatment.

Support System for Secondary Infertility 

“It can be shocking and surprising for women who were once able to become pregnant and have a child easily to find that when they want a second one they cannot. Learning to accept this and the feelings of guilt that may follow can be the first step in addressing the problem and working towards a resolution,” says Patricia Sachs, LCSW-C.

Many women who experience secondary infertility can feel surprised, alone, and not know how to share their feelings with their friends and family. You may experience unwelcomed reactions from your friends and family who may not understand why you’re so upset because you already have a child. It can be very difficult to make sense of these challenges and to stop feeling so distant from everyone around you. You are not alone though and there are support groups and resources available. Shady Grove Fertility has free support groups that meet regularly in the Mid-Atlantic region.

The most important thing to remember when you are experiencing secondary infertility is that you are not alone and that it can happen to anyone. A fertility specialist will be able to provide you with an accurate diagnosis and then create an individualized treatment plan to help you conceive.


Editors Note: This post was originally published in February 2015 and has been updated for accuracy and comprehensiveness as of November 20, 2016.

Chandra, A., Ph.D., Copen, Casey E., Ph.D., & Stephen, Elizabeth Hervey, Ph.D. Infertility and Impaired Fecundity in the United States, 1982-2010: Data from the National Survey of Family Growth. National Health Statistics Report. August 2013. doi: http://www.cdc.gov/nchs/data/nhsr/nhsr067.pdf

Medical Contribution by: Dr. Shrui Malik of Shady Grove Fertility’s Fair Oaks and Woodbridge, VA offices.

For more information about secondary infertility or to schedule an appointment with a Shady Grove Fertility physician, please contact the New Patient Center at 877-971-7755.