The difference between primary and secondary infertility is that in the case of secondary infertility, the sufferer has already had a child or even children. Primary infertility is the inability to conceive or to carry a pregnancy to term in the first place. Quite often, the causes are similar. Whatever the cause, experiencing primary or secondary infertility can be surprising, bewildering and a cause for very real distress and grief.

What causes secondary infertility and what can we do about it?

Why does secondary infertility happen?

The current social trend for women and couples to delay childbearing or starting a family for social and financial reasons, with the resulting age-related decline in fertility, is a common factor in both primary and secondary infertility. It is especially common in women who have waited until their late thirties, when fertility has already started its downhill trend and who are subsequently trying for another child in their even later thirties or around the age of 40. This is not only an issue for women. For men too, fertility starts to decline, through poorer quality and quantity of sperm, around the age of 40 to 45.

But for secondary infertility there can be other causes as well. These include:

• Male infertility due to a low sperm count or problems with sperm shape (morphology) or the ability of sperm to move (sperm motility). If you are already a father, it could be that age or lifestyle factors have affected your sperm quality. If you are a woman who has previously had a child and you have a new partner, it may be that your partner needs to undergo some tests.
• Ovulation problems which may be new or could have become worse since last time around. For instance, it is possible that you had an existing condition like endometriosis or polycystic ovarian syndrome and that you were lucky with your first pregnancy but not this time. Or an already low ovarian reserve has become further depleted.
• Complications related to prior pregnancy or surgery underwent after it
• Health changes since your first pregnancy. One of the glaringly obvious differences between primary and secondary infertility is that in the latter case, you already have a child, a small and therefore demanding one, to care for. This can easily, even with the most careful management, lead to weight gain, weight loss, or an increase in stress and lack of sleep, all of which can impact your fertility.
• New health problems since your last successful pregnancy. It’s possible that you or your partner have developed a condition that has a detrimental impact on fertility such as diabetes, high blood pressure or even depression, and the associated medication is lowering your libido or reducing your fertility. If you are taking any medication that you weren’t the first time around, speak to your doctor or a fertility specialist about it.

The hidden emotional pressures of secondary infertility

Disappointed expectations can be painful for anyone at any time. Secondary infertility is no different, but it can bring added and sometimes invisible pressures. After all, you already have a child: isn’t that enough for you? Such thoughts can add guilt to the other emotional pressures. This could take the form of guilt that you are not content with your existing child or children, or perhaps guilt that you can’t give them the little sibling that they want. There’s also the difference that with primary infertility you can avoid painful situations like a child’s birthday party or the school gates; with secondary infertility you are right inside that world. How can you deal with these added emotional pressures?

• Accept your feelings. It is inevitable that you will fell shock and distress, especially if your pregnancy the first time round was easy. Don’t make things worse by trying to bury those reactions, or feeling that they are somehow wrong. Especially don’t feel guilty that, with a child already, you have no ‘right’ to long for another. Just accept that the yearning for a child is one of the most natural impulses in the world. Don’t feel bad.
• Talk to family, friends or a support group. If you have a partner, they are going through the same thing as you. Try to stay connected and make time to talk. If you have a trusted and supportive family member or friend, talk to them and if not, there are support groups and specialists out there. Remember secondary infertility is even more common than primary, and that you are far from alone.
• Don’t put off seeking help. Already having a child can make many people delay seeking help for longer than they should. If you’ve been trying for a year, or for six months if you’re over 35, it’s time to take action and consult a fertility specialist. You could well find that having a focus and a potential way forward helps to alleviate the other emotional pressures.

What can you do about secondary infertility?

Consulting a fertility specialist won’t guarantee that you’ll have another child, but at least you’re giving yourself the best chance. Why not browse the IVI website which is always up to date with the latest facts, figures and advances in the world of assisted reproduction? You could also have a look at our video about what to expect on your first visit.

If you need cheering up and a positive focus, have a look at our independently audited clinical results and overall success rates. They will give you further reassurance that you’re not alone, and that the odds on a positive outcome are very good. Remember that 90% of women and couples who consult IVI with fertility problems, and put their faith in us, do go on to achieve their dream.