Minimal modern interior of nursery. B&WYou and your partner are the proud parents of a beautiful child. You pour your heart and soul into your family and love every minute that you get to spend shaping the heart and mind of this little gift. But you are sad, too, because after a year of trying to conceive a sibling, you still aren’t pregnant. Since you got pregnant the first time without infertility treatments, you aren’t sure what the problem is, but you suspect that you have secondary infertility.

Unfortunately, this is the case. Secondary infertility can be a surprise for couples that conceived naturally the first time.

Defined as trying to conceive for one year without being able to become pregnant or being unable to carry a pregnancy to term after the birth of another biological child, secondary infertility is a common condition. The Centers for Disease Control estimates that secondary infertility affects 11 percent of couples that already have a biological child conceived naturally. Furthermore, some estimates say that almost half of infertility cases today are the result of secondary infertility.

Like primary fertility, the diagnosis splits 40 percent to the women and 40 percent to the men, with the balance being unexplained or a combination of factors between the couple. But unlike primary infertility, secondary infertility isn’t talked about as much.

What Happened to My Fertility?

Many couples that learn they are suffering from secondary infertility wonder what happened between the first and second child. There is not always a clear answer, unfortunately. But many times, the change to a couple’s fertility occurred between the first child and the present time. Some common causes could be:

  •  A depleted ovarian reserve or decrease in quality of eggs remaining due to age of the mother
  •  A decrease in sperm count, movement or shape for the father
  •  An infection that injures or impairs the reproductive system, such as a blocked fallopian tube or the growth of fibroids
  •  A missed diagnosis before their first pregnancy that worsened since the last pregnancy, like endometriosis or polycystic ovarian syndrome (PCOS)
  •  A significant weight gain by either partner, as a healthy reproductive system requires a body mass index between 18.5 percent and 25 percent BMI.

Secondary Fertility Is Tougher for Eliciting Empathy

Couples with the diagnosis often receive less empathy from their family and friends than couples with primary infertility. Generally this is because the couple does have a child or children. As a result, family and friends can minimize the emotional shock and distress the couple experiences as a result of secondary infertility. Many couples hear things like, “Well, do what you did last time” or “At least you have a child (or children)” in response to their diagnosis.

In addition, the couples are often left with feelings of guilt for not being able to provide a sibling for their child or children. Feeling they have denied their family this important relationship, these parents suffer stress and grief as a result. This can be difficult to manage when parenting their other children.

The Good News: There Are Successful Treatment Options for Secondary Infertility

While the diagnosis can be difficult, there are treatments for these couples that can help successfully build their families. Assisted reproductive technologies (ART) can help these couples conceive, including the use of infertility drugs, intrauterine insemination (IUI) and in vitro fertilization (IVF). If the secondary infertility diagnosis is the result of of blocked fallopian tubes, fibroids or endometrial tissue in the pelvic cavity, laparoscopic surgery can help correct these conditions to facilitate successful conception.

Secondary infertility is a difficult diagnosis for many parents. With a successful pregnancy in their past, facing infertility treatments to continue their family building can be an unpleasant surprise. But the treatment for secondary infertility, which is the same as it is for primary infertility, can help these couples realize their dream of having the family they always wanted.

“Secondary Infertility.” Web. 6 May 2014. <>

“What is Secondary Infertility?” Web. 6 May 2014. <>