Struggling to Conceive Baby Number Two? Understanding Secondary Infertility and What to Do Next

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Having trouble getting pregnant again after your first child? You're not alone. Secondary infertility affects up to 15% of couples—here's what you need to know and how to get help.

What Is Secondary Infertility?

If your first pregnancy was a breeze, it's confounding—and heart-wrenching—when becoming pregnant the second time isn't as simple. This annoyance is often referred to as secondary infertility, or the inability to conceive or become pregnant after having had a previous child.

"It is so frustrating and bewildering when you have already conceived easily naturally," comments Dr Carole Gilling-Smith, Medical Director and CEO of the Agora Clinic.

How Common Is Secondary Infertility?

About 10–15% of couples are estimated to experience secondary infertility, according to research. However, diagnosis is only typically made after 12 months of trying (or 6 months if the woman is over 35 years).

Common Causes of Secondary Infertility

There are various reasons why it might take a while longer to conceive for the second time, even if the first time was problem-free.

1. Age-Based Decline in Fertility

• Women over the age of 35 may experience a decrease in egg quality.
• Men over 45 may see a decrease in sperm quality.
• Medical problems like fibroids, which increase in size over time, can affect implantation.

2. Recovery of the Body After Pregnancy

Trying for a baby again before giving your body enough time to recover—ideally 18 months between them—is likely to reduce fertility.

"Many women are eager to complete their families and do not realize their bodies may not have recovered yet," says fertility expert Zita West.

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3. Lifestyle and Health Factors

Second-time mothers may be less mindful of:

• Maintaining a healthy weight
• Avoiding booze and cigarettes
• Managing stress

Dr Carole adds: “Obesity, high stress, smoking, and excessive alcohol can all reduce fertility.”

4. Complications from Previous Pregnancy or Birth

Issues such as:

• Damage to the fallopian tubes or uterus during delivery
• Postpartum infections
• Irregular periods post-birth

can all hinder your chances of conceiving again.

5. Breastfeeding and Hormones

Breastfeeding can affect ovulation due to high prolactin levels. If you’re still feeding regularly—especially at night—it may delay your fertility.

Could It Be PCOS?

PCOS can affect fertility, even if it did not with your first pregnancy. It may go unnoticed until it is difficult to conceive again.

Signs of PCOS Include:

• Unpredictable periods
• Weight gain
• Acne or excessive facial or body hair

If you suspect PCOS is the issue, speak to your GP or a fertility specialist.

When to See a Doctor About Secondary Infertility

If you are under 35 and have been attempting 12 months, or over 35 and attempting 6 months, book a fertility check-up appointment. Earlier intervention is advised if:

• You have an irregular menstrual cycle
• The partner has a diagnosed sperm issue
• Pregnancy has previously been complicated

The Initial Testing Often Comprises Of:

• Hormone testing and ovulation assessment
• Semen analysis
• Pelvic ultrasound

Treatment For Secondary Infertility

Once the cause is identified, the following fertility treatment can be prescribed:

1. Clomid or Letrozole (Ovulation Induction).Induces release of eggs from the ovaries.
2. IUI (Intrauterine Insemination). Sperm is inserted directly into the uterus during ovulation.
3. IVF (In Vitro Fertilisation). Eggs and sperm are combined in a laboratory and the embryo is inserted into the uterus.
4. ICSI (Intracytoplasmic Sperm Injection). A single sperm is inserted directly into an egg—male factor infertility good.

 "IVF or ICSI are typically recommended for unexplained infertility, tubal blockage, or male issues," says Dr Carole. "Success depends on age, cause, and general health."

Key Funding Note:

NHS funding is typically limited to couples with one child. Check the [Fertility Network UK](https://fertilitynetworkuk.org) website for guidance and local funding policy.

Natural Fertility Boosters in the Home

Implementing healthy lifestyle changes is often the first and best course of action:

• Eat a healthy, balanced diet
• Maintain a healthy BMI
• Quit smoking and drinking
• Decrease caffeine intake
• Exercise regularly, moderately
• Sex every 2–3 days, especially when ovulation is occurring

"It is possible to see measurable improvements in 3–6 months through making lifestyle changes," contributes Dr Carole.

Don't minimize stress, too. Stress-relieving activities like yoga, acupuncture, meditation, or therapy might be helpful.

The Emotional Weight of Secondary Infertility

Trouble having a second child carries an added emotional weight. Parents are left with:

• Guilt feelings about desiring "more" when they already have one
• Exclusion from others who won't "get it"
• Parenting and trying to conceive again, leading to emotional depletion

"There's a sense of guilt—a sense that you should be grateful for the child that you do have," states Susan Seenan, former Fertility Network UK chief executive.

Children may also wonder why they don't have a sibling, and put pressure on you.

Where to Get Support

You're not alone—and you deserve support.

Helpful Resources:

Fertility Network UK- [fertilitynetworkuk.org](https://fertilitynetworkuk.org)

Tommys – Pregnancy and baby loss support

Mind or BetterHelp – Mental health support

Consider joining online or local support groups so you can discuss with others who are going through the same.

Final Thoughts

Secondary infertility is real—and you're not alone. If you're finding it difficult to conceive again, act early: speak to your GP, review your lifestyle, and look at your choices. With time, support, and perhaps treatment, many couples go on to have healthy babies.