Secondary infertility

The phrase secondary infertility applies to anyone who has had at least one child, and then faces problems having another one.

Possible causes

Causes are very similar to the causes of primary infertility and if you have any tests or investigations, and then treatment, they’re likely to be similar , too.

You may have conceived quickly before – maybe it was luck, hitting the right time in your cycle, or both of you were somehow in peak fertile condition. It could be that you have since developed a condition that has an impact on fertility. Women may be a couple of years older, or more and this will have an effect too.

If you’re a woman with a new partner, and he has not had children before, the first logical step would probably be a sperm count for him as a reason for delay.

If you needed medical or surgical help, or assisted conception with your first pregnancy, then it’s very possible you’ll need the same process again (though this depends on the reason for the original help – if you had surgery to unblock your fallopian tubes you will not need this again, as the condition should have been cured).

Possible worries and concerns

In these situations, you can end up coping with several concerns:

• That expectations from people close to you that you want to have another child
• That your child will suffer without siblings
• Queries from people who ask directly if and when you’re going ‘to have another one’
• Guilt that you’re somehow being ‘greedy’, especially if you went through problems to have your first child – maybe you should be happy with what you’ve got?
• Criticism from other people if you seek help – they think you just need a bit of patience, or that you’re taking up the time of a clinic from someone else who really needs it
• If you have a new partner, expectations that you will definitely want a child, and direct questions about it
• Concern for your new partner’s feelings about the assumptions others may make that he has a fertility problem
• Hostile feelings towards other people, known and unknown to you, who seem to have children without fertility issues
• A yearning for another baby, maybe as intense as the feeling you had first time round
• Worries about repeating the investigations and processes you went through before or worries that treatment won’t work for you
• Concerns about how far you want to go with treatment, and with trying to conceive
• Confusion about how long to wait before speaking to your doctor, especially if you feel time is running out.

Share your concerns

Try to share your concerns and worries with others. There are forums and message boards on the internet directed specifically at people in just this situation. It’s also important to share your concerns with your doctor or fertility clinic, and get an informed view of when it would be reasonable, if at all, to get some medical input.