After your first baby, you might think that getting pregnant a second time will happen just as easily, but that’s not always true. While many couples have no problem conceiving the second time around, millions of couples struggle with secondary infertility.

The inability to conceive or carry a pregnancy to term successfully following the delivery of a previous child is described as secondary infertility. While it isn’t uncommon, the good news is that you’re more likely to have a successful second pregnancy if you already have a child.

If you’re a woman over 35 and struggling to conceive but still hoping for another child, be aware that there you are not alone and there is hope. One of the most important factors that influence your chance of getting pregnant is your age. Changes in hormones and risk for certain diseases also increase as you age, and both can impact fertility. 

If you are a woman in your mid-to-late-30s and older, you are more likely to experience secondary infertility since you lose eggs as you age. But if you’re in your mid-30s and are still waiting for a second child, don’t despair: Just because it might take you longer to get pregnant doesn’t mean you won’t get pregnant again. 

And if you’re a man whose sperm count is low, you might also be prone to secondary infertility.  Age, health or medications sometimes affect sperm quality or quantity. But don’t be surprised to learn that some common practices can decrease sperm production. 

These include taking testosterone supplements and exposing the testes to heat. The testes are outside of the body for a reason, if they are too warm, either from tight clothing or the use of electronics, it can affect sperm counts.

If you’re a woman with polycystic ovary syndrome (PCOS), a hormonal imbalance that can disrupt ovulation, it is a common cause of secondary (and primary) infertility. If your periods are irregular or absent, you might have PCOS.

In addition to PCOS, abnormalities caused by previous surgeries or infection also may cause infertility. For instance, being overweight can cause challenges with conceiving. For any woman, a healthy weight is essential and as a man, excess weight can lead to lower sperm counts.

If you drink too much alcohol or smoke, you can be at higher risk of problems with conception. While it’s no surprise that smoking isn’t good for you, you might not know that smoking can wreak havoc on your fertility, too. Women who smoke are more likely to experience infertility. Smoking can damage eggs and sperm DNA and cause ovulation problems. 

If you are trying to get pregnant again, try to relax and not worry too much. However, if you have been trying for a year and still haven’t conceived, talk to your Ob/Gyn or fertility specialist. And if you’re over age 36, consider talking with your doctor sooner — once you have tried for three or four menstrual cycles without success, 

The guidelines on when you should see a fertility doctor for secondary infertility are exactly the same as for any woman trying to get pregnant.

You should seek the assistance of a fertility doctor if you are under 35 years old and trying to conceive for 12 months. It is recommended that you seek help after just six months of trying if you are 35 years old or older.

So can you get pregnant with secondary infertility? The short answer is yes, you can get pregnant with secondary infertility, but you may need to seek out the assistance of a fertility doctor. If you’re over 35, you still have eggs left, but it becomes more difficult to get pregnant because the eggs are of lower quality. 

The older a woman is, the more likely it is that her eggs have a chromosomal error which will, in turn, result in embryos being aneuploid, or chromosomally abnormal. In your mid-to-late 20s, the rate of aneuploidy in your eggs is a little more than 20 percent, rises to the mid-30s by age 35, is about 50 percent by age 40, and is nearly 90 percent by age 42 and 43.

This means that while about 20 percent of the embryos you create may be abnormal in your late 20s, almost 90 percent could be abnormal by your early 40s. That is a significant change in a little over a decade.

Aneuploidy has a lot to do with successful pregnancy. The opposite of aneuploid is euploid, which means an embryo is chromosomally normal, or that it has the normal amount of chromosomes and has a good chance of implanting inside the uterus and leading to a successful pregnancy. Aneuploid embryos, on the other hand, have too few or too many chromosomes, and often fail to implant inside the uterus.

In the chance they do implant, they often lead to miscarriage or an affected child. So the older the woman, the higher her chances of producing aneuploid embryos that fail to implant, leading to infertility. 

If you were able to get pregnant naturally and gave birth without issue in the past but are having trouble conceiving on your own for the second or third time, you may have secondary infertility. However, it is also possible that there is another cause for your infertility, and doing the necessary fertility testing will help you determine the cause so you can move forward with the appropriate treatment.

You would need to undergo diagnostic testing to get a complete picture of your fertility before moving on to treatment. The good news is that secondary infertility is treatable, and many women diagnosed with it go on to have successful subsequent pregnancies.

There are various treatment options based on the woman’s specific fertility profile, including intrauterine insemination (IUI) where sperm is inserted into a woman’s uterus at the time of ovulation. There is also In Vitro Fertilisation (IVF) where sperm and egg are fertilized outside the woman’s body and a resulting embryo is transferred back into the woman’s uterus in hope of implantation.

It may not be out of place to say that IVF is more successful for couples with secondary infertility. It is often the only or most successful fertility treatment option. However, no matter which treatment path you pursue, you should have hope that you can overcome secondary infertility with a little bit of help. 

While struggling with infertility can be very hard to deal with alone, it is important to know that there are support groups out there dedicated specifically to couples dealing with infertility. Try them. 

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