Secondary Infertility

After successfully having their first baby, a small percentage of couples are shocked to find that they have trouble conceiving a second child. This phenomenon is known as secondary infertility.

Infertility is defined as a year of regular intercourse without getting pregnant. Some experts shorten the year to six months in women who are over age 35 because it can take longer to get pregnant as women age.

If you do not conceive easily a second time, take a deep breath and do some simple things at home before calling an infertility specialist.

  • Chart your menstrual cycle – Do you still have a 28-day cycle or has it lengthened? If your cycle is now 35 days, you’ll ovulate on the 20th day, not the 14th.
  • Use a home ovulation kit – These kits detect the hormonal changes that occur at ovulation.
  • Take your temperature – Use a thermometer every morning for a couple of months. A slight rise will indicate ovulation, and that day would be a good time to try to conceive.

If, after using the ovulation kit, you still find you haven’t gotten pregnant, ask your doctor to consider helping you get pregnant medically. Possible interventions include:

  • Clomid and other drugs that increase egg production.
  • Artificial insemination with your husband’s sperm or a donor.
  • In vitro fertilization.

Just as in primary infertility, there are many reasons why you may not be able to get pregnant.

  • Your menstrual cycle may change after having a baby.
  • Fertility decreases in the mid- to late-30s and early 40s, diminishing almost entirely by the mid-40s.
  • If you gained a lot of weight in your last pregnancy and didn’t lose it, it may cause you to have irregular menstrual cycles.
  • Some women have heavy postpartum bleeding that may cause damage to the pituitary gland, which produces the hormone that signals your body to ovulate. If this is the reason for not ovulating, your doctor usually will detect other hormonal changes.
  • If you are breast-feeding, the frequency of ovulation can be reduced. But remember, breast-feeding is not a reliable means of contraception. If you are nursing and aren’t ready for another baby, use contraception.
  • Finally, remember that it takes two to tango and to make a baby. Your partner may be contributing to the difficulty conceiving. A proper workup of infertility includes evaluation of both partners.


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