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“I can’t be infertile. I already have a child. So, what’s wrong with me?” These words are spoken too frequently by loving women struggling to expand their families. Infertility is a heartbreaking condition that impacts 7.5 million American women. While many associate infertility issues with couples striving to conceive their first child, more than three million women who have already had a child find themselves unable to conceive a second time, leaving them frustrated and uncertain.

If you’re looking to grow your family, but are experiencing difficulties conceiving after your first child, talk to your OBGYN about the possibility that you are experiencing secondary infertility. To prepare for your conversation, read on to learn more about this condition, and its causes.

Secondary Infertility Defined

Secondary infertility occurs when a woman is unable to get pregnant, or carry a pregnancy to full term, after she has had her first child. Your OBGYN may diagnose you as experiencing secondary infertility if:

• You have already given birth without the use of medical support or fertility medications but are then unable to get pregnant again, or you experience recurrent miscarriages, and;
• You are under age 35 and have been trying for one year to get pregnant, or;
• You are age 35 or older and have been trying for six months to get pregnant.

Secondary Infertility Causes

Just like with primary (or first time) infertility, a wide variety of factors in both the male and female partner could be the cause of secondary infertility. In some cases, the underlying cause of a woman’s infertility may have worsened after her first birth. To determine the exact cause of any conception issues you face, speak with your OBGYN. What follows, however, is a list of possible causes.

• Advanced reproductive age, which could lead to poor egg quantity or quality.
• Endometriosis, which occurs when tissue that normally lines the uterus grows outside the uterus.
• Pelvic adhesions, a condition that makes it difficult for an egg to be picked up by the fallopian tube, and could be caused by endometriosis or prior abdominal scarring.
• Asherman’s syndrome (intrauterine adhesions), which may have developed after a complicated earlier pregnancy, such as one in which a uterine infection occurred that caused the development of adhesions around the fallopian tube.
• Poor sperm quality or quantity, which could be caused by changes in a man’s health, new medications, or excessive weight gain.
• Defective ovulation, which may or may not be caused by excessive weight gain.
• Smoking, by either the male or female partner.
• Pelvic or uterine scarring.
• A blocked fallopian tube(s).
• Irregular menstrual cycles.
• Being underweight.
• Excessive drinking.

Treatment Options

If you fear you may be experiencing secondary infertility, start by speaking with your OBGYN. He/she can prescribe a fertility treatment that will best address your specific complications. In most cases, treatments for secondary infertility are the same as those used to treat primary infertility. Recommended treatments may include assisted reproductive technologies (ART), medications, fertilization procedures, and egg donation.

What’s most important to remember is that you are not to blame for your inability to conceive a second (or third, or fourth) time. Talk to your OBGYN. Together, you can work to identify the cause of your struggles and determine a plan that will help you bring another beautiful life into the world.