What Is Secondary Infertility? Causes & Treatments

After easily bringing their first child into the world, some couples can’t conceive or carry another baby to term. An expert explains why this happens, and two women share their journeys.


When all you want is a baby, pursuing that dream can feel like being on an out-of-control emotional rollercoaster that just won’t stop. The hope and joy of conception followed by the heart-wrenching pain of loss, repeated in an endless loop, can be an all-consuming experience.

In some cases, couples who had their first child without any issues hit a wall when it comes to conceiving or bringing to term another child. Known as secondary infertility, it can be a harrowing ordeal for those who go through it.

“Secondary infertility can be as difficult or even more difficult psychologically on some couples than primary infertility because they weren’t expecting to have infertility and they strongly desire to add a sibling to their family,” says Dr. Rebecca A. Chilvers, reproductive endocrinologist at Fertility Specialists of Texas. “Each patient has specific desires and plans, and unique journeys and circumstances, that color their views. Some patients have stronger support networks than others to deal with infertility. Each patient’s perspective is individual.”

What causes secondary infertility?

When couples are struggling to conceive, their biggest question is often: Why? According to Dr. Chilvers, the answer is varied and complex. “Age is a primary concern for many patients who have trouble with secondary infertility,” she says. “This is predominantly due to the decrease in egg numbers and egg quality that accompanies normal ovarian aging. But in certain people, this process can be accelerated by genetics, tobacco usage or other disease processes.

“There are a few other factors that may affect chances of having more children. Scar tissue in the pelvis may be present from prior surgery or infections, which can affect the fallopian tubes, leading to blockage or an inability of the tube to reach the ovulated egg. Post-surgical changes after cesarean can also lead to decreased pregnancy rates, although this isn’t common. Also, weight gain that’s persistent and significant after a prior pregnancy can lower chances of pregnancy. Worsening disease processes such as endometriosis can also be a factor. It’s best to have a specialist review the patient’s history and do an evaluation to determine the possible causes.”

A mom who refuses to give up hope

Portland mama Leanne has been trying to have a second child for four years. She’s had more miscarriages and rounds of intrauterine insemination (IUI) than she cares to remember, and now she’s getting ready to throw their last pennies into a second – and final – round of IVF. “It’s so hard emotionally,” she says.

“I feel like a failure for not being able to provide a sibling for my daughter. I feel incomplete as a family. But if it doesn’t work… will I have this feeling forever? I think I’ll eventually have to make peace with it, but not yet. I’m not ready to give up.”

Despite her determination to stay positive, Leanne admits it isn’t always easy. “It’s hard not to get bitter and angry, or jealous of all my friends who got their second baby two years after their first. Even the mom who didn’t want to have other children got pregnant while on the pill with twins. And it’s hard on my relationship too. Having sex on command when you’re tired after a long day of work but you ‘force’ yourself to do it so you don’t miss the opportunity. Let’s just say it gets old. It was harder on my husband than on me, and now he has to do it in a cup! I’m not sure which is better!”

A miracle baby after five years

When NYC mom Margaux decided she was ready to give her one-year-old son a sibling, she had no idea that the journey she was about to embark on would change her life forever. Over the next five years, she had countless rounds of the fertility drug Clomid and four miscarriages. She and her husband were both tested, but nothing was “wrong” with either of them. Then, after being consumed with trying to conceive a baby for most of her 30s, Margaux fell pregnant naturally at the age of 37. Her beautiful baby boy was born in 2014 and she now feels that her family is complete.

“There’s nothing that adequately describes the feeling of not being able to accomplish what we’re told that our body is designed to do,” says Margaux. “The feeling of failure is overwhelming. The feelings of loss and emptiness and despair over and over again – it’s just brutal. We’ve moved internationally many times, so my rational mind was able to talk myself off a ledge, saying things like, ‘One child works for our family’. But my heart wasn’t able to make that leap – I knew all along I wanted another. This elusive fourth family member existed long before he was born. He had to happen.”

“When I was eventually pregnant with him, I was fearful and at the beginning I was resigned to the possibility that I would miscarry again. As the pregnancy progressed, I decided to manifest positive energy. I visualized him, I had daily positive affirmations, I grew him in my mind and in my heart and in my belly. I had to allow myself to believe he was going to happen. And boy did he happen – I got every baby I didn’t have rolled into one. He’s a miracle.”