Secondary infertility: when you can't conceive again
What is secondary infertility?
Secondary infertility is when you can't get pregnant or carry a pregnancy to term after having given birth before. Doctors usually begin looking into it after 12 months of trying to conceive, or after six months if you're over 35.
If you're reading this, you may have spent months wondering why something that happened before isn't happening now. Maybe your first pregnancy came easily and you assumed the next one would too. Maybe you've started to dread the question, "So when's the next one?" Whatever brought you here, what you're feeling makes sense, and you are not alone in it.
How common is secondary infertility?
It's far more common than most people realize. According to Cleveland Clinic, secondary infertility is just as common as primary infertility and affects about 11% of couples in the United States. Yet it's talked about much less, which is a big part of why it can feel so isolating.
What causes secondary infertility?
A lot can change between one pregnancy and the next. Some of the causes a medical provider may look at include:
• Age, since egg quality and quantity decline over time
• Scarring or blockages in the uterus or fallopian tubes
• PMOS, formerly known as PCOS
• Endometriosis
• Weight changes, smoking or alcohol use
• For male partners, lower testosterone, a varicocele, changes in sperm count or quality, or certain medications
Your reproductive endocrinologist is the right person to walk you through testing and treatment. My role is different: helping you carry everything this process brings up along the way.
When there's no clear answer
Sometimes testing doesn't point to a single cause. Unexplained secondary infertility can be one of the hardest outcomes to sit with, because without a reason, many people start looking for one in themselves: something they did, something they didn't do, or the feeling that they waited too long. That self-blame is incredibly common, and it's something we can work through together.
Why secondary infertility can feel so lonely
Secondary infertility is a quiet kind of grief. RESOLVE: The National Infertility Association notes that people with secondary infertility tend to receive far less support from others than people with primary infertility, because they already have a child. That can leave you grieving in a place where few people think to look.
"At least you already have one"
Well-meaning people say it all the time. It's meant as comfort, but it can leave you feeling like your grief doesn't count. You can be deeply grateful for the child you have and still long for another. Both are true at the same time.
Guilt toward the child you already have
Many parents feel guilty for being sad while their child is right in front of them, or for not being able to give them a sibling. Some worry that their stress is spilling into their parenting. These feelings are a reflection of how much you care, not a sign that you're failing anyone.
When everyone around you is having a second baby
Secondary infertility comes with its own triggers: pregnancy announcements from friends who started trying after you did, sibling questions at school pickup, and the age gap you keep calculating in your head. It's okay not to feel excited about other people's pregnancies while you're struggling this hard. We all have limits on what we can manage, and those limits deserve respect.
How to cope with secondary infertility
There's no single right way through this, but these are some of the places I often start with clients.
Name the grief out loud
Grief that goes unacknowledged tends to get heavier. Saying "this is hard, and it's a loss" to yourself, your partner or a trusted friend can take some of the pressure off.
Talk with your partner about what you each need
If you're going through this with a partner, you may be experiencing it differently. One of you may want to talk about it often while the other copes by staying busy. Neither is wrong. Checking in about what each of you needs, rather than assuming, can help keep this process from pulling you apart.
Set boundaries around your triggers
You're allowed to skip the baby shower, mute a friend's announcements for a while, or have a simple answer ready for "When are you giving them a sibling?" Something like "We'd love that, and it's not something we're talking about right now" is enough. Protecting your energy isn't selfish.
Find people who understand
RESOLVE runs a monthly virtual support group for women experiencing secondary infertility and I also offer individual and couples therapy for secondary infertility, in person in Lee's Summit, MO or virtually for Kansas or Missouri residents.
When to stop trying, and what comes next
Many people reach a point where they wonder how long to keep going. There's no right timeline, and it's a decision only you can make. For some, that means continuing treatment. Others begin to consider building their family with donor eggs, donor sperm or donor embryos. Some decide the family they have is complete, and that choice can bring its own mix of grief and relief. Therapy can give you room to explore each path without pressure.
How therapy helps with secondary infertility
Infertility counseling isn't about talking you out of your feelings. It's a space to process grief, ease the self-blame, strengthen communication with your partner, and find ways to cope with the parts of this you can't control.
I have specific training in infertility and perinatal mental health. I'm certified in perinatal mental health (PMH-C) and a member of the Mental Health Professionals Group of the American Society for Reproductive Medicine, and I work with individuals and couples through every stage of infertility, including secondary infertility.
My office is in Lee's Summit, and I see clients from across the Kansas City area in person, or virtually anywhere in Missouri or Kansas. Learn more about my infertility therapy, or book a free 15-minute consultation to see whether we're a good fit. You don't have to carry
