When you’ve had a baby before, it can feel baffling—and deeply emotional—when trying for another doesn’t go as planned. This is known as secondary infertility, and while it’s more common than many people realise, it often comes with a unique blend of confusion, guilt, and isolation.

In this post, we’ll explore what secondary infertility is, why it happens, how it's diagnosed, and what fertility treatments like IVF can offer if you're struggling to grow your family.

What Is Secondary Infertility?

Secondary infertility is the inability to conceive or carry a pregnancy to term after previously giving birth, without the use of fertility treatment.

It’s often defined as trying to conceive for 12 months (under 35) or 6 months (over 35) without success, after a previous live birth.

Unlike primary infertility—when someone has never had a biological child—secondary infertility can feel especially bewildering. You may have assumed that past success meant future fertility wouldn’t be an issue. But that’s not always the case.

Why Does Secondary Infertility Happen?

There are many possible reasons why fertility may change over time. Common causes include:

1. Age-Related Fertility Decline

Egg and sperm quality both decline with age. If you're trying for another baby several years after your first, your ovarian reserve or your partner’s sperm health may have changed.

2. Hormonal Shifts

Hormones that support ovulation or menstrual regularity—like AMH, FSH, and LH—can fluctuate, especially with age, weight changes, or postpartum recovery.

3. Pelvic Conditions

Some people develop issues after their first birth, such as:

• Uterine scarring (from a C-section or D&C)

• Endometriosis (which may worsen over time)

• Blocked fallopian tubes (possibly due to infection or inflammation)

4. Male Factor Infertility

Your partner’s sperm health may have changed since your last pregnancy. Issues like low motility, poor morphology, or low count can all impact conception.

5. Lifestyle or Medical Changes

Weight changes, new medications, thyroid problems, or chronic conditions like diabetes can affect fertility for either partner.

How Is Secondary Infertility Diagnosed?

If you're under 35 and haven’t conceived after a year of trying (or 6 months if over 35), it’s worth speaking to your GP or fertility specialist.

Here’s what you can expect in an initial work-up:

• Ovarian reserve testing (e.g. AMH, FSH levels)

• Ultrasound scan (to assess follicles, uterus, and ovaries)

• Semen analysis

• HSG (tubal dye test) to check if your fallopian tubes are open

• Review of your birth and medical history

Even if you’ve had a healthy pregnancy before, testing is still important. Secondary infertility can be just as medically complex as primary infertility.

Is IVF the Right Option for Secondary Infertility?

In-vitro fertilisation (IVF) may be recommended if:

• You’re over 35 with declining egg reserve

• You have blocked tubes or uterine scarring

• There’s a male factor issue

• You’ve tried less invasive treatments (like timed intercourse or IUI) without success

IVF offers the advantage of bypassing common roadblocks, such as poor egg quality, tubal issues, or sperm problems. It can also provide more diagnostic clarity, particularly in cases where standard tests have been inconclusive.

The Emotional Weight of Secondary Infertility

Secondary infertility often comes with complicated emotions. You might feel:

• Guilt for wanting “more” when you already have a child

• Grief for the family shape you imagined

• Isolation, especially if others expect you to feel “lucky”

But your pain is real—and valid. Wanting another child doesn’t negate your gratitude for your first. It simply reflects your hopes for your family.

Where to Go From Here

If you're struggling with secondary infertility:

• Talk to your GP and request fertility tests

• Seek a referral to a fertility clinic (NHS or private)

• Explore IVF options, especially if age or time is a factor

• Join support groups for people navigating secondary infertility

• Be kind to yourself—this is a difficult road, even with a child in your arms

• AMH, FSH and Egg Reserve Explained

• What to Expect at Your First Fertility Appointment

• Semen Analysis Explained

• How to Talk to Your GP About Fertility Concerns