Secondary infertility is defined as the inability to become pregnant following the birth of one or more naturally conceived children.

In reality, it means that a couple desperately wanting their second or third (4th, 5th...) child, may be caught completely by surprise when they have difficulty achieving a pregnancy again.

Secondary infertility is not uncommon. More people experience fertility related issues following the birth of their first child than those yet to conceive, however medical practitioners have a tendency to underestimate the likelihood of infertility and may initially advise them to just keep trying.

In addition, those who attempt to share their frustration with friends and family at not being able to fall pregnant, are often hurt by the unhelpful advice that they should be grateful for the child/children that they already have. This apparent lack of support can have devastating effects on a woman's emotional well being.

One of the most likely causes of secondary infertility may be related to age. The year/s that would have passed since their first pregnancy may now mean the quality of the woman's eggs have declined to the point where the chance of natural conception has significantly declined. Advancing female age remains the most important reason to quickly recognise secondary infertility and seek treatment before chances diminish further.

The causes for secondary infertility include all those for primary infertility plus a few more:

• The couple may always have been subfertile and the first child may have been sheer luck,
• Complications of the first birth could be making a contribution to the problem,
• During the intervening years all the common causes of infertility have had more time to develop, e.g. endometriosis,
• Finally there is the factor of age – the first child may have been conceived before the age of commencement of fertility decline but now the ageing egg factor is having an influence.

Even though infertility is commonly thought of as a female problem, it is actually caused by both male and female factors. In our experience 30% of cases are male related, 35% are female related and 35% are deemed unexplained infertility. In many cases both partners may be contributing to their infertility.

The good news is, just like primary infertility, in many cases secondary infertility can be treated and there a numerous options available.

It is vital that secondary infertility is recognised quickly and treatment is sought before chances of a successful pregnancy diminish further.