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Fertility Health
secondary infertility

If you conceived easily in the past, and have had a successful pregnancy at least once, you may assume that having another will also happen easily. So, it can be a shock when you start trying and can’t get pregnant as quickly as before. This type of problem is called secondary infertility. In this article, we explain secondary infertility and share some tips to improve your chances for baby number two.

Primary Infertility vs. Secondary Infertility

According to RESOLVE: The National Infertility Association, approximately one in eight couples in the United States struggle with primary infertility.  Although you may think that secondary fertility is less common, in reality, it accounts for around half of all infertility cases.  Strictly speaking, secondary infertility is the inability to conceive naturally following the birth of one or more biological children who were born without the help of any fertility treatments or medications.

Primary infertility is defined as not being able to conceive despite having unprotected sexual intercourse for at least one year. The causes of primary and secondary infertility are often similar.

However, unlike couples struggling with primary infertility, those affected by secondary infertility are much less likely to seek infertility treatment. Some are reluctant to seek help if healthcare professionals, friends and family downplay their struggle. It is common to find that others may be insensitive to your struggle since you already have children.

Reasons for Secondary Infertility

The reasons for secondary infertility may typically include:

guide to fertility health

Tips for Secondary Infertility

Whether you’re struggling with primary or secondary infertility, specific lifestyle changes can help improve your chances of conceiving.  Both men and women can consider certain nutritional supplements to improve fertility. Moreover, seeking support from those who are also struggling can be the lifeline you need to navigate this difficult time.

Lifestyle Changes

Stop smoking

Smoking reduces your chance of getting pregnant and makes ART treatments difficult. It can be hard to quit. Once you acknowledge this fact, you can begin taking the steps necessary to quit once and for all.

The American Cancer Society recommends setting a date to quit, getting support from others who are trying to quit or have quit, and, if needed, seeing your physician for assistance from products that may help. Many people have long-standing habits, such as drinking coffee, that they associate with smoking cigarettes. Identify your smoking-connected habits and plan out substitutes for them, such as drinking tea.

Caffeine

The studies on the effects of caffeine on fertility are mixed. A Danish study of over 3,500 women did not find any association between caffeine intake and the ability to conceive. Some studies show a link between caffeine intake and increased risk of miscarriage.

Although the reasons are sometimes unknown, recurrent miscarriage is one of the factors of secondary infertility, and it can be devastating for parents.

According to the U.S. National Survey Data adults consume on average 165 mg caffeine per day. Eight ounces of coffee typically contains between 70 to 140 mg caffeine. Unfortunately, the FDA does not require manufacturers to declare the precise amount of caffeine on a nutrition label. Here is a caffeine chart that provides a list of familiar dietary sources of caffeine.

If you are using caffeine while trying to conceive, be sure to discuss your intake with your healthcare provider.

Get to a healthy weight

New mothers and fathers can experience weight gain after having a baby due to skipped workouts, changes in eating habits and lack of sleep. For the mom, retaining excess weight gained during pregnancy can adversely affect subsequent fertility. Unfortunately, weight gain for both men and women may contribute to secondary infertility.

Here are some strategies to help you lose weight and improve fertility.

Exercise: Getting to a healthy weight can increase your chances of conceiving, and regular exercise can help you manage your weight.

  • Take walks together with the stroller. Schedule your walks for a time that works for both of you.
  • Track your steps. This simple habit can increase your motivation to move more.

Eat healthfully: As often as possible, choose fruits, vegetables, lean poultry, fish, and whole grains since these foods can help control calorie intake. As a bonus, these foods contain many nutrients that can be beneficial for sperm quality and female fertility.

Nutritional Supplements

Both partners should have their vitamin D level checked since this level is linked to fertility for both men and women. If it is low (below 30 ng/mL), consider taking 2,000 to 4,000 IU of vitamin D3 for a few months to restore it to a normal level. Once your vitamin D level is in the normal range, take 2,000 IU of vitamin D3 per day to maintain this level.

Fertility supplements for men

Nutritional supplements may help to improve male fertility. Consider supplementation with vitamins C, E, folic acid (folate), zinc, selenium, lycopene, CoQ10, omega-3s, and L-carnitine to provide optimal nutritional support for your sperm.

Fertility supplements for women

As you begin trying to conceive, it’s important to start taking a good preconception prenatal vitamin. Your preconception prenatal should include enough folate, iron, iodine, vitamin D, and choline.

If you are over 35, you may want to consider taking a CoQ10 supplement. Research indicates that taking a CoQ10 supplement can improve egg quality and potentially increase your chances for a healthy baby.

Inositol is a nutrient that may be beneficial for female fertility. Studies have shown that taking an inositol supplement before fertility treatment improves embryo quality and pregnancy rates.

Low levels of melatonin may make it harder to conceive. Studies show that melatonin supplementation may improve egg and embryo quality in women undergoing controlled ovarian stimulation for IVF.

Emotional Support

Infertility is difficult to come to terms with, even if you already have kids. It can affect personal relationships and may also deplete your bank account. Don’t struggle alone. Getting support from others who are struggling can be so helpful.

RESOLVE offers support resources for families who are struggling. You can search for a support group near you, start a support group, participate in in-person events, online chat support or a phone helpline.


If you suspect you have secondary infertility, contact a Reproductive Endocrinologist for a fertility evaluation. Women under 35 years old should have their fertility evaluated if you have been trying for one year without success.  If you are between the ages of 35-39, seek help after six months of trying, and if you are 40 and over, seek help after three months.

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guide to fertility health