Infertility

Secondary Infertility

Sometimes women who have been pregnant in the past find that they are unable to conceive again – this is called secondary infertility. Secondary infertility is more common than primary fertility and includes those who have had a child and then had problems conceiving a second and those who have achieved a pregnancy but then sadly lost the pregnancy. We included experiences of miscarriages and ectopic pregnancy in the section, ‘When fertility treatment fails’.

While primary infertility is recognised as a condition which has an impact on the wellbeing of women and men, secondary infertility can also be a source of great disappointment and distress. A new partnership or a desire to complete a family can make some people feel very strongly that they want another child.

The treatment for secondary infertility is similar to primary infertility in as much as the investigations follow a similar path in trying to identify whether the female partner is ovulating normally and the male partner has normal semen analysis.

Martha and Kate both had difficulty conceiving their second child although their first pregnancies were straightforward.

Martha had conceived easily with her daughter but had difficulty when she started trying for a...

Martha had conceived easily with her daughter but had difficulty when she started trying for a...

Age at interview: 34
Sex: Female
Age at diagnosis: 30
SHOW TEXT VERSION
PRINT TRANSCRIPT
Well I had my daughter with no problem, I got pregnant with her quite easily and when she was about fourteen months old we started trying to have a second one. And, [exhales breath] well it became clear quite quickly it wasn’t going to happen as fast as it had with her, but you know, you sort of think, okay, well [little laugh], you know, just carry on with it and whatever. I mean I think probably people have told you this before, I mean everyone says oh you shouldn’t worry until it is like this long or whatever. You do start worrying, you know, after just a few months especially if it has been quite easy. And I would say by six months into it and nothing was happening I was really, getting quite worried about it, and so what I had heard was that you are supposed to wait for a year, you know if you are the age that we were then and so after a year I went to the GP and I still find it quite shocking because I have not heard of another place where they say this, but here they will tell you oh no, we won’t do anything till you have been trying for two years which just seems like a really long time. And when I kind of pushed that, what they said, is the reason why, some, I can’t remember how the percentages break down but they decided to on this thing that something like 97% of people do manage to get pregnant within two years. But if you actually look at that it is like sort of 89% of what they were in the first year and then this tiny little percentage in the second. So I think it is a bit of a strange way of going about it, but that is how they went about it.
 
And so, well we, you know, I guess at that point, I think at that point I talked the GP into getting a couple of sort of simpler tests like hormone tests and whatever, and, I had those done and they looked normal so everyone was kind of, you know, well go away, and whatever. Do you want me to keep going?
 
Yes. That is great but carry on.
 
Yes. And so it was probably, I lose track of the timing of this, but it would have been a few months after that that I just finally decided I couldn’t really cope with it. I mean because I am sort of glossing of the whole fact that this is incredibly, you know, difficult to deal with for everybody. While all of this was going on.
 
And so we decided to go and get some private investigations done and I should say that we were probably in a better position than a lot of people who do that because my husband gets private health insurance through his work and I am on it, which means that they don’t cover, they won’t cover fertility treatments, but they will cover investigations, which means things like, what I got was a laparoscopy and that would, you know, if you had done that privately it would have been sort of £2,000 but we didn’t have to pay for it, so that, it made a big difference in terms of being able to go a bit more quickly than the NHS would have had us go.
 
So we went and did that and by then it would have been probably a year and a half with still nothing happening and so we went and did that, you know, go and got some tests, and we got the tests you would get really, and nobody could find anything wrong, you know, it was unexplained infertility. 
 

Martha felt that her GP, with whom she usually had a good relationship, did not take her concerns very seriously. She went on to have IVF to conceive her son.

Martha found that people couldn't really believe there was a problem with her fertility because...

Martha found that people couldn't really believe there was a problem with her fertility because...

Age at interview: 34
Sex: Female
Age at diagnosis: 30
SHOW TEXT VERSION
PRINT TRANSCRIPT

Well it was horrible. It was completely awful. And I mean I am not someone, I suppose I am not someone who deals with uncertainty very well anyway. And I think that just really pretty quickly into it, it got to be quite a big thing, especially for me, you know, to have people saying, “Oh well.” This is the thing, as everybody, especially as you have got one. Everybody’s reaction is, “Oh you have had one. There is nothing wrong.” You know, and they somehow assume, may be this is putting too much on people for me. But to me it felt like people somehow assuming that you must be doing something wrong. Because there is no way that this couldn’t be happening because you already have a child. So yes. So I mean it is not only that it is sort of a problem for what going on for you, but you are not getting an awful lot of support, at least I wasn’t from, you know, anybody else either, so… yes.

Martha also raised the difficulty of attending an infertility clinic with a child in tow. She said that she would not feel comfortable taking her daughter to a clinic because, “It could have felt weird” and she would expect little sympathy from women who had no children.

It was difficult to go through infertility treatment while also looking after a young child.

It was difficult to go through infertility treatment while also looking after a young child.

Age at interview: 34
Sex: Female
Age at diagnosis: 30
SHOW TEXT VERSION
PRINT TRANSCRIPT
Well yes, I mean certainly once that was going on, that was really, really, really, horrifically difficult because for us, [hospital] or any place. Basically when we came to choosing a place to go. The hospital in [city], it actually doesn’t have the best reputation around here for infertility treatment. They wouldn’t do IUI which is what wanted to begin with. They would only do IVF and for that even for a private patient there was a two year waiting list. So, I mean we weren’t going to do that and then it was either [city] or [hospital] and they are both two hours away. So you know, I was looking at these four hour round trips, you know, several times a week, trying to find… I never wanted to bring her with me. That was something I just felt like, this is not her problem and I really… I mean I did see people in there with small children, but I also would have felt really weird bringing a child into this place where some of these people, you know, hadn’t even, because this is the other thing that secondary infertility is, that you get very little sympathy because you already have a child and I felt like it just would have been really weird to bring her in there with people who couldn’t even have one to begin with. So yes, it was a lot of shuffling and trying to find child care and all of that. And trying to explain it when I would have kind of break downs in the middle of nowhere, or out of nowhere rather. And I remember this one day, when the hospital phoned up to cancel something with absolutely no apology or whatever and [husband] was out and I completely just like broke down crying and she is like, oh my God, and she probably three or whatever and she is like, “Mummy, what’s the matter?” and I am going, “I am okay.” Oh oh oh and sort of it’s awful, and I remember she decided it was because I had said, “Oh when is daddy going to come back?” And she decided that I was crying because I didn’t know when daddy was coming back. It was awful, it was just like trying, and you couldn’t explain this to her, because she had no idea what was going on. And you know, it was just that kind of thing was really, yes. It was quite hard.
 
Yes. I mean I think a lot of it… it is maybe not, may be not so significant for me, myself. You know, but certainly for [daughter], you know, for another child involved in it. I don’t really know. But I do know that it affected her having a Mother who was constantly upset, and constantly frazzled, and constantly, well almost just like hormonally messed up and that kind of thing. And I think it all kind of goes out the window if it works. You know, because it did and now we have got [son] and you know, we are happy with him and all of that. But I think if it hadn’t worked I would feel pretty bitter at this point, not because it hadn’t worked but because it would feel like an awful lot of wasted time. I mean, I remember even feeling like that at the time, just feeling like, feeling like I wasn’t sort of present enough, and I mean that not a physical sense, but you know, for [daughter] as she was going through a few years of her childhood that I was so consumed by this that it was very hard to kind of be, you know, the Mother, the kind I wanted to be for her. And so it is that kind of thing, you know, the fact that it does take a toll on everybody involved. I mean I am just using her as an example, but I mean it does, you know. I don’t think there is anybody who has done this where they probably haven’t lost friends over it or lost contact with family members over it. Or, you know, there is just so much involved, and nobody looks at it the same way, and everybody has their opinions and it just is going to change things really, yes.
 

Martha worried about the effect on her daughter of having a mother who was, “Constantly upset and constantly frazzled”.

When Anne’s daughter was about four years old she felt ready to try for another child, but nothing happened.

After 18 months of trying for a second baby Anne went to her GP who referred her to a clinic. She was unable to pursue treatment because her partner was unwilling to take part.

After 18 months of trying for a second baby Anne went to her GP who referred her to a clinic. She was unable to pursue treatment because her partner was unwilling to take part.

Age at interview: 41
Sex: Male
Age at diagnosis: 39
SHOW TEXT VERSION
PRINT TRANSCRIPT
So we removed all contraception and started I think about 2004, January. So obviously, we tried like the medical textbooks say you do. And you automatically assume, especially when you are a teenager and you are taught the facts of life, when you have sex there is a very good chance you can have a baby.
 
Well as 2004 went on and nothing happened it was like no it doesn’t happen all the time like that. So we left it a year. And then 2005 came and then I think it was about March 2005 or somewhere around that time, I went to my doctor and obviously explained about I had been trying for over a year, etc. etc. 
 
So he arranged for me to have some blood tests. They all came back quite normal and I also mentioned to him that I had extremely bad ovulation pain in the middle of my menstrual cycle. So he said, “Well we will just get it checked out.” He said, “And then we will see what the situation is.” 
 
So we obviously kept on trying. 
 
So I went to one of the hospitals in [city] and saw a gynaecologist and he basically said to me, it was quite normal what I was experiencing. And didn’t see any major, anything wrong, because I think I had an internal scan as well to see if there was any ovarian cysts or anything like that. 
 
So he said, “Since you have been trying for nearly a year and a half, we will send you to the fertility clinic.” So I said, “Okay that is fine.” 
 
Anyway when I got the forms back from the fertility clinic to actually fill out medical history, names, addresses and what have you, I asked my partner for his details and he basically said, “I am sorry [name] but I don’t want to take part in any of these tests.” So I said, “Oh why?” He said, “I just don’t want to.” He said, “Don’t badger me about them.” He said, “I just don’t want to do it.” So I was like, “Oh, okay.” So he said, “If it happens, it happens. I am not going down this road of any testings and having this tested and what have you and stuff.” 
 
So I rang up the fertility clinic and they basically said to me, “We can’t take this any further, because your partner won’t agree to any tests.” So I went, “Oh, okay, right.”
 
So I then started doing a bit of research for myself and that is when I found that I had got this medical condition, or what I presume has happened to me. It is called, secondary infertility, which means the... you find it impossible to conceive again after you have had a baby. 
 
So that avenue was sort of blocked and the only way forward basically would be if I had any, I had a load of money to pay for private treatment. 
 
And then after reading various information articles and booklets and stuff, a lot of people or a certain proportion found and even my doctor said this to me. Once they have had fertility treatment and they have not worked and they have given up, they have conceived naturally, probably because of all the stress that has been taken off them and what have you.
 
So I thought right, okay. I also got myself a new job in this interim period, so I was a lot more, not as focussed on babies as much as I was the year before sort of thing. So I thought right okay, we don’t need to use any contraception. We will just keep on trying.
 

Anne found it hard to cope with secondary infertility and wishes there had been more support for...

Anne found it hard to cope with secondary infertility and wishes there had been more support for...

Age at interview: 41
Sex: Male
Age at diagnosis: 39
SHOW TEXT VERSION
PRINT TRANSCRIPT
So I sort of like tried to think more, I need to get focused. I need to try and think of something different to do which will take my mind off it, and you know not make me think about it all time. Like I was saying about I was going to go back to college to do another teacher training qualification. Or try to do something different in a weekend rather than being stuck in the house and brooding a little bit, you know, do something different with [daughter], which is my daughter. So yes, it was difficult some days, especially also when you went into work and was told somebody was pregnant. It sort of like came crashing down again on you and you think oh I didn’t really want to know that because I am trying to build myself up again to get out of the pregnancy bubble sort of thing and then suddenly it just goes pop and you go back down again.
 
I didn’t realise it was this hard. I assumed it would be quite easy to get pregnant again. It would happen within a year. I wish I had known a bit more about miscarriages because they can happen to anybody. I wish that I hadn’t had the bleeding problem after the miscarriages because that doubled the pain I was feeling at the time. 
 
I would love sometime to go to women who find it easy to get pregnant and say, “You do not know how lucky you actually are to be able to get into that condition,” sort of thing to some people out there. I mean sometimes when you are in like situations, you might hear somebody saying, “Oh I don’t know why that woman has had so many children, she can’t look herself properly as well as her own children.” Blah blah blah and sometimes life does seem unfair in that way. 
 
It is unfortunately part of life and you have to deal with it, but I can imagine that having infertility that doesn’t lead to a baby, is possibly one of the worst scenarios that anybody can actually have. I mean it has obviously been going on since time began, because you hear of all kings and queens that were married and xx had no children. Xx had still born children and stuff and you think well it has been happening for ages, but they didn’t know about it just then. But it is an awful condition and there is nobody who can help you apart from somebody else who is going through the same as you. But how do you find these people. I wish there was some type of scheme whereby you could voluntarily put your name on a register and when your doctor is aware of what is happening or somebody say would you like to be contacted by somebody who can support you through this who is doing exactly the same. But there is nothing. Absolutely nothing.
 

Eventually Anne was successful in conceiving without treatment, three and a half years after she started trying.

Last reviewed July 2017.

Copyright © 2024 University of Oxford. All rights reserved.