What is secondary infertility? Plus, 9 ways to cope

Physical WellbeingWomen's Health

Sep 2

Written By Calm Editorial Team

Clinically reviewed by Dr. Chris Mosunic, PhD, RD, MBA

Secondary infertility can feel confusing and lonely. We’ll explain the common causes for men and women, and 9 ways to help you cope while protecting your mental health.

Deciding to expand your family can be exciting and all-consuming, even if you’ve done it before. You might imagine your older child doting on a younger sibling, another face at the dining room table, and the sweet chaos that comes with a new baby.

But if you've been trying for months without success, that anticipation can quickly turn into anxiety and stress. Maybe you’re grieving the age gap you’d always envisioned, worrying about the family you may not have, or feeling guilty for wanting another child when you already have one.

Secondary infertility is isolating for a number of reasons, and making matters more complicated, you’re still a parent in motion, packing lunches, arranging playdates, and coordinating drop-offs and pickups. Taking the time to unpack your feelings may feel impossible.

If this experience sounds familiar, know that you’re not alone. Let’s explore what secondary infertility is, possible causes and treatments, and ways to care for yourself while tending to the family you already have and love.

What is secondary infertility?

Secondary infertility is the medical term for struggling to conceive or carry a pregnancy to term after you’ve already had at least one child without interventions. It’s diagnosed after six to 12 months of trying (depending on your age), and it’s often met with surprise. After all, if it happened once, shouldn’t it happen again?

Unfortunately, having a successful pregnancy in the past doesn’t guarantee the same in the future. Many factors can change between one child and the next, such as your age, health conditions, hormone levels, or your partner’s fertility.

Some people experience secondary infertility after a long delay between children, while others might struggle immediately after a first birth. Either way, the emotional toll can be heavy, especially when people around you assume everything’s fine.

How common is secondary infertility?

Secondary infertility is more common than you may have realized. According to the Centers for Disease Control and Prevention (CDC), about 13% of women with one child experience impaired fecundity, or difficulty conceiving or carrying a child to term. The organization also reports that 6% of married women who have given birth at least once experience infertility.

Globally, the World Health Organization estimates that one in six couples experience infertility (either primary or secondary) at some point in their reproductive lives. And yet, conversations about fertility often focus only on those couples who’ve never had a child. This can leave people facing secondary infertility feeling invisible — or worse, ungrateful.

Common causes of secondary infertility

There’s no single reason why secondary infertility happens, which can make it all the more frustrating. Sometimes, a clear cause is found after medical testing, but other times, everything looks “normal” on paper and you’re left without answers.

Here’s what we do know about some of the most common contributing factors — but note that this isn’t an exhaustive list.

Age-related fertility decline: Fertility naturally changes over time, and this is especially true for women. Egg quantity and quality both decline with age, particularly after 35. This can affect ovulation, increase the risk of miscarriage, and make fertilization less likely. If your first child came easily in your 20s or early 30s, it might feel confusing that you’re struggling now. But biologically, even a few years can make a difference.
Ovulation or hormonal changes: Conditions like polycystic ovary syndrome (PCOS), thyroid imbalances, high prolactin, or perimenopause can disrupt the hormones that control ovulation. These issues can show up for the first time after pregnancy or worsen over time, even if your cycles were once predictable.
Structural or physical complications: Pregnancy, delivery (especially C-sections), or other uterine procedures can cause scarring in the uterus or fallopian tubes. Conditions like fibroids, endometriosis, or pelvic adhesions can also develop or progress, interfering with implantation or egg transport.
Sperm quality or quantity issues: Women aren’t the only ones dealing with fertility challenges. About one-third of infertility cases involve male-factor causes. Aging, illness, certain medications, or lifestyle shifts can reduce sperm count or motility, even if there were no issues with your partner’s fertility before.
Weight, lifestyle, and health changes: Significant changes in weight, sleep, or stress levels can impact fertility. New or chronic medical conditions, such as diabetes or autoimmune diseases, may also play a role.

How to cope with secondary infertility: 9 tips to care for your mental health

Secondary infertility carries a unique emotional weight. You may be grieving the future you imagined while parenting a child who already sees you as their whole world. That duality can be overwhelming, and you might even feel guilty for feeling the way you do.

While it’s impossible to remove the pain entirely, know that there are strategies that can help you care for your mental health while still showing up for your family in the ways that matter the most.

1. Start with validation, not shame

You’re allowed to want more than one child. This desire doesn’t make you ungrateful or selfish — though for many, these emotions may bubble up.

Start by naming your feelings without judgment, whether that’s grief, resentment, exhaustion, jealousy, or hope. Journaling, therapy, or even saying them out loud can help unstick the fears that are lodged in your chest.

💙 Make space for your complicated emotions with Jay Shetty’s Accept Anxious Feelings meditation.

2. Make space for your invisible grief

Secondary infertility often goes unrecognized by others. Friends may assume you’re “already lucky” or “not really struggling,” which can make it harder to open up about how you truly feel.

Your grief still exists, whether other people acknowledge it or not. That’s why it’s essential to create intentional space for it, whether that’s with a quiet walk, time with a therapist, a conversation with a partner, or a support group where you don’t have to pretend to be fine all the time.

3. Communicate openly with your partner

Fertility challenges can strain even the strongest relationships. You may even cope with the issues differently: One of you might need to talk often, while the other could require more space.

Try to check in regularly about how you’re doing emotionally, what you need, and how you can support each other. A simple, “Do you want comfort or space right now?” can go a long way.

💙 Learn how to explore Kind Communication with your partner with this meditation from the Love and Relationships series with Tamara Levitt.

4. Carve out low-pressure time with your child

It’s common to feel distracted, guilty, or even resentful while parenting through infertility. Instead of forcing joy, aim for presence.

Set aside some time—maybe 15-30 minutes a day—to give your child your undivided attention. This might include whatever brings them joy, like reading books, building forts, baking cookies, or even snuggling quietly. These micro-connections matter so much more than you might think.

5. Build a circle that gets it — and set boundaries with those who don’t

It can just be a relief to know that you’re not alone, so you may want to join a support group or online community for people experiencing secondary infertility.

At the same time, you may need to set boundaries with loved ones who offer unsolicited advice, dismiss your feelings, or unintentionally cause you pain. A simple, “I’m not up for talking about this right now, but I appreciate your care,” can help you protect your energy.

6. Choose if, when, and how to talk to your child about it

Depending on their age, your child may pick up on emotional changes or wonder if they’re going to get a younger sibling. You don’t have to share everything, but offering a gentle explanation, like “We’re hoping to have another baby someday, and sometimes that takes a little time,” can help them feel secure and included. Keep it age-appropriate and open-ended.

But if you don’t want to discuss it or it doesn’t feel right, that’s okay too. Your relationship with your child is your own, and you’ll know how best to handle the situation if they ask.

7. Find a steady self-care rhythm

Grief can make self-care difficult, so go easy on yourself. Instead of assuming you need to create the perfect 10-step morning routine, focus on small rituals that soothe your nervous system, like sipping a warm drink in silence, deep breathing for 60 seconds, walking barefoot in the grass, or taking five minutes in the car before re-entering the house. Small shifts can make a huge difference if you do them consistently.

💙 Learn how to take just a few minutes to relax with Chibs Okereke’s Breathe to Calm Down meditation.

8. Limit exposure to emotional triggers

Give yourself permission to decline invitations to baby showers or mute or unfollow certain social media accounts if they leave you feeling sad or depleted. It’s okay to prioritize your mental health.

Instead, replace these inputs with ones that feel neutral or hopeful, like infertility podcasts, mental health accounts, or anything unrelated that brings you joy.

9. Set boundaries around treatment timelines and emotional bandwidth

Trying to conceive can take over everything, from your mental bandwidth to your time. If it’s taking longer than you expected, talk to your doctor. Sometimes, just having a plan can bring relief.

Also, give yourself permission to pause. Skipping a cycle, taking a vacation, or focusing on family time doesn’t mean giving up. You’re allowed to honor the rest of your life, even when things feel difficult in this particular area.

Secondary infertility FAQs

Who is at risk of secondary infertility?

Anyone who’s previously had a child and is trying to conceive again can experience secondary infertility. Risk factors include being over the age of 35, having a history of reproductive health issues like endometriosis or polycystic ovary syndrome, or past complications during childbirth or surgery, such as a cesarean section that caused uterine scarring.

Partners may also face changes in sperm health due to age, illness, or lifestyle shifts. Even couples who conceived easily the first time may encounter new obstacles as their bodies and circumstances evolve.

What are the signs of secondary infertility?

The most obvious sign of secondary infertility is the inability to conceive after six to 12 months of trying. But there may also be more subtle signals, like irregular periods, changes in menstrual flow, pain during sex, or symptoms of hormonal imbalance — like unexplained weight gain or hair thinning.

For male partners, signs might include changes in libido, erectile function, or ejaculation. Still, many people experience no obvious symptoms until they begin trying again, which is a big reason why secondary infertility can come as such a shock.

Can stress cause secondary infertility?

Stress doesn’t directly cause infertility, but it can influence it. Chronic stress can disrupt the hormones that regulate ovulation and sperm production, making conception more difficult. It also tends to increase cortisol and inflammation, which can affect reproductive function.

Aside from this, the emotional toll of trying to conceive month after month can create a feedback loop of anxiety and despair. While managing stress won’t guarantee pregnancy, caring for your mental health is a meaningful part of the process. Practices like mindfulness, therapy, and low-impact movement can offer relief during this difficult time.

How long should I try to conceive before seeing a fertility doctor?

It depends on your age and medical history. If you’re under 35, most doctors recommend trying for one year before seeking an evaluation. If you’re over 35, the timeline shortens to six months.

If you’re over 40 or have known risk factors like irregular cycles, past miscarriages, or a diagnosed reproductive condition, it’s a good idea to check in sooner. Trust your instincts here. If something feels off or the stress is becoming too much to carry alone, reaching out earlier can provide clarity.

What are some treatment options for secondary infertility?

Fertility treatments vary depending on the underlying cause. For hormonal issues, medications like Clomid or letrozole can stimulate ovulation. If there are structural concerns (such as blocked tubes or uterine scarring), surgery may be recommended.

Intrauterine insemination (IUI) and in vitro fertilization (IVF) can also be common next steps when less invasive options haven’t worked.

For male-factor infertility, treatments might include medication, lifestyle changes, or sperm retrieval techniques. Not everyone chooses to pursue medical treatment, but if you feel like it makes sense for you, know that there are options available.

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Calm Editorial Team