Are you suffering from secondary infertility?

For many parents, trying to conceive a second time can prove more difficult than they imagined. Fertility expert Emma Cannon explores the subject

Interestingly, according to Chinese medicine, a woman needs five years between children to recover her energies and make space in her life in order to give proper care and attention to the next child. But with the average age of a woman having her first child being 29, this would be impossible for many, and it has become necessary to have children closer together.

Secondary infertility is the inability to become pregnant following one or more successful pregnancies. One in seven couples struggle with secondary infertility and many of the patients I see in clinic are finding it difficult to conceive a second or third child. Infertility affects approximately 15% of the population and secondary infertility approximately 5%.

Sometimes it is simply a matter of reduced opportunity; it can be hard to fit in enough sex when you already have one or two children and you are tired from broken nights. Furthermore, there is a growing trend to have our children in quick succession with very little gap in between.

Sadly, many couples who suffer with secondary infertility can remain uninvestigated for too long. Often it is assumed that since they conceived perfectly easily the first time it is only a matter of time before they will again. Or they wait too long to seek help because they feel they are ‘lucky enough’ to already have a child. Listen to your instinct, if you feel something is not right or that something in your body or menstrual cycle has changed then be sure to visit your GP or find a fertility consultant who can help.

Dr Alan Beer, author of Is Your Body Baby Friendly? suggests that in some women an immunological problem can develop; “Women with one liveborn child followed by a history of infertility, IVF failure or miscarriage have the highest incidence of autoimmune disorders.” He suggests that if the problem is of an immunological nature, these women can actually be among the hardest to treat. If immunology is the cause it often results in a problem around implantation. So the sperm and the egg can appear to be normal and fertilisation will occur, but the embryo will fail to implant. It is thought that elevated NK (natural killer) cells are to blame. There is much controversy around this diagnosis and treatment, making it hard for the patient to find suitable answers. The good news is, research suggests couples who have had one or more children and are seeking treatment are more successful and have more live births than couples who have not had children.

When you’re trying to conceive… 

Seek help if you have been having regular sex for a year and have not conceived.
Try acupuncture to help optimise fertility.
Address your diet and manage your BMI.
Prioritise sex and make space in your life for your partner and your relationship.
Monitor your menstrual cycle and note if there are any changes. Your menstrual cycle is the only outward sign of your fertility.
Be positive and have gratitude for all the gifts in your life.
Seek emotional support if you think you may be traumatised by a previous birth.

• Turn your life into ‘project baby’ and become obsessed with having the next one.
• Become a Google addict.
• Compare yourself to other people.
• Forget that this is about your loving relationship with your partner.
• Diary sex in – it is such a turn-off for your partner and makes sex less enjoyable for you.
• Leave it if you really feel something is wrong and you have tried everything mentioned here.
• Wait too long if you are over 35 and you want another baby.

Do I have a problem?

As a general guide, if you are having regular sex every two or three days and you have not conceived within a year, then seek help. It is important to also check the following:

Have your periods returned to normal?

Did you breastfeed for longer than nine months? This can result in the blood becoming deficient and responds well to acupuncture and herbal medicine.

Have you gained or lost a significant amount of weight? If so, get your thyroid tested. Weight can also affect conception if your BMI is too high or too low.

Did you lose a lot of blood in your previous delivery or after?

Did you have retained products of birth which were hard to pass, or had to be surgically removed? You might need a scan to check that the uterine lining is clear and there are no adhesions.

Did you have a traumatic birth or suffer from postnatal depression? If yes, perhaps you need to work through this with a counsellor.

It is worth getting a sperm test because sometimes sperm problems can develop, particularly if your partner has had an acute illness with a fever.

Age. It’s important to remember that as you get older your fertility does naturally reduce and may play a part in subsequent pregnancies taking longer to conceive.

Resist the habit of comparing yourself to other people. We are all different and just because those around you are having babies close together, you don’t have to follow the crowd. When babies are small, a year or so seems like a long gap, but in the bigger scheme of life it really isn’t that long.

Asherman’s Syndrome is scarring of the uterus. This can result in lighter periods or no periods at all as it is difficult for the endometrium to be shed. If you think you might be suffering from Asherman’s, visit your GP as it is treatable.