Although thousands of couples are affected by the experience of secondary infertility, it remains a little known condition that people rarely talk about.

Here’s what you need to know:

What is secondary infertility?

Secondary infertility is when you have given birth to at least one baby but find you are unable to conceive again. Tammy, 38 has one daughter, Sarah aged four and has been trying for a second baby for 18 months. “I had no problem getting pregnant with Sarah, in fact I think it took us just two months, but this time round it’s been a long hard slog. To begin with I just laughed it off but these days I cry every month when my period comes. Friends are unsympathetic hinting that I should be happy as I have one already, and even my husband says it’s okay if it never happens but it’s not. I feel desperate for another baby but don’t feel I have the right to complain.”

Why does it happen?

Unfortunately past fertility does not equal future success. Midwife Zita West and the author of Zita West’s Guide to Fertility and Assisted Conception (Vermilion 2010) says she sees many women suffering with secondary infertility and one of the reasons it’s on the increase is because more of us are having babies later. “SI is a very difficult condition because there is a huge emotional factor involved,” says Zita. “If you have your babies later, then it’s likely you are conscious of your declining fertility and want your babies in short succession. But really the body is not ready for at least 18 months and maybe even longer especially if your first birth was traumatic.”

When should I worry?

If you’re trying to conceive again and/or are over the age of 35 you should seek help after six months. See your GP and ask for a referral to a fertility specialist.

What are the causes of secondary infertility?

There are a number of underlying medical conditions such as endometriosis, a poor sperm count and fibroids that may not have affected your first conception but could affect subsequent ones. Or problems that can kick in after the birth of your first child, which can then affect your ability to conceive. For example a Caesarean may have caused uterine adhesions, a womb infection post labour or a retained placenta can all also cause scarring making conception difficult.

What else could be wrong?

Lifestyle can also have a massive effect on your fertility. If you’re having problems look at your lifestyle to see if it has radically changed from the first time you became pregnant. For instance, compared to the first time you conceived have you and your partner:

• Gained weight/lost weight (both have an adverse effect if taken to extremes)
• Taken up unhealthy habits such as smoking or drinking
• Are you more stressed?
• Are you having regular sex once or twice a week
• Has your menstrual cycle changed/do you know when you’re ovulating?
• Do you have high blood pressure?
• Are you tired all the time?

All of the above can affect your ability to get pregnant.

What will a specialist do?

A fertility specialist will determine if you are ovulating, if your partner’s sperm is healthy and strong and look for damage and abnormalities in your reproductive system, through a range of tests (see article When to See an Expert).

Where can I go for secondary infertility support?

It’s not uncommon to feel alone and unable to talk to close friends and family about secondary infertility, which is why the forums on the following sites, can be a great help.

Infertility Network UK www.infertilitynetworkuk.comFertility zone www.fertilityzone.co.uk