Updated by the Progyny Editorial Team — September 2025.
Secondary infertility can feel confusing and stressful. It happens when you have trouble getting pregnant after having one or more prior successful pregnancies. We spoke with Dr. Christine Hur, reproductive endocrinologist (REI) at Indiana Fertility Institute, to help explain what secondary infertility is, why it happens, and what support and treatment options are available.
Secondary infertility shares many of the same causes as primary infertility. Its causes include but are not limited to:
One of the most important considerations is age. Unlike people with sperm, who produce new sperm every few months, people with ovaries are born with all the eggs they will ever have. Egg quantity and quality both decline over time, which makes conception more difficult. Sperm quality can also decrease with age, but this usually happens later in life.
Your overall health may also play a role. Weight changes, alcohol or tobacco use, or newly diagnosed medical conditions can affect your ability to conceive.
Certain medical conditions can develop or worsen after a prior pregnancy and interfere with fertility. These may include hypertension, diabetes, obesity, endometriosis, polycystic ovary syndrome, adenomyosis, and uterine fibroids.
For people with sperm, a decline in testosterone or other hormone changes can affect sperm production and quality.
Complications from a previous pregnancy or birth — such as scar tissue from procedures or infections — can also affect the uterus or fallopian tubes.
Diagnosis usually starts with a thorough medical history and physical exam. From there, an REI fertility may recommend tests to check:
These tests can help identify the underlying cause and guide your care plan.
Treatment is tailored to the cause of infertility and may include:
Secondary infertility can bring up many emotions, including confusion, frustration, guilt, and grief. These feelings are valid, and you don’t have to manage them alone. Support can come from:
It can also help to educate people close to you about the realities of secondary infertility, since many assume that if you’ve had one child, having another should be easy. Sharing your experience can build understanding and reduce feelings of isolation.
Secondary infertility affects about one in ten couples. With comprehensive care, tailored treatments, and the right emotional support, many people are able to conceive again and grow their families.
Progyny is here for you, too. Please contact your Progyny Care Advocate for support.
Disclaimer: The information provided by Progyny is for educational purposes only and is not medical advice. Always consult a qualified healthcare provider for medical guidance.