Important update
This article was originally created with Apricity Fertility in 2024. The Human Fertilisation and Embryology Authority (HFEA) confirmed that Apricity Fertility ceased all operations from 1 January 2025. We have retained the useful educational parts of the original article but removed outdated booking links, prices and descriptions of services that are no longer available.
Secondary infertility: navigating the journey of conceiving again
You've felt the joy of welcoming a child into your life—the first smile, the tiny fingers gripping yours, the milestones that fill your heart with pride. As your family grows, so does your dream of giving your child a sibling.
But what happens when that dream is met with unexpected silence? When months of hoping bring repeated disappointment?
This is the often-hidden struggle of secondary infertility. WHO defines secondary infertility as infertility following at least one previous pregnancy. Having conceived before does not guarantee that conceiving again will be straightforward.
Common causes of secondary infertility
The causes can mirror those seen in primary infertility and may involve either partner.
Age
Fertility generally declines with age, particularly as ovarian reserve and egg quality reduce over time.
Male-factor infertility
Changes in sperm number, movement or shape can affect the chance of conception.
Ovulation disorders
Conditions such as PCOS can affect how regularly ovulation occurs.
Uterine or tubal factors
Blocked or damaged fallopian tubes, fibroids, endometriosis or previous pelvic infection may affect conception.
Lifestyle factors such as smoking and heavy alcohol use can also affect fertility, but infertility should not be reduced to a lifestyle problem or blamed on stress.
NHS fertility funding and secondary infertility
NICE recommends up to three full cycles of IVF for eligible women under 40 in defined circumstances, but actual NHS-funded access is decided locally by Integrated Care Boards (ICBs). Local policies can differ, including criteria relating to age, BMI, smoking and whether either partner already has a child.
That variation means some people with secondary infertility may not meet their local funding criteria even when treatment would otherwise be clinically appropriate. Ask your GP or local ICB for the current policy where you live rather than relying on old CCG guidance or historical price comparisons.
The emotional toll of secondary infertility
The journey can bring complex emotions, including:
- Isolation: other people may assume having one child should make the struggle easier.
- Guilt or shame: wanting another child can coexist with deep gratitude for the family you already have.
- Jealousy and sadness: seeing other families grow can be painful.
- Relationship strain: partners may grieve, communicate and cope in different ways.
These responses do not make you ungrateful. Fertility counselling or support groups can provide a space where the experience does not need to be explained or minimised.
Seeking support and treatment
Assessment depends on your history and may look at ovulation, sperm, the womb and fallopian tubes, as well as other health factors. Treatment is tailored to the cause and can include medicines to support ovulation, surgery in selected cases, or assisted conception such as IVF.
If you have been trying to conceive for a year without success, NHS guidance recommends speaking to a GP. Seek advice sooner if the woman is aged 36 or over, or if there is a known fertility concern.
What not to say to someone experiencing secondary infertility
- “At least you have one child.”
- “You should be grateful for what you have.”
- “Maybe it's not meant to be.”
- “Just relax and it will happen.”
More helpful alternatives can be simple:
- “I'm here for you if you want to talk.”
- “I can see how hard this is.”
- “Is there anything I can do to help?”
Final thoughts
Secondary infertility is a real and often misunderstood form of infertility. A previous pregnancy does not remove the need for support, investigation or treatment when conception becomes difficult.
Open communication, appropriate medical assessment and support from people who understand fertility-related grief can make the journey feel less isolating.
Sources and current-service information
HFEA: statement on Apricity Fertility
NHS: infertility treatment
WHO: infertility







