Why Can’t I Get Pregnant Again? Causes of Secondary Infertility


What are the causes of secondary infertility? Do I need to see a doctor or get infertility treatment even If my first child was pregnant naturally?

The term “second-child infertility” is often used to describe cases in which a woman is unable to get pregnant despite her best efforts to have a second child. This may be due to a variety of reasons, including age, that makes it more difficult to get pregnant than with the first child.

Whether your inability to get pregnant is a mere coincidence or whether you should consider infertility treatment, …… is a good place to start if you want to have a second child, or if you are thinking about having a second child in the future.

What is Second-Child Infertility?

Although there is no clear definition of second-child infertility, it is generally defined as “a condition in which a woman does not get pregnant for one year after she has finished breastfeeding her first child, despite having unprotected sex.

It is said that some people have problems with second child infertility, such as “I had my first child, but I can’t have a second child” or “I want to have a sibling for my child as soon as possible.” There are also those who feel alone, saying, “I can’t talk to anyone about it because I’m worried about those who are having trouble having their first child.

However, in the case of second-child infertility, the point is the same: “I want to have a child, but I can’t.” The concept of treatment is the same for both first-child and second-child infertility.

Causes of Second-Child Infertility

There are several causes of second-child infertility. In many cases, the cause of infertility is unknown, and it cannot be attributed to one gender or the other. The same is true for second-child infertility, which is thought to be a combination of multiple factors.

This is not to say that because you had your first child, it is wrong that you cannot have a second child as well.

Difficulty in getting pregnant due to aging

By the time a couple wants to have a second child, they are both older than they were when they had their first child. As a result, the mother’s body, eggs, and sperm have aged, making it more difficult to get pregnant in the first place.

According to the Ministry of Health, Labor, and Welfare’s Current Population Survey for 2019, the average age of mothers at the time of the birth of their first child was 30.7 years old.

A 2017 report by the Japanese Society of Obstetrics and Gynecology found that the pregnancy rate drops after the age of 30). The later the timing of wanting a second child, the lower the chances of pregnancy inevitably become.

Physical changes after the birth of the first child

The scarring of the uterus caused by the cesarean section during the first pregnancy can make it difficult for the fertilized egg to implant. In addition, gynecological diseases such as endometriosis and uterine fibroids may cause a decrease in the pregnancy rate.

Factors on the partner’s side

In some cases, it is more difficult to get pregnant because the partner’s circumstances have changed since the first pregnancy. There are a number of reasons for this, including stress, changes in the living environment, a decline in sperm count or activity rate due to aging, lack of opportunities for sexual intercourse due to a busy work schedule, and inability to have intercourse.

Difficulty getting pregnant, to begin with

In some cases, the cause of infertility may have been present from the time of the first pregnancy. If the pregnancy rate was low in the first pregnancy, it will be difficult to have a second child.

Measures for second child infertility

The measures to deal with infertility are almost the same for both second and first child infertility. The first step is to check whether you or your partner is infertile. It is then important to consult a doctor and undergo tests.

Determining the timing of fertility treatment

It depends on the fertility policy of the doctor and the age of the mother, but in general, if there are no signs of pregnancy for a year, despite the fact that the mother is trying to get pregnant and having regular sex, infertility treatment should be considered.

If the mother is over the age of 35, you may decide to seek treatment after about six months.

Check to see if infertility treatment is necessary.

When you are breastfeeding, the pituitary gland secretes a hormone called prolactin, which suppresses ovulation. If you have been trying to get pregnant for more than one year (six months if the mother is over 35 years old) after breastfeeding ends and menstruation begins, and you can think of any of the following, you should consult an obstetrician.

  • Female side
  1. Menstrual flow is too heavy or too light
  2. Severe menstrual pain
  3. Irregular menstrual cycle
  4. Had a cesarean section or ectopic pregnancy during the birth of your first child
  5. Infected with an STD after the birth of your first child
  6. Had a major surgery after the birth of your first child
  • Male side
  1. Problems with sexual function (e.g., erectile dysfunction, inability to ejaculate)
  2. Had testicular surgery
  3. Had mumps after the birth of the first child
  4. Experienced infertility with another partner (e.g., if remarried)

Things to Consider Before Deciding on Infertility Treatment

Before starting infertility treatment, you and your partner should check what you can do together, and make a life plan of what your future life will be like as a result of infertility treatment.

If either one of you becomes overwhelmed or under a lot of psychological pressure, it will be difficult to get pregnant, and there are also concerns about the psychological impact on the first child.

Have you cleared up issues such as obesity, smoking, and lifestyle-related diseases?

As you get older, it becomes harder to get pregnant. Do not leave them untreated, but treat them proactively and review your lifestyle and other factors to make it as easy as possible to get pregnant again.

Are you trying to lead a healthy life, including sleep and diet?

Try to keep your body and mind healthy on a daily basis. In addition to avoiding stress and insomnia, it is also important for men to avoid overheating their testicles (e.g., not using a laptop on your lap, refraining from taking long baths or saunas), and for women to keep their bodies cool.

Are you convinced about the financial issues involved in infertility treatment?

Regardless of the type of treatment you choose, infertility treatment can be very expensive. Including public subsidies, family support, etc., consider how much money you can afford to spend without it affecting your life. If the financial burden becomes too great, long-term treatment will become difficult.

Do you understand the burden and sharing of the care of the first child and household chores?

Do both partners have a good understanding of how to cooperate with each other in housework and childcare? Since infertility treatment often places a heavy burden on a woman’s body, it is important to make adjustments, especially to raise the awareness of the partners, so that the burden of housework and childcare is not placed on them.

Have you discussed the timing and conditions for giving up on the second pregnancy?

Continuing to want a second child can be an emotional burden for the first child. It is a good idea to decide how long you want to continue fertility treatment, both financially and for the sake of your physical and mental health.


If you can’t have your second baby easily, don’t worry about it and don’t blame it on you. It’s a natural thing. You just need to check your body condition and your partner’s condition as well. Be sure to talk about it openly with your partner to find the best solution for you.

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