Many women experience some difficulties when trying for a second pregnancy. Even after having a previous pregnancy, sometimes the second pregnancy is a lot of work to achieve. Occasional infertility without any apparent reason, after all, this woman or couple already has a child. Some couples have the first child and, after some time, resume attempts to conceive believing that everything will be easier, but that’s not always the case.
The issue with a second pregnancy is precisely expecting that it will be easy for the woman to become pregnant. Even more so if the first pregnancy happened relatively quickly, concerns may start to arise after some time trying for a second pregnancy. For a healthy couple of reproductive age, a normal, safe, and recommended time for trying for another pregnancy is one year.
Worrying factors for a delay in a second pregnancy can be varied, and so are the situations in which this difficulty occurs. Couples wishing for another child and who have been trying for over a year should see a doctor, just as couples who are trying for their first. Tests are essential to discover the reason for waiting without results. In search of the cause of the delay of a positive result for the second pregnancy, the doctor treating the couple should consider if:
- The first pregnancy was with the same man as the current attempts
- If there is any new physical factor preventing a second pregnancy
- Lifestyle (health, diet, and habits)
- External factors (clothing, accidents, etc.)
For those seeking their first or even second pregnancy, it is important to remember that health should be as good as possible. Quitting smoking, drugs, and alcohol during attempts to conceive can help pregnancy happen more smoothly 1. Physical reasons that may prevent fertile couples (who have already conceived) should indeed be investigated. Hormonal testing for men and women, uterine ultrasound, and semen analysis are some of the basic exams for those trying for a second pregnancy.
Some illnesses can develop after the first pregnancy, especially if there’s a long wait before the second one. Time may bring a uterine infection, anovulation, and hormonal changes for the woman. It can also result in a testicular infection for the man, which may result in low sperm count or even poor sperm quality.
Treatments for Couples Trying for a Second Pregnancy
Usually, cases involving a second pregnancy are easier from a medical perspective. The important thing is for the couple to be open to seeking the cause of their current infertility. After one year of trying, a good professional should be consulted, who will request some additional exams to assess the couple’s health. Couples with a history of infertility when trying for the first pregnancy may or may not find it hard the second time. In these specific cases, new tests must be done to diagnose what is preventing conception. In more specific cases, with conditions such as endometriosis, polycystic ovaries, or even varicocele, treatment can already be started to shorten the couple’s waiting time.
Another factor that can have a major impact and even cause a longer wait for a second pregnancy is age. Women over 35 years old may have greater difficulty than a younger woman, about 25 years old, for example. The older the age, the longer it takes to get pregnant due to egg quality. The difference for women trying for a second pregnancy who are a bit older, around 40 years old, is that the waiting period should be reduced from one year to six months. Along with this, a good recommendation is to take appropriate fertility vitamins 2.
If pregnancy does not occur, the couple’s investigation should be started by a doctor. The most common problems that make a second pregnancy difficult may be the same as those that existed before the first pregnancy. Remembering that time can lead to a more advanced stage of disease, making it even harder to conceive. Examinations to investigate secondary infertility:
- Hormonal: will detect any alteration preventing ovulation
- Ultrasound: checks for issues such as polycystic ovaries, endometriosis, fibroids, cysts or tube adhesions that could make pregnancy more difficult
- Semen analysis: checks for changes in the seminal fluid or presence of infection
Once diseases that prevent pregnancy are ruled out, a new step can be taken. The doctor may recommend procedures and medications like ovulation inducers 3 and fertility vitamins for women, as appropriate supplements without health risks.
Having the patience to wait for a second pregnancy may not be any easier than for women trying to conceive for the first time. The wait is never pleasant for a couple wanting a baby, and uncertainties about what is happening with the body, since there was already a first pregnancy, make the process painful. These are different expectations and situations, and they should not be minimized simply because there has already been a child before.
In cases of couples whose first pregnancy did not result in a child, a more in-depth investigation should be carried out with the doctor in charge. Looking for genetic, hormonal problems and even possible causes such as thrombophilia is very important for the success of a second pregnancy.
Author’s note: The journey toward a second pregnancy was a very long process for us. Right after Joana’s first birthday, we started trying, and it lasted for 3 long years. Even though we already had a child, each negative cycle was more heartbreaking than when we were trying for the first time. We saw several doctors and 90% of them said it was just a matter of time, that we weren’t infertile because we already had a daughter. But do you know when that explanation just isn’t enough? I felt I had to do something more for us.
That’s when, in a conversation with my husband, we decided to do tests to find out what was happening. We saw specialists, a gynecologist for me and a urologist for him. After all the tests, it turned out to be varicocele. The doctor said it had always been there, but together with a recent infection, it worsened the sperm quality. The treatment was relatively easy and short, and after 3 months with Vitergan and tribulus, I unexpectedly got pregnant! We weren’t even expecting that news so soon. You can check out more of this journey in search of a second pregnancy in my birth story of Dudu.
This story clearly shows us that the difficulties in getting pregnant are not only on the woman’s side.
Make your doctor your best ally, because only they will be able to recommend the best alternatives after assessing your case.
