Why do some couples conceive quickly once or twice and then struggle to have any more children?  The medical term for this situation is secondary subfertility.

The first step is to see if anything has changed that could affect the couple’s fertility. Lifestyle changes such diet and weight can sometimes not go as well as hoped especially when there is a young child at home. The advice is to try and maximise  health before seeing a doctor, and also remember to start pre-conception folic acid as pregnancy can happen at any time.

A visit to a gynaecologist  would normal include a run through the medical history to try to find out if anything has changed with either partner’s health. For instance, a change in the menstrual cycle or perhaps starting a new medication.

A couple’s sex life is likely to be different once there is a baby or two in the house. Trying to fit in a love life around feeding times, nappy changes and holding down a job is very difficult.  It can be tricky to juggle family life and trying for a new baby.  As a result it’s not surprising and perfectly normal that trying to get pregnant at this time can cause a little bit of tension between a couple!

It’s unlikely that childbirth will cause a physical problem with future fertility. Only very rarely would a complicated lower caesarean sections and internal infections cause the type of scarring around the fallopian tubes that could cause a future fertility problem. Thankfully this is extremely rare and a GP or doctor should provide reassurances about this.

When there is a delay in conceiving it’s usual to run a number of normal fertility tests which includes checking for ovarian reserve, ovulation, fallopian tube patency and semen analysis.

But why check the sperm count if dad’s already conceived?

There are quite few reasons that a sperm count can change over time, and it’s very important to make sure that it is still viable. It’s not uncommon to see that the sperm count is not completely normal following a repeat test. If this is the case then it is more than possible that the secondary fertility issue may be down to the sperm.

Another cause of secondarily fertility issues is female age as fertility does drop particularly in women over 35. This maybe the main reason why there has been a delay in conceiving and often patience and trying for longer is all that is required.

Changes in female fertility can be assessed by blood tests (Anti-Mullerian Hormone, FSH and estrogen levels) and by ultrasound looking at the number of small follicles in the ovaries.

Reassuringly, most couples who have had one successful pregnancy before will go onto to conceive again.

If you would like to discuss further then please contact Yvonne on 0207 125 0547 or liebermanpa@gmail.com