Bottom line up front: Secondary infertility — the inability to conceive or carry a pregnancy to term after previously having a child — is nearly as common as primary infertility. It accounts for roughly half of all infertility cases. The causes are largely the same as primary infertility, with age being the single biggest factor. Treatment works just as well, and the prognosis is often better because you have already demonstrated the ability to conceive.
What Counts as Secondary Infertility?
Secondary infertility is defined as the inability to conceive or carry a pregnancy to term after previously giving birth to one or more children without the use of fertility treatments. The standard clinical threshold is 12 months of trying for women under 35, or 6 months for women 35 and older.
It does not include difficulty conceiving after a previous pregnancy that required fertility treatment — that would be a continuation of the same fertility issue. And it does not include cases where the partner has changed, as the new couple has no established fertility history together.
📊 The Numbers
According to the WHO, secondary infertility is roughly as common as primary infertility globally. In some regions it is actually more prevalent. Many people are surprised by this — the assumption that having conceived once guarantees future fertility is one of the most common misconceptions in reproductive health.
Why It Happens
The most common causes of secondary infertility overlap significantly with primary infertility:
Age
This is the number one factor. If your first child was born when you were 30 and you are now trying at 35 or 36, your egg quality and ovarian reserve have declined meaningfully in the interval. The decline accelerates after 35 and becomes steep after 38. A gap of even 2–3 years can make a significant difference.
Changes in Ovulation
Hormonal shifts after pregnancy — including conditions like PCOS that may not have been present (or noticeable) before — can alter ovulation patterns. Weight changes, stress, thyroid dysfunction, and breastfeeding can all contribute.
Uterine or Tubal Issues
Complications from a previous delivery — including C-section scarring (isthmocele), uterine adhesions (Asherman syndrome from D&C procedures), or post-delivery infections — can affect the ability to conceive or maintain a pregnancy. These are often treatable once identified.
Male Factor Changes
Sperm quality can decline with age, lifestyle changes, medications, or new health conditions. A semen analysis is always warranted when investigating secondary infertility, even if the previous pregnancy occurred easily.
Endometriosis Progression
Endometriosis is a progressive condition. Mild or undiagnosed endometriosis during a first pregnancy may advance to a stage that impairs fertility by the time a couple tries again.
The Emotional Weight
Secondary infertility carries a unique emotional burden that is often underestimated — sometimes even by the people experiencing it. There is guilt about wanting more when you already have a child. There is frustration that your body did this before and will not do it again. And there can be a profound isolation, because the infertility community is largely oriented around primary infertility, and friends and family may dismiss your struggle with comments like "at least you have one."
These feelings are valid. Secondary infertility is real infertility, and the grief of not being able to grow your family the way you planned deserves the same acknowledgment and support as any fertility struggle.
⚠️ Do Not Wait Too Long to Seek Help
One of the most common mistakes with secondary infertility is assuming it will resolve on its own because it worked before. The standard timelines apply: see a specialist after 12 months of trying if you are under 35, or after 6 months if you are 35 or older. If you are 38+, consider consulting a specialist after 3 months.
Treatment Options
Treatment for secondary infertility follows the same pathways as primary infertility — timed intercourse, ovulation induction, IUI, and IVF. The specific approach depends on the identified cause and your age.
The good news: treatment outcomes for secondary infertility are generally equal to or better than for primary infertility. Your body has successfully carried a pregnancy before, which is a positive prognostic indicator — particularly for the implantation and pregnancy maintenance stages of IVF.
When IVF Makes Sense
IVF is typically recommended for secondary infertility when age-related egg quality decline is the primary factor (especially for women 37+), when tubal damage or severe male factor is present, when IUI cycles have not succeeded, or when time pressure makes lower-success treatments impractical.
IVF for Secondary Infertility in Colombia
Many international patients pursuing IVF for secondary infertility choose Colombia specifically because the cost savings allow for multiple cycles without financial devastation. When you already have a child at home and are managing the logistics of treatment abroad, affordability and efficiency matter enormously.
Colombian clinics offer complete diagnostic workups that may identify causes overlooked in your home country, particularly surgical evaluation for uterine scarring from previous deliveries. IVF cycles start at $3,500–$8,000, and the total cost for a two-week treatment trip — including flights, accommodation, and daily expenses — typically comes in under $10,000.
💡 Logistics with a Child at Home
Most international patients undergoing IVF in Colombia are away for 2–3 weeks. For secondary infertility patients, this means arranging childcare for the existing child. Some patients bring their partner and child along — Medellín and Bogotá are both family-friendly cities with excellent short-term accommodation. Others split the trip: one partner stays home while the other travels for treatment.
Ready to Grow Your Family?
Secondary infertility responds well to treatment — and Colombia makes it affordable. Let us connect you with the right clinic.
Get Free ConsultationThe Bottom Line
Having conceived before does not guarantee you can conceive again — but it is a good sign. Secondary infertility is treatable, and IVF success rates for patients with a previous live birth are among the strongest in reproductive medicine. If cost is the barrier, Colombia offers the same quality of care at prices that make multiple cycles feasible.
Read more: Unexplained Infertility | How Many IVF Cycles? | Cost Guide