Having trouble expanding your family? You are not alone. Secondary infertility is the inability to become pregnant after previously having a child. It’s actually a lot more common than we think! Secondary infertility accounts for more than 50% of all couples struggling with conceiving.

Secondary infertility poses a unique set of challenges on the emotional front. Balancing the frustration of not conceiving with feelings of guilt that may be associated with lack of attention on your current child or “not being grateful for what you already have” can be difficult.

So what can you do? You can start by learning about your body and knowing how it has changed.

Keep a menstrual diary. Documenting how many days between your menses, how many days of menses, whether the menses are light, regular or heavy. Note if there is any spotting before or significant pain with your menses. Find out when you are ovulating. Simple ovulation predictor kits are in every pharmacy. Knowing what changes your body is going through can help your physician guide your evaluation.

Have an evaluation. If you are 39 years or younger, you can try for up to 6 months first. However, if you are 40 years or older, you should see a fertility specialist for an initial evaluation as soon as you’ve made the commitment to become pregnant. The evaluation will thoroughly assess the uterus, tubes, and ovarian function.

We like to begin with a focus on your anatomy. Pregnancy and delivery is a major event and can initiate changes in the uterus or fallopian tubes that prevent future pregnancies from occurring. Common causes such as uterine polyps, scar tissue affecting the tubes or the inside of the womb can be detected by an ultrasound or x-ray.

By definition, struggling with conceiving additional children means you are older then you were with your prior pregnancy. Age has a profound effect on a woman’s fertility especially after she reaches her mid-30s. Ovarian function is most sensitive to age, and can be tested with a simple blood draw and/or ultrasound.

The final area of attention is the male partner. Male factors (abnormal sperm production) account for half of all infertility diagnoses. The function of the sperm is evaluated with a semen analysis.

Being pro active and knowing what factors are creating your challenge is the best first step. After the age of 35, fertility can rapidly change. You deserve to understand why this time isn’t as easy as the last, and have the care that you need to create the family that you always dreamed of!