When a couple has already borne one or more children, they may assume that difficulty in conceiving another child could not be due to infertility. However, many couples have discovered that there is a condition known as "secondary infertility," which is essentially the same as infertility except that it occurs after a successful pregnancy.

What's the cause?

There can be a variety of causes – the same ones that cause primary infertility. A delay in childbearing age may be a primary factor. Other common factors include ovulation problems, endometriosis, pelvic adhesions, and uterine fibroids or polyps.

Medical professionals do not always realize that advising a couple to "just keep trying" may be robbing them of an opportunity to investigate what is wrong and treat it, if it is possible to do so. It is important to explore all medical causes to determine if there is a chance that medical intervention could be helpful. As a rule of thumb, if you are under 35, have been having regular, unprotected sex for a year and have not been able to conceive, consult your doctor and/or get a referral to a fertility specialist. If you are over 35, then start investigating the issue after six months of regular, unprotected sex.

Be open with your spouse

Recognize also that, like primary infertility, this can place a significant amount of stress on your relationship. Talk openly about the hopes and fears that you have as a couple and realize that you may feel differently about the situation. Aim to understand your spouse’s feelings on the matter and what they would like to do about it rather than try to get them to feel the same way you do. Make your marriage and your existing family your priority; it is important to function as a team. Get educated about your options. Most of all, pray for direction, guidance and grace.

Wendy Kittlitz is vice-president of counselling and care ministries at Focus on the Family Canada.

© 2010 Focus on the Family (Canada) Association. All rights reserved.

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