Obstetrician and gynaecologist Dr Peter Chew tells us what to know when you’re struggling to have more than one child — and SmartParents gives you 4 ways to take action!

Secondary infertility — what you can do

Secondary Infertility is a condition where the woman is unable to become pregnant or carry a pregnancy to term, following the birth of one or more children. Some 20 per cent of couples experience secondary infertility.

Common causes include:

Age (fertility decreases from age 30 and more sharply from age 35);
• Polycystic ovary syndrome (or PCOS, a condition where a woman’s hormones are out of balance, which causes ovulation issues);
• The blockage of fallopian tubes caused by endometriosis (a condition caused by the backflow of menstrual blood); and
• Pelvic inflammatory disease (usually the result of a sexually transmitted disease).

The condition could also be caused post-abortion, where the lining of the womb is damaged, or poor quality or low sperm count — usually from varicoeles, a condition where there are dilated veins surrounding the testes. Illness, or a poor diet or lifestyle can also affect sperm quality and quantity.

Couples with secondary infertility may have conflicted feelings towards their child — grief and pain from the inability to have more children, yet already feeling the joys or being a parent. Some feel guilty that they are unable to give their child a sibling. Between the couple, the emotional experiences of distress, anger, guilt and jealousy may lead to depression and marital conflicts.

If you suspect you have secondary infertility, consult your gynaecologist early to determine the cause and start appropriate treatment. Treatment methods include ovulation medication, the removal of fibroids or cysts, and also intra-uterine insemination and in-vitro fertilisation.

What you can do

1. EAT ORGANIC Commercially reared animals are often given antibiotics that can interfere with your hormone levels.

2. SUPPLEMENT YOUR DIET Take a pregnancy multivitamin — one UK study found it increased conception rates from 40 to 70 per cent.

3. KNOW YOUR BODY Keep track of your periods — this will help you work out your ovulation window during each menstrual cycle.

4. GO FULL FAT A study in the Journal of Human Reproduction by Oxford University found that eating one portion of full-fat dairy daily can reduce the risk of ovulatory infertility by 27 per cent.