Is it easier to get pregnant a second time

Kim Kardashian and husband Kanye West have been working on adding a baby to the family (South West?), but Kim is finding it much harder to get pregnant this time around, she told the DailyMail.com at the E! International Press Junket this past Friday. It begs the question: Is Kimye just having some bad luck, or are sophomore pregnancies really more difficult? 

According to ob-gyn Alyssa Dweck, M.D., Kim's problem is one plenty of women face. Secondary infertility—a.k.a. trouble conceiving the second time around when you had no issues with the first pregnancy—is more common than primary infertility in women, she says. Here are a few reasons why Kim (and you) might be seeing the delay and what to do to speed things along.

Age
Obviously, time will have passed between trying to get pregnant the first and second time, and Dweck says that when it comes to trying to conceive, time is on none of our sides. "Starting from age 32, fertility begins to decline slightly, then more rapidly by 35," she says. "At 40, it takes a plunge." Additionally, with age come certain chronic illnesses that may have gone unnoticed in the previous pregnancy, such as diabetes or thyroid issues, both of which decrease chances of pregnancy. 

Weight Fluctuations 
Whether you packed on the pounds after your first pregnancy or overworked yourself to drop the baby weight and more, drastic weight gain or loss may mess with your hormones—and your pregnancy attempts. Now more than ever, maintaining a healthy lifestyle is crucial to your chances of conceiving. 

Bedroom Behavior Changes 
You may feel like you're having a ton of sex when you're actively trying to get pregnant, but there's a good chance you're still having less than you did before your first pregnancy. Between having a child at home, time constraints, and fatigue, the numbers might not stack up the way they did when you had an active, child-free sex life. Dweck's solution? Make having more sex a priority, even if you think you're having enough.  

Stress
Kim Kardashian expressed her frustration that a second pregnancy was proving so difficult despite the fact that she and Kanye are actively trying, whereas North wasn't the product of a strict plan. Turns out, trying too hard to get pregnant can kill your chances, due to the mental stress that comes with putting pressure on yourself. "When your stress level is high, your body goes on high alert to prevent you from getting pregnant under stressful circumstances," says Dweck, noting that meditation and relaxation exercises have been shown to increase fertility.

First Pregnancy Complications 
For example, if you had a C-section delivery with your first child, there's a chance that some fertility-interfering scar tissue could have developed inside the uterus or outside in the pelvis, says Dweck. 

When to See Your Doctor: So your diet and exercise, sex life, and stress levels are all in check, and you're still not seeing that little plus sign? If it's been more than six months, especially if you're over 35, don't be afraid to ask for help, says Dweck. "You won't be the first person to go see their gynecologist to get some assistance in getting pregnant a second time."

After having your first baby, you might think that getting pregnant a second will happen just as easily, but that’s not always true.

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While many couples have no problem conceiving the second time around, millions of couples struggle with secondary infertility, according to the National Center for Health Statistics. This includes couples who experienced infertility but eventually had a successful pregnancy.

Secondary infertility is the inability to conceive or carry a pregnancy following the delivery of a child. While it isn’t uncommon, the good news is that you’re more likely to have a successful second pregnancy if you already have a child, says Ob/Gyn Laura Detti, MD.

If you’re struggling to conceive but still hoping for another child, here are six possible reasons you may have a problem getting pregnant again — and when you should seek help.

1. You’re a woman over age 35

It’s probably no surprise that one of the most important factors that influences a woman’s chance of getting pregnant is age. Changes in hormones and risk for certain diseases also increase as we age, and both can impact fertility, she says.

“Woman in their mid- to late-30s and older are more likely to experience secondary infertility since eggs are lost as we age,” says Dr. Detti.

But if you’re in your mid-30s and are still waiting for a second child, don’t despair: “Just because it might take you longer to get pregnant doesn’t mean you won’t get pregnant again — it just means you have less time to work with,” she says.

2. You’re a man whose sperm count is low

You likely know that age, health or medications sometimes affect sperm quality or quantity. But it surprises many men to learn that some common practices can decrease sperm production. They include:

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• Taking testosterone supplements.
• Exposing the testes to heat.

“The testes are outside of the body for a reason,” Dr. Detti says. “If they are too warm, either from tight clothing (think biker shorts) or use of electronics, it can affect sperm counts.”

3. You’re a woman with polycystic ovary syndrome

Polycystic ovary syndrome (PCOS), a hormonal imbalance that can disrupt ovulation, is a common cause of secondary (and primary) infertility. If your periods are irregular or absent, talk with your doctor to see if you might have PCOS.

In addition to PCOS, abnormalities caused by previous surgeries or an infection also may cause infertility.

4. You’re overweight

In both men and women, being overweight can cause challenges with conceiving. In women, added pounds can contribute to insulin resistance and elevated testosterone levels, which can stifle ovulation. Also, implantation rates are lower for those who are overweight (or underweight) than for those at a healthy weight.

For men, excess weight can increase estrogen levels, leading to lower sperm counts.

5. You drink too much alcohol

For men or women, drinking too much alcohol can cause problems with conception.

“Moderate to heavy alcohol consumption in women (more than two drinks per day or more than seven drinks per week) increases the time it takes to conceive and reduces your chances of delivering a healthy baby,” says Dr. Detti.

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Men who are trying to conceive can also benefit from drinking less alcohol. Moderate to heavy consumption can disrupt hormones and hinder sperm production.

6. You smoke

While it’s no surprise that smoking isn’t good for you, you might not know that smoking can wreak havoc on your fertility, too. Women who smoke are more likely to experience infertility. Smoking can damage eggs and cause ovulation problems, Dr. Detti says.

Men aren’t off the hook either. Research shows that smoking may damage sperm DNA.

Patience is good, but don’t wait too long to get help

If you are trying to get pregnant again, try to relax and not worry too much — at least at first.

However, if you have been trying for a year and still haven’t conceived, talk to your Ob/Gyn or fertility specialist. And if you’re over age 36, consider talking with your doctor sooner — once you have tried for three or four menstrual cycles without success, Dr. Detti says.

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