I didn't plan to become pregnant with my first child. Like so many other amazing things that have occurred over the course of my life, it just happened. And after assessing my finances and goals and career and relationship, I realized that, yes, I wanted to do the whole carry-a-pregnancy-to-term-and-be-a-mom thing. Four years later, however, another pregnancy was definitely part of my plan. And riding on the coattails of the realization that I wanted to expand my family was the question: is it easier to get pregnant after having a baby?
Turns out — and again, like so many other amazing things that have occurred over the course of my life — the answer is complicated.
According to Dr. Kenan Omurtag, MD, Professor of Reproductive Endocrinology and Infertility at Washington University St. Louis School of Medicine, who spoke to Romper via email, it is generally easier to get pregnant after you've had a baby. But, Dr. Omurtag says, the answer varies from person to person.
"Every person who has had a prior live birth may be struggling to have a second child for a myriad of reasons that were not present before," he tells Romper. So while having a live birth does usually and under general circumstances give one a better prognosis with fertility treatment moving forward, a prior live birth doesn't mean all people trying to conceive again will automatically be successful.
"The average success rate, at age 32, for IVF is 50 percent," Dr. Omurtag explains. "And if you have had a prior live birth, your prognosis may be better than the average. How much better, though, is hard to quantify."
So, why would it be easier to become pregnant after you've already had a baby? "Commonly, we think that the body has demonstrated the ability to put all of the pieces together before, from the ability of the brain to signal ovulation, to the sperm's ability to fertilize the egg, followed by the fertilized egg's ability to grow into a competent embryo that was then able to implant into a properly prepared uterine lining," Dr. Omurtag explains. "There are literally six events that just go into the fertilization of the egg and hundreds of others that have to line up correctly. If one's body has demonstrated the ability to do that, then it should be able to do it again... unless something has changed."
But things do change, Dr. Omurtag says, including and most specifically, time. And with the inevitable change in time can come a slew of other changes, including but certainly not limited to: a chlamydia infection, a lost fallopian tube due to a ruptured tubal pregnancy, or a partner taking testosterone and experiencing low sperm count.
The worst thing one can do is wait too long assuming that 'since it worked before it will eventually work again.'
But even if the aforementioned changes haven't occurred, and time is the only altered variable, it is, in fact, time that can have an impact on a person's fertility. "It's not uncommon for me to see someone who had a live birth at 32 and then struggled to have the second baby now, at 34-35," Dr. Omurtag says. "Assuming no other interval problem (sperm bad, tubes damaged from infection, endometriosis popped up, etc.), it could be age-related decline in fertility."
Dr. Omurtag explains that everyone has a fixed number of eggs and a pre-programmed rate of decline for those eggs. "She may have had no problems conceiving because she had the first babe at age 32, but, unbeknownst to her, she started with a smaller cohort of eggs, and now at 34-35, the number of eggs she has is fewer." Dr. Omurtag says. The rate of egg decline is most steep at age 37, he continues, but for some people it might be sooner, especially since tobacco smoke can accelerate the rate of loss of eggs.
Dr. Omurtag says it's important to remember that it's not the number of prior pregnancies that are important when considering a person's ability to conceive, but the number of live births. "Someone who had four pregnancies that all resulted in miscarriage is different from someone who had two pregnancies that resulted in a live birth, and one elective termination and one miscarriage," he says. "It's important to be clear."
If you are struggling to get pregnant after having a baby, Dr. Omurtag says you should subscribe to the following: If you are under the age of 35 and you're not pregnant after 12 months of unprotected sex, you should contact a fertility specialist. If you're over 35, you should contact a specialist after six months.
"The worst thing one can do is wait too long assuming that 'since it worked before it will eventually work again,'" Dr. Omurtag says. "It will likely be fine and some OB-GYNs might tell their patients to wait longer than 1 year. The decision to reproduce is complex and highly individualized, but you should seek a fertility specialist if you have been trying for more than a year."