Your life’s dream: to work in a field that brings personal satisfaction and a good paycheck as you raise a family. So, like many working moms, you waited to have your first child until you were established in your job. Then you went back to work and waited a few more years to get pregnant again—only it isn’t happening. And it’s heartbreaking. Infertility affects more than seven million Americans, roughly one in eight couples in their childbearing years. And it’s estimated that some three million Americans experience secondary infertility, in which a woman cannot conceive or carry a pregnancy to term even though she has before. Most of us know that fertility decreases as we age, especially after age 35. One of the most common causes of secondary infertility is the aging ovary, says Rebecca Booth, MD, a board-certified ob-gyn and author of The Venus Week: Discover the Powerful Secret of Your Cycle…at Any Age. But some are not as aware that lifestyle choices can also be factors: Smoking, alcohol use and unhealthy body weight may prevent ovulation. Smoking also accelerates aging of the ovaries and egg cells. Fertility issues can stem from men, too: Low sperm count, hormonal imbalances or poor sperm movement or shape are factors. Many moms who experience secondary infertility suffer sadness, depression, anger and jealousy of those who can conceive, not to mention guilt over feeling less than grateful for what they already have. It’s the guilt and embarrassment that stop some couples from seeking care, says Dr. Booth. “Other couples will say, ‘If it happens, it happens,’ only to look back in haunting curiosity later on at the What if ? when they realize they could have sought help.”

Medical Support Experts recommend that couples seek medical attention if they’re unable to conceive after a year of regular unprotected sex, or after six months if the woman is older than 35. But a recent survey by the support organization Fertility LifeLines and Conceive magazine reveals that about a third of women who tried for more than a year didn’t seek help, even though several viable medical options are available. For example, a woman’s fallopian tubes can be assessed for blockage. She can also be checked for pain, abnormal bleeding or ovulation disorders. Such problems can be investigated through procedures like blood tests, ultrasound and laparoscopic surgery. A man can be tested with a semen analysis and physical exam. Plus, uterine insemination, in vitro fertilization, donor eggs or surrogacy can help couples expand their families. Emotional Rescue Once a mom addresses the physical issues, she should seek help for her head and heart, says Dr. Booth. Contact the nonprofit RESOLVE: The National Infertility Association (resolve.org), which offers information, advocacy for family-building options, teleseminars and support groups—and is spearheading National Infertility Awareness Week from April 25 to May 2. Moms can also register at fertilitylifelines.com to get the free booklet In the Know: What No One Tells You About Fertility, learn about treatment options and find a nearby specialist. Ultimately, there’s a lot you can do to cope with and overcome secondary infertility, says Alice D. Domar, PhD, founder and director of the Domar Center for Mind/Body Health at Boston IVF, who wrote the foreword for In the Know. “Most of the women I’ve met over the years who’ve faced infertility have gone on to conceive and are now enjoying their ever-growing families,” she says.