If you dealt with infertility before conceiving and delivering a baby, it’s only natural to hope you may be more fertile postpartum. After all, you did it! You had a child despite the odds. But even if you didn’t have difficulty getting pregnant the first time around, there are articles out there that do feed into the idea that women can undergo a “fertility reset” after giving birth.
The more you Google postpartum fertility, however, the more overwhelmed you may get, as the evidence online can be contradictory and far from straightforward. Don't worry; we’re here to break down the truth and, yes, give you more concrete answers.
So, are you more fertile after having a baby?
“The quick and dirty answer is no,” says Jennifer Nichols, DO, FACOOG, a reproductive endocrinologist with IVFMD in Viera, Florida. “In general, most people are not more fertile immediately after pregnancy.” Dr. Nichols goes on to explain that there are numerous reasons why this isn’t the case, with the more obvious ones being a) you don’t get your period immediately after giving birth and b) if you’re breastfeeding, your period may not return for another several months.
For women who gave birth after experiencing infertility, Dr. Nichols warns that they’re likely still going to be dealing with those same factors postpartum. “The biggest downfall is whatever led to the initial infertility,” she says. Whether that’s a tubal factor, a male factor, or an ovulation factor, “[infertility] may initially go away because the hormones balance a little bit, but given a few months, it's probably going to resume.”
Dr. Nichols also mentions that significant weight gain in pregnancy can lead to irregular ovulation and periods during the postpartum period. For example, if a patient had PCOS going into pregnancy and had irregular periods, her postpartum menstrual cycle may become "even more irregular.”
If you want to determine your postpartum fertility, a lot depends on ovulation. It's never a bad idea to track your cycle, keeping in mind that your breastfeeding choices can have a significant impact on when ovulation resumes. “You’re not going to resume ovulation until you are at least not breastfeeding through the night or you've decreased your breastfeeding,” Dr. Nichols says.
What causes secondary infertility?
If you have been trying to conceive for more than a year — 6 months if you're over 35 — and haven't been able to achieve a pregnancy, secondary infertility may be to blame. “Secondary infertility is the inability to conceive or carry a pregnancy or baby to term after previously giving birth,” explains Dr. Nichols, and it accounts for roughly half of all infertility cases. This can happen with patients who experienced infertility prior to their first pregnancy or with patients who didn’t have any issues becoming pregnant the first time.
Dr. Nichols says secondary infertility may arise when there is a tubal or uterine factor stemming from the primary pregnancy, where scar tissue is now present in either the fallopian tubes or the uterus. If your first delivery was via c-section, she highly recommends a hysterosalpingogram (HSG) to check your fallopian tubes, as well as a saline sonogram (SIS) to check your uterine cavity. “If you had a c-section, then those tubes are definitely worth checking, and in the uterus, something did drastically change.” Scar tissue may have appeared if the patient had placental problems and the obstetrician performed a D&C after delivering the placenta. “It's worthwhile to get a full history of what occurred during your delivery and what's changed since then,” advises Dr. Nichols.
Also, Dr. Nichols adds, “We can't ignore the fact that maybe the male factor changed and the sperm has been compromised," so a semen analysis is highly encouraged.
Improving postpartum fertility
Unfortunately, there is no magic pill to increase your fertility postpartum or prevent secondary infertility, which is why Dr. Nichols recommends many of the same lifestyle choices for achieving a healthy pregnancy. Since vitamin deficiency can occur after delivery, she recommends taking a prenatal vitamin with folic acid, as well as getting your vitamin D levels checked.
She also suggests checking your thyroid levels and maintaining an overall healthy diet, which, she sympathizes, can be extra difficult now that you’re looking after a baby or toddler. “You're eating exactly what they eat or you're so busy, you're not eating anything,” she says, "so you want to make sure you’re getting your fruits, veggies, and significant carbohydrates.”
Whether you're experiencing secondary infertility or having trouble restoring ovulation after having a baby, Dr. Nichols recommends having a check-in with your OB/GYN or fertility doctor. “You do the same workup that you would do for any infertility patient, whether it’s primary or secondary,” says Dr. Nichols. “You check the ovaries, the ovarian reserve, and ovulation. You check the fallopian tubes, you check the uterus, and you check the sperm, to see if anything has significantly changed. Depending on how long you've been trying, you can consider increasing the chances with fertility treatment.”
While every individual and couple is different, it’s important to stay on top of your medical history, especially anything significant that occurred during pregnancy or delivery. The more information you and your fertility team have on hand if or when you decide to try for another baby, the better prepared you’ll be for your next fertility and pregnancy journey. Best of luck!
Sarene Leeds holds an M.S. in Professional Writing from NYU, and is a seasoned journalist, having written and reported on subjects ranging from TV and pop culture to health, wellness, and parenting over the course of her career. Her work has appeared in Rolling Stone, The Wall Street Journal, Vulture, SheKnows, and numerous other outlets. A staunch mental health advocate, Sarene also hosts the podcast “Emotional Abuse Is Real.” Visit her website here, or follow her on Instagram or Twitter.