There is a term that we use when talking about fertility issues and it's called, secondary infertility. That's a term that denotes a couple who has been pregnant on their own without any difficulty, and most of the time, they say that the first or second month they tried, they got pregnant and had a baby with no complications and no problems. We've been trying for three years now and nothings happened. That's called secondary infertility. Lots of things can be the reason behind that. Sometimes one of the two of you can be on medication that's affecting things. They may have had a surgery that create a problem with her fallopian tubes. History is the important step to take. You have to talk to them and find out what's changed in their lifestyle; whether it's from a medical standpoint or a social standpoint. Maybe one of them is smoking and didn't smoke before or smoking more than they did the first time. The importance in understanding secondary infertility is taking a detailed history from the woman and the man, and determining if something has changed in their history that is causing them to be infertile. Over time, things can change. Maybe the male was a little older when they conceived the first time. Maybe his sperm production has changed. Those are the things we look at in the first step analysis of secondary infertility.