When most people picture infertility, the mind usually jumps to couples desperately trying to conceive their very first child. But what happens when baby number one arrived without a hitch, yet conceiving for the second time seems tough? That is when the confusing, often frustrating reality of secondary infertility shows up.

And it is surprisingly common. More common, in fact, than you would think. But, as with many awkward health topics, it is rarely discussed outside hushed whispers. Fertility woes tend to carry a stigma, and once a couple already has one child, society assumes they should be immune to such struggles.

Dr Megha Garg, Fertility Specialist at Birla Fertility and IVF, Dwarka, explains, “Many couples are often caught by surprise when conceiving a second time does not come as easily as their first. This condition is known as secondary infertility, and it occurs more frequently than most realise. Yet, the topic remains largely under-discussed.”

Numbers back her up. “In developing nations such as India, as well as globally, research estimates that almost 10–15 per cent of couples suffer from secondary infertility, and there is an increasing prevalence of such cases being seen in clinical practice,” she adds. That is not a fringe issue; that is a fair chunk of hopeful parents stuck in the waiting room of fate.

What makes secondary infertility different from primary infertility?

The biological clock, as it turns out, is a stubborn timekeeper. “Secondary infertility can be influenced by several factors, with age being the most important,” says Dr Garg. Many couples today delay starting families, focusing first on careers, travel, or simply surviving modern life. By the time they are ready for round two, their bodies may not be on the same page. For women, this can mean reduced egg quality and diminished ovarian reserve.

But biology is not the only player here. Lifestyle has a starring role too. Stress, obesity, smoking, and alcohol consumption all contribute, while underlying conditions like endometriosis, PCOS, thyroid problems, or male factor infertility can throw in extra hurdles. Even complications during the first pregnancy or delivery can cast long shadows over attempts at the second.

And then comes the social side, the bit nobody really talks about. “The stigma around fertility challenges further prevents people from talking openly about secondary infertility,” Dr Garg observes. Families often dismiss concerns with a casual wave: “You already have one; why stress?” What they do not realise is that this adds pressure and guilt, making couples feel ungrateful for wanting more while simultaneously grieving what feels like a loss.

Silence, though, is not a solution. “This silence must be broken,” urges Dr Garg. Seeking timely help is crucial, as fertility outcomes are strongly linked with age and how soon intervention begins.

What can couples actually do?

Secondary infertility is not a rare phenomenon, nor should it be brushed aside as an overreaction. It is a medical condition that deserves awareness, compassion, and timely care. As Dr Garg points out, “Recognising it early and seeking guidance can make all the difference in a couple’s journey to parenthood again.”

In other words, if you are struggling with baby number two, you are not alone, you are not imagining things, and you definitely do not need to suffer in silence. The conversation needs to move out of the shadows and into the open, because when it comes to building families, no couple should feel like their struggles are second-class.

Vaccinated for human papillomavirus (HPV)? Now, take that Pap smear test. This is the most common advice women hear to prevent the risk of cervical cancer that annually causes around 6,60,000 new cases and around 350,000 deaths worldwide.

However, it's easier said than done for most of the fairer sex.

A Pap smear is typically a gynecological examination where a speculum is inserted to collect cells from the cervix.

Although the procedure is brief and generally safe, the discomfort discourages many from getting screened. Fear of pain, anxiety of the results, form the common psychological barriers worldwide, and is followed by shame, cultural attitudes, and concerns with male clinicians.

A study in Iran, published in the BMJ Open journal in January 2024, showed that psychological stress, cultural issues, and fear, along with limited information and health services, were the biggest hindrances to getting Pap tests.

Another research published in the BMC Women's Health in December 2022, focusing on Africa, Asia, and South America, reported that many women avoided or delayed Pap smears because they are afraid the procedure will hurt. Many also reported being embarrassed about the pelvic exam or fear of having a stranger see their private areas. Some also worried that the test could damage the uterus.

A Pap Smear test, however, is proven to be safe and is recommended for every woman above the age of 21 years.

“A Pap smear is a rapid, safe, and painless screening procedure that detects irregular cellular changes well before they become malignant. The ability to treat at this pre-cancerous stage of disease provides an excellent outcome,” Dr. Tirathram Kaushik, Senior Consultant GI, HPB, Gastrointestinal & Thoracic Oncology and Robotic Surgery, HCG Cancer Centre, Borivali, told HealthandMe.

A 2025 study, published in the Journal of Contemporary Clinical Practice, showed that pap smears are excellent at ruling out precancerous risks. It also remains a valuable screening tool where molecular testing is limited.

There are many myths about Pap smears that make people anxious or avoid screening. Let’s clear up the most common ones:

Pap Smears Are Painful

The Pap smear procedure, which takes only a few minutes, is often described as uncomfortable. While some feel like a quick pinch, others experience slight discomfort or spotting. Severe pain is not considered normal.

“From an oncology perspective, this myth results in a delay in diagnosis. Cervical cancer often occurs silently in its early stages, without any noticeable symptoms,” Kaushik said.

I Am Healthy, So I Don’t Need A Pap Smear

While individuals may feel completely well, they still have abnormal cells developing silently. As a result, regular Pap smear screening is important because it detects these changes early -- before they turn into cervical cancer.

“The HPV infection and subsequent changes that lead to cervical cancer happen slowly over many years. HPV infection is also very common, and one in two women is likely to get infected. Regular screening by a Pap smear will help to catch infection early before it can convert into cancer,” Dr. Deepak Jha, Chief - Breast Surgery & Sr. Consultant Surgical Oncology, Artemis Hospitals, told HealthandMe.

I Have Only One Partner, So I Don’t Need Screening

“HPV doesn’t need penetrative sex for infection. It can be transferred if there is any contact of bodily fluid. It’s always safe to test and be assured rather than repent later,” Dr. Jha said.

Testing Means Cervical Cancer

“Even if HPV is detected, it usually indicates a pre-cancerous stage that is highly treatable,” Dr. Parminder Kaur, Consultant Gynecologic Oncologist at CK Birla Hospital, Delhi, told HealthandMe.

Moreover, a Pap smear only screens for cervical cancer; it can’t detect other gynecological cancers such as cervical, ovarian, uterine (endometrial), vaginal, and vulvar cancers. So, screening and appropriate tests for those will be required, irrespective of the Pap smear.

I Am Old, So I Don’t Need A Pap Smear

I Got Vaccinated, So I Do Not Need A Pap Smear

Irrespective of vaccinated status, a woman should go for regular screening between the ages of 25 and 79. Also, if a woman already had HPV exposure before being vaccinated, she would not benefit, the experts said.

“Screening is not just a routine procedure - it is a preventive measure. In the treatment of cancer, early detection alters the disease course, whereas waiting for symptoms to develop means the disease is likely to be already advanced,” Dr. Kaushik said.

Dr Kaur called for more awareness and stated that open discussion are key to help more women take the important screening test.

When To Get Screened

The United States Preventive Services Task Force (USPSTF) and the American Cancer Society (ACS) recommend getting your first Pap test at age 21, followed by Pap testing every 3 years. Even if you are sexually active, you do not need a Pap test before age 21.

• Individuals must start getting Pap tests at age 21. If the result is normal, repeat the test after three years.
• For individuals aged between 30 and 65 years old, doctors are likely to recommend an HPV test along with a Pap test. If both are normal, repeat after five years.

In women older than 65, you don't need to be screened anymore if:

• You have had at least three Pap tests or two HPV tests in the past 10 years, and the test results were normal or negative, and
• You have not had a cervical precancer in the past, or
• You have had your cervix removed as part of a total hysterectomy for non-cancerous conditions, like fibroids.

Vaccinated for human papillomavirus (HPV)? Now, take that Pap smear test. This is the most common advice women hear to prevent the risk of cervical cancer that annually causes around 6,60,000 new cases and around 350,000 deaths worldwide.

However, it's easier said than done for most of the fairer sex.

A Pap smear is typically a gynecological examination where a speculum is inserted to collect cells from the cervix.

Although the procedure is brief and generally safe, the discomfort discourages many from getting screened. Fear of pain, anxiety of the results, form the common psychological barriers worldwide, and is followed by shame, cultural attitudes, and concerns with male clinicians.

A study in Iran, published in the BMJ Open journal in January 2024, showed that psychological stress, cultural issues, and fear, along with limited information and health services, were the biggest hindrances to getting Pap tests.

Another research published in the BMC Women's Health in December 2022, focusing on Africa, Asia, and South America, reported that many women avoided or delayed Pap smears because they are afraid the procedure will hurt. Many also reported being embarrassed about the pelvic exam or fear of having a stranger see their private areas. Some also worried that the test could damage the uterus.

A Pap Smear test, however, is proven to be safe and is recommended for every woman above the age of 21 years.

“A Pap smear is a rapid, safe, and painless screening procedure that detects irregular cellular changes well before they become malignant. The ability to treat at this pre-cancerous stage of disease provides an excellent outcome,” Dr. Tirathram Kaushik, Senior Consultant GI, HPB, Gastrointestinal & Thoracic Oncology and Robotic Surgery, HCG Cancer Centre, Borivali, told HealthandMe.

A 2025 study, published in the Journal of Contemporary Clinical Practice, showed that pap smears are excellent at ruling out precancerous risks. It also remains a valuable screening tool where molecular testing is limited.

There are many myths about Pap smears that make people anxious or avoid screening. Let’s clear up the most common ones:

Pap Smears Are Painful

The Pap smear procedure, which takes only a few minutes, is often described as uncomfortable. While some feel like a quick pinch, others experience slight discomfort or spotting. Severe pain is not considered normal.

“From an oncology perspective, this myth results in a delay in diagnosis. Cervical cancer often occurs silently in its early stages, without any noticeable symptoms,” Kaushik said.

I Am Healthy, So I don’t need A Pap Smear

While individuals may feel completely well, they still have abnormal cells developing silently. As a result, regular Pap smear screening is important because it detects these changes early -- before they turn into cervical cancer.

“The HPV infection and subsequent changes that lead to cervical cancer happen slowly over many years. HPV infection is also very common, and one in two women is likely to get infected. Regular screening by a Pap smear will help to catch infection early before it can convert into cancer,” Dr. Deepak Jha, Chief - Breast Surgery & Sr. Consultant Surgical Oncology, Artemis Hospitals, told HealthandMe.

I Have Only One Partner, So I don’t need Screening

“HPV doesn’t need penetrative sex for infection. It can be transferred if there is any contact of bodily fluid. It’s always safe to test and be assured rather than repent later,” Dr. Jha said.

Testing Means Cervical Cancer

“Even if HPV is detected, it usually indicates a pre-cancerous stage that is highly treatable,” Dr. Parminder Kaur, Consultant Gynecologic Oncologist at CK Birla Hospital, Delhi, told HealthandMe.

Moreover, a Pap smear only screens for cervical cancer; it can’t detect other gynecological cancers such as cervical, ovarian, uterine (endometrial), vaginal, and vulvar cancers. So, screening and appropriate tests for those will be required, irrespective of the Pap smear.

I Am old, So I don’t need A Pap Smear

I Got Vaccinated, So I Do Not Need A Pap Smear

Irrespective of vaccinated status, a woman should go for regular screening between the ages of 25 and 79. Also, if a woman already had HPV exposure before being vaccinated, she would not benefit, the experts said.

“Screening is not just a routine procedure - it is a preventive measure. In the treatment of cancer, early detection alters the disease course, whereas waiting for symptoms to develop means the disease is likely to be already advanced,” Dr. Kaushik said.

Dr Kaur called for more awareness and stated that open discussion are key to help more women take the important screening test.

When To Get Screened

The United States Preventive Services Task Force (USPSTF) and the American Cancer Society (ACS) recommend getting your first Pap test at age 21, followed by Pap testing every 3 years. Even if you are sexually active, you do not need a Pap test before age 21.

• Individuals must start getting Pap tests at age 21. If the result is normal, repeat the test after three years.
• For individuals aged between 30 and 65 years old, doctors are likely to recommend an HPV test along with a Pap test. If both are normal, repeat after five years.

In women older than 65, you don't need to be screened anymore if:

• You have had at least three Pap tests or two HPV tests in the past 10 years, and the test results were normal or negative, and
• You have not had a cervical precancer in the past, or
• You have had your cervix removed as part of a total hysterectomy for non-cancerous conditions, like fibroids.

Are you still experiencing brain fog, fatigue, and mood changes even after years of a mild COVID-19 infection? A new study showed that the SARS-CoV-2 virus, behind the COVID infection, can cause persistent brain inflammation and lung injury, according to a study.

Researchers from Tulane University, in Louisiana, US found that the brain inflammation lasts long even after the virus was no longer detectable.

Their study, published in Frontiers in Immunology, can answer why long COVID often includes neurological symptoms such as brain fog, fatigue, and mood changes.

"Long-term effects on the brain were unique to SARS-CoV-2. That distinction is critical to understanding long COVID," said lead author Dr. Xuebin Qin, professor of microbiology and immunology at the Tulane National Biomedical Research Center. Qin also mentioned "lasting lung injury" among COVID patients.

In a mouse model, the team found that immune cells in the lungs failed to fully stand down and also spiked the buildup of collagen -- a protein associated with scarring.

The changes stiffened lung tissue, making breathing feel more labored -- a possible answer to breathlessness faced by COVID survivors.

Further, the researchers also noted no repair to the injury, suggesting the virus may interfere with the lung's natural healing process.

On the other hand, in the brain, the mice with COVID showed signs of persistent brain inflammation weeks later. The team also reported tiny areas of bleeding.

Conducting a gene expression analysis, the team found ongoing inflammatory signaling and disruption of pathways involved in serotonin and dopamine regulation -- brain functions linked to mood, cognition, and energy levels.

What Is Long COVID?

Long COVID is a collection of symptoms that last three months or longer after your first COVID symptoms. They include fatigue, brain fog, headaches, breathlessness, altered sense of smell or taste, headaches, and more.

While many of the Long conditions remain to be fully recognized, some people have more than one symptom.

mRNA Vaccine Against COVID

As per recent data from the World Health Organization, more than 43,000 new cases have been reported from 61 countries, between January and February.

Vaccination that prevents SARS-CoV-2 infection is the most effective way to prevent long COVID.

Recently, the European Medicines Agency (EMA) recommended a marketing authorisation in the European Union (EU) for mCombriax -- a messenger RNA vaccine for protecting people aged 50 years and older against COVID-19 and seasonal influenza (flu).

Co-infection with the influenza virus and SARS-CoV-2 can result in more severe disease than would occur with either SARS-CoV-2 or influenza virus infection alone.

mCombriax works like other vaccines by preparing the body to defend itself against infection. It contains messenger RNA with instructions for making proteins found on SARS-CoV-2 and the following seasonal influenza viruses: influenza type A-H1N1, influenza type A-H3N2, and influenza type B of the Victoria lineage.