A: Tom, You are not alone in your desire to have more children, nor are you unique in having some difficulties conceiving this time around. Before I discuss some of the reasons you may not be pregnant, I suggest you and your partner speak with her gynecologist. There are some easy tests to help determine if you do have a fertility problem, and the gynecologist will help you decide if a visit to a fertility expert is necessary.

You have proven fertility, which makes it very likely you will get pregnant again. However, it takes two to tango. So, we have to take a look at you and your partner. Testing your fertility with a semen analysis is a prudent way to start. Surprisingly, you could have a low count and gotten your partner pregnant by luck the first time. Or your partner may have problems with her menstrual cycle, preventing the release of an egg, or a recent infection blocking her fallopian tubes.

A careful evaluation by the gynecologist should steer you in the right direction. Also, there are many excellent web sites dedicated to infertility, which can elaborate in great detail on the causes of infertility.

I'm confident that working with the doctor, you will find the right answer and another child. Good luck.