You may have had your first child easily, perhaps within a few months of trying, or maybe your first baby was accidental, so when it comes time to think about number two, you may assume that the next pregnancy should be, if not as easy, at least something that will happen in the not-too-distant future. When it doesn’t, this can be a shock for the couple involved, especially if the first pregnancy happened easily. The inability to conceive again, after having had one or more healthy babies is called secondary infertility and affects more than one million couples in the US, according to the National Survey of Family Growth. The most common reasons for secondary infertility are:
- A previously fertile partner is trying to get pregnant with a new partner with fertility issues
- One or both of the partners have developed fertility issues since they had their first child.
These fertility issues include:
- Endometriosis (one of the most common causes of secondary infertility in women)
- Fallopian tube disease
- Irregular ovulation
- A decline in the motility or concentration of sperm
- Age (even five years is a long time in terms of a woman’s fertility or a man’s sperm count)
- Scarring after childbirth
Secondary infertility can be just as emotionally difficult as primary infertility
As well as the typical feelings of stress and sadness that are associated with infertility, wanting and failing to give your child a sibling can also result in feelings of guilt for waiting too long. In addition, well-meaning friends and family members may unknowingly ask questions about whether or not a second child is planned and may also be less sensitive to the couple’s infertility problem as they already have one child.
Another area of stress can be seeing your pregnant or nursing friends at events that your child wants to go to, such as birthday parties. For obvious reasons, these events are much harder to avoid than a couple without children.
What steps can I take to deal with secondary infertility?
- Be proactive when it comes to seeking medical assistance. If you haven’t conceived after either a year of unprotected sex if aged 35 years or younger, or after six months if you are over 35 years of age, make an appointment to see your healthcare provider. And if you’re worried sooner, even after three or four months, don’t feel embarrassed about speaking up. If there does turn out to be an age-related issue, every month counts and waiting for a year or six months to find out there is an issue with egg supply or sperm quality can lead to a lot of heartbreak. After seeing your primary care doctor or your ob-gyn and you still aren’t pregnant after a few months, make sure you see a fertility specialist.2
- Sit down with your partner and plan a fertility road map together outlining which treatments you are willing to undergo and for how long you are willing to undergo them. Some potential questions include whether or not you would undergo in vitro fertilization, and if yes, then would you be willing to use an egg donor. Build in a loosely defined timeline as this can help counteract the feeling of infertility being an endless void.2
- Educate yourself about what tests you might need to undergo, such as laboratory tests, which will assess your fertility among other things, an ultrasound examination to evaluate the health of your uterus and ovaries, an X-ray to check whether or not your Fallopian tubes are functioning properly, and semen analysis (if you are male) to assess your sperm count and quality.2,3
- Accept your feelings and take action if necessary. Having a child doesn’t make going through infertility any easier and feelings of anger, sadness, and stress are common amongst couples dealing with secondary infertility. If you feel like you can’t cope with your feelings, make an appointment with a mental health professional, or seek out online blogs and chat groups for secondary infertility. Speaking from experience, these last two suggestions can really help with the feelings of isolation and loneliness if you are going through infertility and don’t know anyone else who is.2
- Most importantly, focus on now and take the time to enjoy the child or children that you do have, even if this is difficult to do. Worrying about whether you will get the larger family that you want robs you of the pleasure of the moment. However, counseling and talking yourself through the tough periods can help you tell yourself that you’re doing the best you can and meanwhile you’re living your life.2