So. You conceived your first child with no problem…
You started trying for number two and, HOLD UP –
It’s not working.
Why isn’t this working?
Everything was fine before!
This doesn’t make any sense…
If this situation sounds familiar to you, I am so sorry. When you experience difficulty conceiving “number two” after a relatively easy time with “number one,” it can be shocking, confusing, and heartbreaking.
But… deep breath. I have answers for you.
This is known in our world as secondary infertility, and it can be deeply upsetting. We typically associate the term “infertility” with those who are unable to have their first child, but secondary infertility is very real and much more common than you might think.
The good news is that you’re not alone and secondary infertility is treatable in most cases. Yes, this time around may look different and you may need to seek help, but that’s perfectly acceptable.
So try to drop that guilt, mama. The desire to have another child should never be dismissed or downplayed. Just because you have a child, or children, and want more doesn’t make this any less important. You deserve support and answers, so read on to empower yourself by better understanding secondary infertility.
What Exactly Does Secondary Infertility Mean?
Secondary infertility is the inability to become pregnant or to carry a baby to term within one year (or six months if you’re over the age of 35) after previously giving birth to a baby.
While you might not hear about this as much as women who are unable to conceive at all, secondary infertility is actually the most common form of female infertility, affecting around 1 in 10 women.
Why Am I Having Trouble Conceiving Again?
Now, for the big question that is likely hanging over your head... why?
Secondary infertility shares many of the same causes of primary infertility. While some fertility challenges show up earlier on, some complications don’t arise until after one, or multiple, successful pregnancies.
To better understand, let’s break down some of the most common causes of secondary infertility.
We know that fertility declines with age. Since egg quality declines as we age, women in their mid-to-late 30’s and older are more likely to experience fertility issues.
Men may experience issues leading to infertility, such as impaired sperm production, problems with sperm shape or motility.
Worsening of underlying fertility problem:
It’s possible that you had an underlying condition like endometriosis or PCOS all along, but you had no idea. Other issues may include hostile cervical mucus or ovulation problems.
You could have scar tissue, fibroids, adhesions, or blocked tubes as a result of a prior pregnancy or surgery.
Since your last pregnancy, you or your partner may now have increased risk factors, such as weight, age, smoking, or taking certain medications.
Also known as recurrent pregnancy loss, is when a woman has three or more consecutive, spontaneous miscarriages.
This option is not ideal, I know. While we can work to understand what is causing secondary infertility, there are occasions where it is unexplainable. However, unexplained DOESN’T mean unsolvable! There are still solutions that could be right for you.
When Should I Call A Doctor About My Fertility?
If you’ve been trying to conceive for one year or longer (or six months for women 35 years or older) with no luck, consider reaching out to a reproductive endocrinology and infertility specialist.
In my experience, women who are facing secondary infertility are more likely to put off seeking support. Maybe your friends and family members are downplaying your struggles because you have successfully had a child or maybe you’re feeling guilty for wanting to further expand your family. Or, hey, you’re a mom – maybe it’s difficult for you to find the time and emotional energy to seek help when you’re already caring for a young child.
There’s no shame in this game. The truth is that coping with secondary infertility can cause anxiety and grief and you deserve support while trying to achieve the family you desire.
How Do You Treat Secondary Infertility?
The short answer: testing and treatment for secondary infertility is typically the same as that of primary infertility.
Let’s dig into more detail… in order to begin treatment, both you and your partner need to be evaluated, and your provider will run tests to determine the cause. These can include a hysterosalpingography (or HSG) and a saline sonogram for her, and a semen analysis for him. (What to expect from a semen analysis? Check it out here.) From there, your Reproductive Endocrinologist will design a unique game plan to solve your secondary infertility.
Treatment plans vary, but these are the most commonly used options:
- Ovulation assistance: This involves taking drugs to make you ovulate, like Letrozole or Clomid.
- Intrauterine insemination (IUI): A fertility treatment that involves placing sperm inside a woman’s uterus.
- In vitro fertilization (IVF): This is the process of fertilization by extracting eggs, retrieving a sperm sample, and then manually combining an egg and sperm in a laboratory dish. The embryo(s) is then transferred to the uterus.
- Donor egg or donor sperm: This involves using donated eggs or sperm from someone you know or from an anonymous donor.
Secondary infertility should not be taken lightly, as it can come with a great deal of stress and guilt. You may be encountering less than supportive friends and family members who wonder why you’re “trying so hard. You already have a kid!” As I mentioned before, your family-building goals are your own, and every one of them are valid and supported by us here at RMA of CT.
The truth is that your need for support and treatment is the same as any person struggling with infertility. You should never feel ashamed about facing infertility just because you “already have kids.” When you long to have a child and are unable to conceive, the subsequent emotions can be heartbreaking.
Please don’t try to cope alone. Advocate for yourself, seek out support, and talk to your health care provider. We see women every day who are struggling with secondary infertility, so while this may feel like a devastating and isolating event, please know that there are solutions available. We understand and we’re here to help.
Ready to take the next step in learning more about tackling your infertility?