By Josephine Atluri, Certified Life Coach & Expert in Meditation and Mindfulness
If you’ve made the decision to start trying to conceive (TTC) while raising another child, but have run into issues growing your family, it can be a confusing and difficult time. It can be even more frustrating when you had absolutely no problem getting pregnant and delivering your first child to suddenly have fertility issues, or what is also known as secondary infertility.
What is secondary infertility?
According to the World Health Organization (WHO), secondary infertility is the inability to conceive after having achieved at least one pregnancy.
Primary vs secondary infertility
While the biggest difference between primary and secondary infertility is the ease with which one becomes pregnant and delivers their first baby, there are some other similarities and differences between these two types of infertility.
One difference between primary and secondary infertility is the implicit bias that you may experience when sharing that your wish to have another child is being hindered by fertility issues. People may not understand the want or need to grow one’s family when there are already children. This bias can show through a lack of sympathy and support from friends and family, and even medical providers.
While primary infertility and secondary infertility have their differences, they can be caused by similar circumstances. Some causes of secondary infertility in females include: problems with the fallopian tubes or uterus, ovulation issues, endometriosis, and complications from a past surgery or pregnancy. For both partners, other factors that can contribute to secondary infertility issues include age, weight, and medications.
How common is secondary infertility?
Fertility problems, whether they occur the first or second time around, can come with a lot of stigma and stress. It can feel very isolating, demoralizing, and confusing to navigate the struggles experienced during one’s TTC journey.
Secondary infertility comes with the added mystery of why it’s hard to get pregnant or sustain a pregnancy after successfully carrying and birthing a child previously. It also comes with navigating the process with a child already in the picture.
According to results from a survey done by the Centers for Disease Control and Prevention (CDC), 13.1% of women up to age 49 have experienced secondary infertility. This percentage is similar to the percentage of women of the same age who have experienced primary infertility. These statistics are helpful in understanding the commonality of both primary and secondary infertility and normalizing what can feel like a very lonely time.
When should you get help from a fertility specialist?
When you are trying to conceive another baby but experience problems in your family planning, you may get a lot of unsolicited advice both from family and friends and possibly even your healthcare professional to “just keep trying” since it worked the first time. But when is it time to get help and consider fertility testing and treatment?
A good rule of thumb is to seek out a fertility specialist (or reproductive endocrinologist) if you have been trying to conceive with unprotected intercourse for over a year (or for 6 months if you are over the age of 35). It’s also a good idea to speak to a fertility specialist sooner rather than later if you are over 30 and have a history of any of the following: pelvic inflammatory disease (PID), painful periods, miscarriage, irregular cycles, or low sperm count.
Remember that you are the person that knows your body best, and it is your right to advocate for yourself when it comes to seeking medical advice, diagnosis, and treatment options.
How to find a fertility specialist
It’s normal to feel stressed or upset when taking the next step to speak with a fertility specialist. Considering you never had to use fertility treatments like intrauterine insemination (IUI) or in vitro fertilization (IVF) during your first pregnancy, it might feel like you are entering unfamiliar territory of the TTC journey this second time around. Even the jargon and acronyms used can be mind-boggling. So where do you begin on this new fertility journey?
A good place to start is with your OBGYN, who may be able to recommend local fertility specialists that they have worked with in the past. It is often helpful to get a trusted referral. You can also reach out to friends and family. Considering how common it is for women to use fertility services, there’s a good chance that someone you know has worked with a fertility expert that they can recommend. You can also use a service like Fertility House Calls to book an initial consultation with a credible clinic near you.
If you’re not ready to share your additional-child TTC struggles with friends and family, that’s your personal decision, and it’s totally valid and understandable. Everyone’s comfort levels regarding the discussion of their own path to parenthood vary, and it’s important to honor your truth and set boundaries that fit the needs of you and your partner. There are great options for support and education available to you, like Fertility Out Loud. Aside from the resources and guidance they can provide, they also have a supportive community of people who have been through it all.
Coping with secondary infertility and your mental health
Infertility of any kind, whether it is primary or secondary, can have negative effects on your mental, emotional, and physical health. The rollercoaster of stress and uncertainty of unexplained infertility, or even fertility issues that have been diagnosed, can lead to difficult emotions like sadness, grief, frustration, embarrassment, isolation, jealousy, anxiety, and depression. Adding to this, women who have trouble trying to conceive their second child often feel guilty and shamed by others for wanting to have more kids and pursuing fertility treatments when they have a child. It’s perfectly normal to feel grateful for the child you already have while still wanting to grow your family and give your child a sibling.
Each TTC process and pregnancy is a unique experience and comes with its own ups and downs. This can be helpful to remember when you feel the urge to compare your current situation to the process with your first child.
There are many ways to support your emotional and mental health throughout the process. One important strategy is to create a community of support that includes your partner and fertility team. Depending on your needs, you may also call on other outlets, such as friends who have experienced infertility, support groups that can be found through organizations like Resolve or at your fertility clinic, a therapist, and/or a fertility coach. Or it may be best for you to just lean on your core group of friends and family. The TTC journey can feel isolating right from the start, so it is very helpful to have support in place.
Try to remember that it’s okay to ask for help. This is not a sign of weakness and it does not devalue your worth—rather, it is a sign of strength. For many, it can feel like your worth as a woman is tied to your ability to create life, but remember that you are more than your role as a child-bearer. It can be easy to forget our worthiness, truth, power, and inner light when we are in the thick of our fertility journey. A helpful strategy is to write down all the reasons you are wonderful and worthy outside of trying to conceive. You can make your list in a journal, an email, on a sticky note, or as a voice memo. Pull out these affirmations or notes when you need a reminder of your beauty and strength outside of trying to conceive.
Another thing you can do on your own to nourish your well-being throughout the challenging times of trying to conceive another child is to create a self-care toolkit. This is a handy strategy to boost your mood any time you feel down and need to be uplifted. Your toolkit can include practices like daily yoga, meditation, journaling, exercise, walking, and any other self-care pampering rituals that you enjoy. Navigating secondary infertility can put a strain on all aspects of your health, so it’s key to have strategies ready to go when you start to feel the swirl of chaos impacting your well-being.
Coping with secondary infertility and your relationships
The secondary infertility journey can affect other aspects of your life, such as your work, outside interests, and your relationships with friends, relatives, your partner, and even your child. Oftentimes, most of the fertility treatments are done to the female who is trying to conceive, and the burden of these experiences may feel like they should be dealt with alone, and not shared with others. This can lead to diminished communication and intimacy with your partner, and jealousy and anger with friends and family.
Some ways to strengthen your relationships with others during this time is to be honest about your feelings and set boundaries that respect your privacy and safeguard your emotions. Be upfront about your comfort levels in discussing your situation and getting advice. Sometimes the concern demonstrated by other people who have not experienced infertility comes across as insensitive and not empathetic. Your feelings take priority during this tough time, so don’t worry about making choices that might be construed by others as selfish. It’s not selfish to care for your well-being.
Secondary infertility can be a stressful and discouraging experience in your TTC journey. As you go along the process of trying to conceive another child, remember to advocate for yourself, create a community of support, and take active steps to safeguard your emotional and mental health and relationships with your partner, child, and others. Whatever feelings you have during this time are completely valid and worthy of extra kindness and grace. If you need help navigating secondary infertility, reach out to the many resources available.