When couples first start talking about the future of their family, one of the first questions that pops up is “How many children should we have?” Often this discussion also includes thoughts about the best age gap between children and the right time to start trying for a second (or third or fourth!) child. 

While many parents look forward to adding a sibling or siblings to the family, some couples may find themselves faced with complications from secondary infertility. Recently, a number of celebrities have come forward about their struggles with secondary infertility, a subject seldom discussed openly, and their stories are giving encouragement to couples dealing with their own challenges in this area. 

What is secondary infertility?

Secondary infertility is the inability to become pregnant or carry a pregnancy to term after previously having a baby. In the US, 1 in 8 couples are affected by infertility and 3 million women are affected by secondary infertility. Just as with primary infertility, the causes and treatments vary widely depending on the unique circumstances involved. 

The exact cause of secondary infertility can be difficult to pinpoint. This could include fallopian tube damage, endometriosis, thyroid problems, ovulation disorders, or uterine conditions. Other causes may be related to a change in partner or may be the result of a change in the sperm itself due to medication or aging. 

Post-pregnancy, some women experience changes in their cycle, which can make it more difficult to figure out when they are ovulating compared to when they tried to conceive for their first pregnancy. These changes may be due to weight gain, less sleep, more stress, or post-partum hormonal changes. Complications from a first pregnancy may also be a factor in secondary infertility. 

Getting Support

Dealing with secondary infertility can lead to increased pressure in other areas of your life and can be an especially isolating diagnosis. The pressure of not only growing your family, but also trying to give your child a sibling can lead to feelings of guilt. It is also not uncommon for family members who may not be aware of your struggles to continue to ask about when another baby might be coming. 

It’s often difficult for people with secondary infertility to find communities dealing with similar struggles. In infertility support groups, the focus is usually on those with primary infertility which makes people dealing with secondary infertility reluctant to speak up about their own challenges. 

However, opening up to those around you and in online and in-person support groups allows you to share what you’re dealing with during an emotionally difficult time. Many women also find their families are more supportive and understanding when they share information about their fertility challenges, and often find others in their family have had similar experiences. 

Remember that while seldom discussed, secondary infertility is more common than you think — likely even among others you know. An increasing number of resources and honest conversation can help turn this silent struggle into a commonality no woman should feel ashamed of. 

What can you do about it? 

Depending on the medical advice you receive from your doctor and where you are in your fertility journey, there are a number of options for women struggling with secondary infertility. 

Monitoring your ovulation is one of the first steps in battling infertility. Without having insight into if and when you are ovulating, it can be difficult to figure out when you should be trying to conceive. Variability in your ovulation timing is relatively common after giving birth, particularly during breastfeeding. Using an ovulation monitor such as OvuSense, which can predict when you ovulate 24 hours in advance, allows you to understand when you are ovulating in real time and when you should be trying to conceive or need further tests. 

Just as with other forms of infertility, many treatment options exist, including stimulated or medicated cycles, which can be used to increase the production of eggs. Depending on your specific medical history and findings with your doctor, the treatments for secondary infertility may be similar to primary infertility, so it’s important to bring any concerns to your doctor early to decide the best course of care. 

Regardless of what you decide your next step should be, taking back some control by educating yourself on the decision can help you feel more confident and take some of the stress out of trying to conceive. 

For more information about secondary infertility, you can find a support group through RESOLVE, the national infertility organization, or through online communities like Facebook and Inspire.

Photo by Alexander Dummer on Unsplash