If you’ve already had one child, you may experience shock or surprise at your difficulties trying to conceive another. Even if you had infertility the first time around and perhaps expected some difficulties again, it can feel confusing and distressing to go back and forth between the fertile and infertile worlds.
At Shady Grove Fertility, approximately 50 percent of the patients we see are seeking support as a result of secondary infertility.
“Although this problem may seem improbable and frustrating, there are some logical reasons why secondary infertility is presenting an increasing challenge for those who want to expand their families,” shares SGF Houston physician Dr. John R. Crochet. “We’re here to help overcome barriers and help you reach the family of your dreams.”
Four common factors that contribute to secondary fertility
There are many reasons someone could be experiencing secondary infertility.
Upon exploring the underlying causes of secondary infertility, some find that they have a fertility-related issue — such as polycystic ovary syndrome (PCOS) — that, by all accounts, may have also prevented them from having their first child.
For others, however, something has changed between the birth of the first child and their attempt at conceiving and carrying another.
One of the leading causes of secondary infertility is age. As a woman ages, the quality and quantity of her eggs decreases. While she may have had her first child without a problem, she could encounter a change in egg quality or quantity if she tries to conceive again several years later. While every individual is different, SGF provides age-based recommendations for when you should see a fertility specialist if you are having difficulty conceiving.
In the span of time between the birth of a first child and an attempt at conceiving another baby, changes within the body may have occurred. Changes to the uterus, infections, or even Fallopian tube issues could make getting and staying pregnant more difficult. Irregular or absent menstrual cycles can often reveal an underlying ovulation disorder, even if previous conception occurred.
Recurrent miscarriage, also known as recurrent pregnancy loss, is defined as two or more consecutive, spontaneous pregnancy losses. It is often unknown why miscarriages occur, even when a previous pregnancy has been successful.
Male aging can also affect reproductive health, potentially affecting sperm quality and quantity. But while these changes may be due to age, they could also be due to new medications, such as testosterone replacement therapy, or lifestyle changes like weight gain or a new smoking habit (which can also affect female fertility). Learn how you can improve sperm quality.
Weight gain can have a significant impact on the ability to conceive, sometimes leading to ovulatory dysfunction in women or reduced sperm quality in men. However, weight loss can reverse these conditions.
In many men and women with a body mass index (BMI) that is above normal, diet, exercise, and lifestyle changes have been shown to make a vast difference in fertility potential. Studies have shown that for women, losing as little as 5 to 10 percent of their body weight can improve the chances of pregnancy occurring.
Available treatment options
If you have had a successful pregnancy before and are now trying to conceive without success, we recommend making an appointment to see a fertility specialist.
After your physician establishes a diagnosis, they will discuss with you the recommended treatment approach. As with other types of infertility, SGF takes a stepped care approach to treatment, which means we start with the simplest, most affordable treatment options first and move up to more advanced treatments only when medically indicated.
Support system for secondary infertility
Many women who experience secondary infertility can feel surprised, alone, and not know how to share their feelings with their friends and family. You may experience unwelcome reactions from your friends and family who may not understand why you’re so upset because you already have a child. It can be very difficult to make sense of these challenges and to stop feeling so distant from everyone around you. You are not alone though and there are support groups and resources available.
The most important thing to remember when you are experiencing secondary infertility is that you are not alone. A fertility specialist will be able to provide you with an accurate diagnosis and then create an individualized treatment plan to help you conceive.
SGF encourages patients to find a community of support and offers a Secondary Infertility Support Group. For more avenues of support, SGF offers a comprehensive resource library for patients, as well as active Facebook, Instagram, and YouTube channels, where current and prospective patients will find a wealth of support and resources.
Questions around secondary infertility you may be asking yourself
“Where do we fit in?”
Secondary infertility can leave you feeling like you’re straddling the worlds of fertile and infertile.
Like primary infertility, we see many patients with secondary infertility who attempt to isolate themselves from family and friends when it becomes too painful being around other people’s babies and pregnancies. However, once you have a child, you are clearly engaged in the “fertile world” and it becomes more difficult to do so. When you take your child to the playground or preschool it may mean encountering other mothers who are pregnant with their second child, newborn babies, and questions about when you will be having another.
You may feel vulnerable in these social situations and may dread having to address these issues. For some, having a script in your mind about how you will reply can help you to feel less out of control. A simple response like “maybe someday“ or “right now we are just focusing on our child” could be a way to end the conversation politely (even though you may feel distressed at having to tolerate the intrusiveness).
“Aren’t you grateful for what you have?” – Those experiencing secondary infertility share common concerns.
This can be one of the most distressing questions someone may ask you. While of course you are thrilled and grateful for the child you have, it doesn’t take away from the very real feelings that may exist in longing for another. You may already be feeling guilty for spending time and energy away from the child you already have, in thinking about or undergoing treatment pursuing a second child. You may also be feeling a mix of excitement as your child reaches each new developmental stage but also sadness at the sense that you may only have one opportunity to experience that particular milestone.
“These feelings are completely normal, and it may be helpful for you to ready yourself with an answer that feels right to you in case this question comes up,” shares Dr. Crochet. “We’ve heard some of our patients reply, ‘I’m grateful for the child I have, and I’d love to go through this wonderful experience again.’”
“What if my spouse doesn’t want to pursue treatment to have another child?”
Partners may differ in their feelings about treating secondary infertility. It’s not uncommon for spouses to be in different places with regard to how intently to pursue having a second child. One of you may have more ambivalence, perhaps asking why you should “rock the boat” and take a risk when you already have one healthy child.
Infertility treatment can take a significant amount of effort and energy, let alone money. We encourage patients to have a conversation early on about the lengths you are willing to go, as a couple, in pursuit of the goal of adding a child to your family.
No matter where you are in your family-building journey, SGF is ready to help you achieve the family of your dreams.
To learn more about an individualized treatment plan for secondary infertility or to schedule a new patient appointment, please call our New Patient Center at 877-971-7755.
Medical contribution by John R. Crochet Jr., M.D.
John R. Crochet, Jr., M.D., is board certified in obstetrics and gynecology (OB/GYN) as well as reproductive endocrinology and infertility (REI). Dr. Crochet received his medical degree from the University of Texas Medical Branch in Galveston. He then completed his residency in OB/GYN at the University of Texas Southwestern Medical Center in Dallas where he received commendations for his teaching and was recognized for excellence in laparoscopic and endoscopic surgery and ultrasonography.