Secondary Infertility
Jill Kane, Psy.D.
When Janet and Bill decided to have their first child, Janet conceived right away. When their son, who is now a healthy and happy 2 -year old, had his first birthday, they felt it was time to add another child to their family. Every month the couple became excited and geared up for ovulation time. Every month, when Janet got her period, they felt disappointed. They remained optimistic until 9 months went by and Janet still wasn’t pregnant. They both grieved for a baby not yet conceived and were anxious that they wouldn’t be able to give their son a sibling.
It never occurred to either Janet or Bill that fertility would ever be an issue. Their first son was conceived so easily, and neither Janet nor Bill had any health issue they knew about that could interfere with conception. They were surprised and saddened by the possibility they might not be able to have another baby and as they reached their year anniversary of infertility, Janet became depressed while Bill tried to be brave and feign an optimistic outlook.
Generally, infertility means the inability to conceive or carry a baby to term. Secondary infertility refers to the inability to conceive or maintain a pregnancy after successfully having one or more babies. While it is normal for conception to take a few cycles, if it has been 6 months (if you’re over 35) or 1 year if you are younger, seek advice from a medical specialist. Those who are struggling to conceive for the second (third, fourth, fifth or tenth) time, may be surprised, confused, concerned, and saddened by their difficulties.
The causes of secondary infertility are generally the same as the causes for primary infertility. The most common are: sperm abnormalities, “advanced” maternal age (35 +), endometriosis, fibroids, irregular or other ovulation problems, timing, and stress. Of course there may be other reasons as well, but medical research cites these as the most frequent. Certainly the best advice is to seek help from a medical professional regarding diagnosis and treatment. There are many ways to treat infertility and it is important to seek professional advice from an infertility specialist before embarking on any fertility regime.
While medical advice is useful for the physical aspects of infertility, the emotional component should not be overlooked. The emotional challenges of dealing with infertility month after month include feelings of grief, sadness, depression, anxiety, and stress. Women may feel betrayed by their bodies, and they may feel a loss of their identity as a woman. Janet felt “barren and unfeminine. Dry and old – just like an empty dusty desert.” She felt embarrassed and ashamed by her sadness, as well as worried and guilty that her healthy and happy toddler might pick up on her grief.
The emotional challenges of infertility can cause conflict in a marriage as well as social isolation. In addition, the emotional pain is often exacerbated by confusion. Common comments from parents struggling with this issue are: “It was so easy to conceive the first time”; or, “I heard second children are conceived so much faster than a first child”; “I figured my body knew what to do now”; and, “I thought it would be easier this time around.” For many people, the only thing that has changed is age. Other than that there is often a sense of bewilderment that accompanies secondary infertility.
Secondary infertility isn’t discussed as often as primary infertility. The reasons for this vary: some parents feel guilty for wanting another baby, some try to mask their sadness and grief and don’t discuss it, some think about how grateful they are for the child they do have and pretend the loss of a potential second is not as great as it really is. To make matters worse, they often don’t get the same sympathy from friends or family that a couple trying for their first baby receives. As Janet put it, “I should be happy I have a healthy child, and my friends and family keep reminding me of this.” Sometimes it can be hard for people to understand that you can love and adore your children and, at the same time, still grieve for the children you worry you can’t have.
For those couples that conceive but are plagued by miscarriage, the hormonal shifts further complicate the emotional picture. Don’t underestimate the power of hormones on mood, sleep, hunger, and sexual desire.
It is important to understand the emotional challenges of secondary infertility, whether you have been trying to have a baby for a few months or a few years. First, it really is okay to mourn the loss of a fertilized egg. It may sound strange, but the hope people have for a baby not yet conceived is very real and very powerful. Each month, there may be a cycle of hope, excitement, disappointment, loss and grief. Each new month, many parents find they have to learn to hold both the grief at the end of one month and the hope at the beginning of a new month simultaneously. This emotional rollercoaster can be challenging, stressful and exhausting.
In addition, many couples find that sex becomes a baby -making chore, rather than an expression of the love and intimacy that it’s meant to be. Regardless of what is happening in the moment, many couples feel they must have sex when ovulating – whether or not they are in the mood. Because the sex is so intertwined with the fierce desire for pregnancy, it loses all spontaneity, becomes mechanical and feels like a chore to be accomplished. These feelings can obviously put stress on the marriage and it is common that couples argue more when baby making becomes a job.
There also tends to be more strife in the marriage when the mother and father are not on the same baby-making page. Sometimes one partner wants a baby more than the other or one wants to explore medical interventions while the other wants to just wait and see what happens. Sometimes anger over the situation transforms into anger toward the partner. To make matters worse, stress has been shown to increase the difficulty of conceiving a child. There is nothing more stressful than infertility coupled with a conflicted marriage.
If you want to have another baby and can’t seem to conceive or maintain a pregnancy, see a medical professional. Know that all the sadness and stress you’re probably feeling is normal for couples struggling with this issue. It may be wise to talk with others who are going through the same thing or a professional who can help you cope with the stressors that are so commonly associated with secondary infertility.
