When you hear the word “infertility”, the first image that may come to mind could be a childless couple longing to have a family. What might not come to mind is the couple down the street who can’t seem to conceive a sibling for their only child. You see, infertility doesn’t discriminate, meaning it can sometimes afflict those who are already parents — even those who showed no symptoms of infertility in previous pregnancies. “What?” you may say, incredulously Googling “Is it normal to have trouble conceiving your second child?” Well unfortunately, the answer is sometimes “Yes.”
Secondary infertility refers to those who were able to achieve a healthy pregnancy at least once (either together or with a previous partner) but have been unable to conceive again. A report by the National Center for Health Statistics (NCHS) estimates that there are more than 3 million women in the US with one child that have had a difficult time getting pregnant again, or carrying another baby full-term.
Secondary infertility can come as a tremendous shock, and those who are diagnosed may feel a range of emotions, including depression and frustration. Making matters worse, friends and family aren’t always the most understanding.
According to Resolve: The National Infertility Association, “couples with secondary infertility tend to receive far less social support from others than couples who have primary infertility because the couple already has a child(ren). The need for support should not be ignored.” A couple can be grateful for their existing child, but still long for more children. It can sometimes feel like the choice to have more children is being taken away. Couples going through any form of infertility often find a disconnect between themselves and friends or family members who have not gone through the same trials to build their families.
It may surprise you that the guidelines for when to seek the help of a fertility doctor do not fluctuate based on your previous childbearing experience (or lack thereof). However, because couples afflicted by secondary infertility were able to conceive once without issue, many don’t recognize that they may need help. The logic is, “We had no problem getting pregnant the first time so I’m sure we’re fine!”
The guidelines are clear on when to seek the help of a reproductive endocrinologist. They are typically:
- If you’re female and under the age of 35, and has been trying to conceive for at least one year
- If you’re female and are over 35 and you have been trying to conceive for at least six months without success
- If you’re female and are having ovulation concerns
- If you’re female and are having missed or irregular periods
- If you’re female and have a history of pelvic infection, such as pelvic inflammatory disease
- If you’re female and have tubal damage or endometriosis
- If you’re female and have had two or more miscarriages
- If you’re male and have had any medical condition that may have impacted your sperm
- If you’re male and have had frequent urinary infections
While many of the causes of secondary infertility and primary infertility are almost identical, another factor to consider is your age. While you may have had little difficulty getting pregnant in your twenties, if you’re now trying for your second in your thirties, age may be a factor. As women age, their ovarian reserve (the amount of eggs they have) diminishes. This means that both their egg quantity and quality decreases. Even a year or two between children can potentially impact a woman’s ability to conceive. Getting older can also be a factor when it comes to a male’s fertility, because the quality and quantity of sperm can decrease in men as they age.
There may also be lifestyle changes that have occurred since you’ve had your first child. This could include any change in your health. This includes extreme weight gain or weight loss as this could affect either ovulation or sperm production.
Changes to your reproductive system could also be contributing to your infertility concerns. This includes conditions mentioned above and others, such as Polycystic Ovarian Syndrome (PCOS), endometriosis, or any undiagnosed fertility issues. These may have existed for a while without having been formerly diagnosed or could be a recent development. Either way, getting a fertility work-up by a reproductive endocrinologist sooner rather than later can help provide some insight into what may be causing any problems.
Just like primary infertility, secondary infertility can come from a combination of factors, though it may be difficult to completely pinpoint what exactly is the source of the issue. Still, you have treatment options that you can discuss with your doctor. Depending on your age, your family building goals and timeline, and what your doctor feels is the best protocol for you, assisted reproductive technologies such as Intrauterine insemination (IUI), In Vitro Fertilization (IVF), and Preimplantation Genetic Testing for Aneuploidies (PGT-A) may be helpful in increasing your pregnancy odds.
Above all it is important to remember that secondary infertility is more common than you think. Even if you didn’t need assistance the first time, it’s ok to ask for both emotional support and medical help. Your feelings and your fertility goals should never be dismissed. Whether you’re working towards your first child, second child, or simply the newest addition, CooperGenomics is here to help you achieve a happy and healthy family!