Most people believe that once you’ve had one child, you’ve proven yourself to be fertile and therefore will have no problems conceiving again in the future. Unfortunately, this is not true. Secondary infertility is a very common problem. In fact, it is so common that it accounts for a much as 60% of infertility cases. Yet, many people fail to see this type of infertility as a problem.
What Is It?
Secondary infertility is usually defined as the inability to conceive or carry a pregnancy to term after successfully and naturally conceiving one or more children. According to a 1995 survey by the National Center for Health Statistics, 3.3 million American women were experiencing secondary infertility. This showed an increase from 1988, when 2.7 million women were affected by secondary infertility.
Unlike those experiencing primary infertility (when a childless couple is unable to conceive), couples that are affected by secondary infertility are much less likely to get treatment. This is usually due to the misconception that once you’re fertile, you’ll always be fertile. Medical professionals who do not have proper training in infertility issues often perpetuate this false belief. It is not uncommon for a couple to be told to just keep trying and that eventually it will happen. While this may be true in some cases, in many others, advice like this only adds to the frustration and heartache experienced by a couple having fertility problems.
Reasons for secondary infertility tend to be the same as reasons for primary infertility. Since you were last pregnant, you or your partner may have had an infection, gained some weight, or started eating fewer healthy foods. These seemingly small variances in your life can have large repercussions on your reproductive health. Additionally, if it has been a few years since you last had a child, your egg quality may have begun decreasing or your partner’s sperm may not be what it once was. Abnormalities with sperm and ejaculate are frequently cited as causes of secondary infertility. Other common explanations for secondary infertility include:
- Ovulation problems
- Pelvic adhesions
- Uterine fibroids or polyps
Should I See A Doctor?
It is always a good idea to seek out a specialist if you have troubles conceiving. If you are under 35, have been having regular, unprotected sex for a year and have not been able to conceive, make an appointment with your doctor or a fertility specialist. If you are over 35, then start investigating the issue after six months of regular, unprotected sex. However, there are times when you should make that appointment sooner.
If you experience two or more miscarriages, have irregular periods, have especially painful periods, an unusual increase or a burning vaginal discharge, or if your partner is experiencing a decrease in his sex drive, painful ejaculations, or impotence, then make an appointment sooner. These are all indications of medical problems that need attention before a successful conception can occur.
Because secondary infertility is often unrecognized as a problem, many couples find it hard to receive the proper support from their family and friends. Some couples may even find that people criticize them as seeming ungrateful for the child or children they already have. You may find it necessary to sit down and discuss the issue with those closest to you so that they can understand why you need their support so much right now.
While fertility problems can always put a strain on a relationship, secondary infertility can be especially stressful. The ways in which people deal with the situation can vary. Communication can breakdown when one partner does not want to discuss the issue at all, causing the other to feel shut out. Whether or not treatment for the infertility should be pursued, and how much to spend can other areas of contention for couples.
It may be beneficial to seek out therapy to help you and your partner deal with the emotions that secondary infertility brings. Joining a support group for people experiencing secondary infertility can help you realize that you’re not the only one going through this difficult time. Support groups have been shown to be very effective in helping people cope during a difficult time.
In addition to dealing with your own problems of infertility and your relationship, you will also need to address the issue with your child in an age-appropriate manner. Children are very receptive to the world around them, so it is unrealistic to think that your child will not notice the tense atmosphere at home. Talk about your feelings and encourage your child to express herself on the issue.
With proper support and guidance, you and your partner will be able to make the right choices for your family.
Revision date: July 7, 2011
Last revised: by Janet A. Staessen, MD, PhD