Even if you've successfully conceived before, you might have fertility issues later in life.

October 03, 2005
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Are you or is someone you know facing secondary infertility? These facts can help you begin to understand the condition.

What is secondary infertility?

Secondary infertility refers to a couple's inability to conceive a baby, even though they've had at least one child in the past, either together or with a previous partner. Couples who experience this condition may confront a range of physical and emotional frustrations, despite the fact that they've been able to successfully reproduce in the past.

How many couples have secondary infertility, and why?

According to the National Survey of Family Growth, more than 1 million couples grapple with secondary infertility. The most common explanations are these: A previously fertile partner is trying to have a child with a new spouse, or one or both partners in an existing relationship have developed fertility problems since their last child was conceived. For instance, a woman might have developed endometriosis (one of the most frequent causes of secondary infertility in women), irregular ovulation, or fallopian tube disease. Or a man might have had a decline in the concentration or motility of his sperm. Other factors can involve age (even five years can make a big difference in a woman's fertility cycle and a man's sperm count), scarring after childbirth, or stress, which can affect ovulation and sperm production.

Couples who have had a previous pregnancy often think of themselves as having "normal" fertility, but this isn't always the case. That's why it's important for both the man and woman to have a complete infertility workup as soon as they feel they're having trouble conceiving.

Why is secondary infertility so emotionally difficult?

Some couples are shocked and in disbelief when they find themselves unable to conceive a second child, particularly if they became pregnant easily, or accidentally, the first time. Other couples, who previously had problems with fertility, may be anxious to try again, and may feel greater pressure the second time around since they know it's possible to have a baby. Still other couples may feel enormous guilt, or a sense of selfishness, for not providing a sibling for their only child, or for delaying a second pregnancy until it became "too late" to conceive.

On top of this, well-meaning friends and family members may unknowingly ask insensitive questions about when a couple is going to have another baby or why they've decided to only have one. They may also be less sensitive to a couple's plight, saying things like "You're lucky to have one child" or "Just relax. It will happen in time." An infertile couple may find it stressful, too, to go through the rigors of testing and treatment when they have a small child at home to care for.

How can couples best cope with the situation?

Couples without children often choose to avoid pregnancy- or child-related activities, such as friends' or relatives' baby showers or first-birthday parties, in order to minimize their pain. But couples with secondary infertility often have young kids of their own and may find themselves surrounded by mothers who are pregnant or nursing, or by the younger siblings of their children's friends. This, of course, makes it harder to sidestep the issue or to avoid their child's questions about wanting a little sister or brother.

Like any infertile couple, those who are facing secondary infertility need empathy, validation, and support from their friends, family members, and fertility clinic staff. They also need time to grieve and accept their situation and whatever outcome it might produce. In time, some couples do go on to achieve a successful pregnancy, while others add to their family through adoption or accept their family size the way it is.

The bottom line is that secondary infertility can cause stress, sadness, frustration, and loss for many couples. If you and your spouse (or someone you know) is facing this condition, it's important to learn all you can through reputable resources and organizations, and to attain the support you need to make the best decisions for you and your family.

Sources: The Couple's Guide to Fertility by Gary S. Berger, MD, Marc Goldstein, MD, and Mark Fuerst (Broadway Books, 2001); The Fertility Sourcebook by M. Sara Rosenthal (Lowell House, 1995); RESOLVE: The National Infertility Association

All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others

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Comments (3)

January 12, 2021
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