When most people think about infertility, they usually imagine a childless couple anxiously trying to conceive their first baby. In reality, fertility problems can affect anyone at any time. If you’ve already had one or more children (especially if you did not struggle to conceive those pregnancies) the natural expectation is that it should be just as simple to get pregnant again. Many parents are dismayed when they find that this is not the case.
The inability to get pregnant or carry a pregnancy to term after the birth of one or more biological children is known as secondary infertility. It is a surprisingly common problem and contributed to up 60% of all infertility cases.
Why does secondary infertility happen?
Secondary infertility can be caused by many of the same conditions that contribute to primary infertility. Sometimes a problem that was not serious enough to prevent pregnancy earlier in life has advanced to a later stage, i.e. endometriosis or Polycystic Ovarian Syndrome (PCOS), or you may have developed a new medical condition, such as a thyroid deficiency or uterine fibroids, which can interfere with your fertility. Lifestyle changes such as a significant weight gain or loss can also contribute to problems conceiving.
The most common factor in secondary fertility, however, is age. Women are waiting longer than ever to have their first child or they are older when they start thinking about adding another child to the family. Fertility begins to decline at age 35 and continues to decline into your early 40s. These days, this is a typical time to begin trying for another baby. However, a decline in egg quality is a factor when trying to conceive later in life. Each woman is born with a finite number of eggs, and as you age those eggs can begin to suffer chromosomal damage. Damaged eggs are less likely to fertilize, and if fertilization does occur, the resulting embryo may not be viable, which often leads to early pregnancy loss.
While men’s fertility is usually less time-sensitive than women’s, men can have issues when trying to conceive later in life as well. Medical complications as men age may contribute to male-factor infertility. A man may have suffered from a prostate infection, an STD, or even diabetes or high blood pressure, which can compromise his sperm count, quality, and flow. Issues such as obesity and substance abuse can also play a role.
Coping with secondary infertility
Dealing with secondary infertility is extremely difficult for many families. The uncertainty, disappointment and heartbreak are just as real as if they are experiencing primary infertility. Secondary infertility often brings its own unique set of complex emotions to the table. Guilt is a huge burden for many. You may feel that you should be “more grateful” and content with the family you already have. You may feel guilty that you can’t provide a sibling and playmate for your other children. You may even worry that you are diverting time, attention, and especially money from your existing children. Should you be spending funds on fertility treatments that could be used for a tuition or a college fund?
It’s also harder for you to shield yourself from painful triggers. You are already deep into the world of raising children, so you can’t help seeing pregnancies and babies wherever you look. School, daycare, birthday parties and baby showers are harder to avoid. Couples suffering from primary infertility have more opportunity to isolate themselves from these things, whereas families who already have a child or children don’t want their kids to miss out on events.
If you make the choice to pursue fertility treatments, going through the emotional and physical stress of treatments such as IVF is much more difficult while dealing with the demands of family life. Couples may struggle to understand each other’s point of view if one partner has more desire for another baby. The constant appointments, procedures, and rigorous, precise medication schedules can be a lot harder to cope with, too. Scheduling all of this around a child’s activities and needs is tough. When you’re dealing with physical side effects of fertility treatments, rest can be much harder to come by, and if you’re struggling emotionally, the pressure to hide that stress from your child can be difficult.
There are no easy answers to any of these issues. A good support system, open communication, and a realization that you are not alone can help ease some of the pain and stress. A close working relationship with a fertility team who understands the unique circumstances of your situation is a valuable asset as you move through diagnosis and treatment.
Seeking help for secondary infertility
If you suspect you may be dealing with secondary infertility, it is important to seek help soon, especially if you are over the age of 35. Your natural inclination may be to “wait and see”, since you have become pregnant before, but time is of the essence. A preliminary exam and testing can be extremely helpful in pinpointing possible causes, and once you have some answers, you can start putting together a plan of action with your doctor.
Assisted Reproductive Technology (ART) has become very sophisticated in the last decade, and treatments such as Intrauterine Insemination (IUI) or In Vitro Fertilization (IVF) can offer fresh hope to many patients. If you’re under age 35, experts often advise seeing a specialist once you’ve been trying to get pregnant for a year without success. Over age 35, the time period is shortened to six months. These are not hard and fast rules, however, and if you are worried after three months, you have the right to be proactive about your fertility. The right clinic will take your concerns seriously and support you through testing, diagnosis, and treatment process.
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