A lot of us have a vision of the ideal family. For some folks, that’s Mom, Dad, and one kid. But for many others, that vision includes several pairs of small feet thundering through the house. 2.5 kids, a dog, and all of that.

We knew we wanted more children, and like many couples, started to mull the idea around once our firstborn was a toddler. And then, like an estimated 3.5 million others with secondary infertility… we failed to get pregnant.

What is secondary infertility?

Secondary infertility describes couples who can’t get pregnant or carry a pregnancy to term after successfully having a child. It’s sort of the limbo land of infertility. On one hand, couples struggling with secondary infertility are parents, and tend not to get a lot of sympathy from those still aching for their first child. But on the other hand, they don’t quite fit in with their more fertile friends, who, often tactlessly, wonder when the next bundle of joy will be arriving. It’s a weird, isolated no-man’s land, and it’s not a lot of fun.

Causes of secondary infertility

Secondary infertility has the same causes as primary infertility. Things may have changed after a couple’s first baby. Tubes get blocked, sperm count changes, ovulation gets wacky. There are also age-related concerns, primarily with the quality of a woman’s eggs. Older eggs just aren’t as likely to make a baby, and as couples wait longer and longer to start families, egg quality becomes a bigger issue.

And sometimes, eggs go bad early. In my case, my ovaries tanked on me young. I had my first child at 29, and we started trying for a second at 31. There was no indication anything was wrong, and I had no real reason to believe I wouldn’t get pregnant easily. That’s one of the problems with secondary infertility; people think that since they got pregnant once before, everything must still work correctly. Unfortunately, that’s not always the case.

Now what?

Facing secondary infertility usually means making a major mental shift. It can be life changing to have your image of your perfect family suddenly uprooted. Couples have a few options:

1. Come to terms with your family at its current size.
2. Pursue medical treatment for infertility.
3. Pursue adoption.
4. Pursue alternative or natural therapies for infertility.

The “right” answer varies for everyone, and it also can change over time. We ended up choosing Door #2, medical treatment. I had no intention of doing anything more invasive than Clomid, a first-line infertility drug. We figured something just needed to be “tweaked,” since we had a healthy son already, so we figured treatment would be relatively easy. Wrong.

We progressed beyond Clomid after 4 failed cycles under the care of an OB. We then moved on to a reproductive endocrinologist, and used injectable drugs, which I had sworn I would never use 6 months earlier. This resulted in a twin pregnancy we lost early on (including one ectopic twin and thus, the loss of a Fallopian tube). Finally, the end game: 4 IVF cycles, each one discouraging, expensive, and painful…until our last one where we conceived our beautiful daughter. Our “tweaking” resulted in two years of intense treatment: a blur of needles (as many as 4 shots a day), pills, schedules, and ultrasounds–and many, many tears….

The psychological toll

No matter what path couples choose, secondary infertility is hard. It’s hard to juggle the infertility’s grief and fear with parenting. When we found out about our ectopic pregnancy, our son, then 2 and a half, was with us at the ultrasound because we couldn’t get a babysitter. When the doctor told us the pregnancy was outside the uterus, I couldn’t help but burst into tears, but the worst part about it was my son saying over and over, “No more sad, Mommy. No more sad.” I was torn with guilt that my desire for another child was damaging the one I had here on earth. It’s a struggle that’s common for couples dealing with secondary infertility.

And, of course ,there were the baby showers, the new babies, the catalogs of baby gear arriving practically weekly. Pregnancy announcements of distant colleagues could send me over the edge. It was psychological tight-rope walking, all the time.

Dealing with it

Couples facing secondary infertility shouldn’t be afraid to seek psychological help. Whether they choose to search for peace with their current family size or choose to pursue other methods of increasing their family, it can be a tough road. Counselors, some of whom specialize in infertility and pregnancy loss, can be a great help. I also turned to therapies like acupuncture and yoga. I was a complete skeptic when I started acupuncture, but I quickly became a convert.

The Other Side

I was talking to a friend of mine who was going through treatment for multiple miscarriages. I could see my former self in her: the fear, the cynicism, the anger, the anxiety. I told her my story, and about the birth of my IVF daughter who is now a (very) active toddler. She said, “It must feel so good to be on the other side of it all.” I told her that there really isn’t an “other side.” You get through it (and as my counselor said, there’s no way through it but through it), but you never pass through completely, even if you do get the happy ending. Infertility is a life-changing experience, even if it comes after having a child.

Resources:

• RESOLVE: The National Infertility Association
• Conquering Infertility, by Dr. Alice Domar
• Wanting Another Child: Coping with Secondary Infertility, by Harriet Fishman Simons