For couples who conceived their first child fairly easily, secondary infertility can come as a bit of a shock. Although it is not as common as primary infertility, it is estimated that as many as one in 10 couples experience difficulty in conceiving a second child.
It took Zoey Martin and her husband 9 months to conceive a younger sibling for their first child, Riley. “We got pregnant with Riley in our first month of trying so I was really unprepared for the emotional roller-coaster of trying to conceive. Every month that we weren't pregnant felt like a loss. Emotionally it was very challenging,” she says.
Dr Stephen Roberts, spokesperson for the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, says there are several causes of secondary infertility.
“The most common reason is age, as women become less fertile as they get older. The second reason is weight; if a woman has gained a lot of weight then she will find it harder to conceive,” he says.
“And the third most common cause is endometriosis, which can be treated with medication.”
In terms of solutions, Dr Roberts recommends that first and foremost, couples trying to conceive should try to be as healthy as possible. “Both members of the couple need to be as fit as possible, limit alcohol consumption, get regular exercise, eat well – all these factors are really important,” he advises.
When there are no obvious causes, Dr Roberts suggests ‘cycle tracking’, a process in which the development of the egg is monitored through hormone measurements and ultrasounds. “We are then able to pin down, almost to the hour, the moment when the woman is most fertile. Couples are then able to time intercourse very precisely to the moment when fertility is at the absolute maximum.”
However, sometimes these tests can reveal that the woman isn’t producing an egg at all; in these cases, fertility drugs can be administered to bring about the release of an egg. This method worked well for Theresa Lee*, who sought medical intervention after 10 months of trying to conceive a younger sibling for her daughter, Lily*.
“I started to worry after about four months as I was tracking my cycle and thought I knew when I was ovulating. But after another six months of trying with no success I started to get more worried and went back to my obstetrician. Tests showed that I wasn't ovulating,” she says.
“His advice was then to take Clomiphene, and I fell pregnant the second month of taking the drug.”
Lucy Bishop* had a similar experience, and after a long period of trying, also sought the help of a fertility specialist. “I was diagnosed with stage two endometriosis. I had to have surgery to clear it out and then go on to IVF,” she says.
“It was a highly emotional experience, and my heart and hopes were on the line. I cried a lot, I was excited and scared.”
Eventually, though, it was a success and they welcomed a son, Matthew. "[He] was destined for this world & we could not be happier. I would do it all again,” she says.
When it comes to dealing with the ‘emotional roller-coaster’, psychologist Cathy Corcoran believes that keeping a positive frame of mind can be helpful.
“I believe in a positive mindset; I think positive thinking and thoughts can make a difference. Cognitive behaviour therapy (CBT) and affirmations can support the outcome,” she says.
Corcoran also points out the importance of having people available to support you emotionally.
Another psychological side effect of secondary infertility is the stress caused when others ask unwelcome and intrusive questions, such as “when are you having another one?” Corcoran recommends that couples devise an answer and stick with it.
“I suggest women say, ‘Thank you for asking but it’s not something we discuss’, and then have another topic to change to,” she says. “People soon get the idea that it is none of their business.”
*Names have been changed.