Confirming a secondary infertility diagnosis or feeling comfortable accepting an identity, can be as settling as it can be distressing. After weeks, months, sometimes years of confusion and uncertainty, to finally have confirmation of the box you belong in, can often be a huge relief.
You can seek the correct advice and treatment, you don’t have to worry about conditions you worried you might have and the confirmation brings to an end a horrid chapter when you’ve feared the unknown and felt gripped by uncertainty.
Realising I had secondary infertility and that my situation actually had a name, did exactly all of that for me. All I had known for all those years was that I wanted another baby. I searched Amazon for books about ‘struggling for a second child’ and ‘trying to extend the family’. I didn’t know the term to type into Google that might have pointed me in the right direction to find useful, specific information and secondary infertility support.
Dealing with secondary infertility
I was 38, happily married with a four year old son, boss of a marketing consultancy, been driven by my career all my life and I was desperate to provide a sibling. To others, I was seemingly happy, I had it all. My son was, and still is, the light of my life and after three years, having eventually conceived him with the help of Clomid, he had always been my dream come true. And yet, despite 15 months on Clomid and then three unsuccessful rounds of IVF, the heartache I carried at failing to conceive a second time was immense. It was often overwhelming.
Was I abnormal? Was it my fault? Was there something about me, my lifestyle, my habits, tastes, beliefs that meant I couldn’t conceive a second time? The truth is I’ll never know why. My secondary infertility, as with the first time, was unexplained. Nobody could tell me what it was about me that meant we were in this situation.
And yet, the confirmation that I wasn’t alone, that it wasn’t just me and that loads of other parents were struggling to provide a sibling too, so much so they’d given the condition a name, was actually hugely liberating! I might not have answers but I wasn’t abnormal and it wasn’t my fault. Whilst we might all be in the same boat, we secondary infertility sufferers are all different!
Different backgrounds, different lifestyles and so many different circumstances, yet the one thing we all have in common is that we are all blessed with a family but have a desire for another child.
The secondary infertility definition is commonly understood to be like my situation, where the couple have a child together, but for some reason or another can’t seem to conceive another child together.
However there are numerous profiles of couples struggling with fertility that I would strongly suggest should also fall into the ‘box’, ‘pigeon hole’, identity whatever you want to call it, that may not consider themselves as such.
For example, when a couple is struggling to conceive a second child, they are not eligible for funding for free fertility treatment as primary fertility sufferers are, because they have proved they can conceive successfully. This is irrespective of whether they required fertility treatment the first time round or not, even if they didn’t receive financial support the first time, they are still not eligible when struggling with secondary infertility on the NHS.
And yet, when either one or both, has a child with a previous partner, they too are not deemed eligible for funding for fertility treatment because they have also proved one or both can conceive successfully, even though this wasn’t together.
For some couples, those children from the previous relationship sometimes don’t even feature in the lives of their parents any more as contact is lost or few and far between for whatever reason. In other instances, those children are embraced by their Step Parents, loved and brought up as their own. In each case the couple understandably want to have a baby together, create their own little family but are seemingly denied the support or the recognition of having secondary infertility when I believe their circumstances show otherwise.
Another, often overlooked, profile is the couple that have more than one child. The most frequent retort when you have a child but say you are desperate for another is “Well count yourself lucky, at least you have little Johnny.”
There is very little understanding. When you already have 3 or 4 children and still feel desperate for more and dare to admit you feel sad that you can’t conceive again, the understanding from those around is pretty non-existent.
Irrespective of how many children you are blessed with, (and I’m sure you understand that you are indeed blessed if you are now struggling) you are entitled to feel the need or to want more and you deserve as much support as anyone else. You may be trying to conceive for your fifth baby but if you are struggling and seeking fertility treatment I would also include you in the secondary infertility statistics.
Women are having babies later, indeed putting off trying for children until later in life and more and more glass ceilings are getting shattered as girls are given more opportunities to excel in the workplace. At 38 I had been Marketing Director for a large PLC, ran my own marketing consultancy and felt I’d achieved many goals of the girl with big dreams, until I realised that all of that might have been at the ultimate expense of my actual biggest dream of being a Mummy to a large family. Here I was on the edge of the precipice at the big drop in egg quality and all that was now threatened. “You’ve left it too late” said some, “that’s why you can’t have more kids!”
In fact they were wrong. Firstly, even at 38, I always had bumper egg production and they were of the most excellent quality, but more importantly, secondary infertility can strike couples of any age. If a couple conceived a child in their late teens or early twenties, there is still every possibility that if they try for another, certain circumstances may dictate that they may not be as lucky second time round, whatever their age. Saying “But we’re still young!” may give them hope, but they should not put off seeking investigations or indeed fertility advice, no matter how young they think they are if they have been trying unsuccessfully for a sustained period.
The other area to consider when profiling secondary infertility sufferers is the World Health Organisation’s broad definition, which includes “all women unable to carry a pregnancy to live birth after a previous pregnancy”. They therefore include those women who have had repeat miscarriages, again a group who may be overlooked as to needing support through a secondary infertility support group.
And I guess whilst medically speaking, the circumstances are slightly different, I would also include some same sex couples in the category of Secondary Infertility where others may not. Why not? If either partner has naturally conceived in a previous relationship, or indeed if the couple have conceived through a donor or surrogate and they already have a family together, the fact that they may want to extend that family, to me, means they will still feel the same pain, longing, guilt and isolation of any other couple wanting another child.
We all like to feel part of something, to share love or interests with others and to have friends around us. Secondary Infertility is such a lonely world; one where you feel you can’t talk about your desires, your pain and your guilt, even to those closest to you. Thankfully more and more people are talking about the situation and so more people are recognising themselves and feeling they not only have an identity and a diagnosis, but also a friend.
It’s important that we all recognise that Secondary Infertility is still Infertility. It’s also important that we recognise that the profile of someone struggling with secondary infertility is not necessarily Mrs Married (to the same man), 40+ with a high flying banking career, high heels and shrivelled ovaries! Nor does she just have one child, just as she’s not necessarily straight, even married or most importantly seeking fertility treatment.
Not all those couples struggling to conceive a second child will contact a fertility clinic, seek advice or indeed access treatment. Their story will never be recorded and they more than most are probably oblivious to relevant support or information.
Figures on Secondary Infertility are scarce on the ground and any that do exist can only be wild guesses. Most fertility clinics don’t note if the cause of infertility is primary or secondary and whilst they may enquire as to the family background, this information is not recorded on any database.
Figures provided by fertility clinics will clearly be wide of the mark from figures generated by survey studies of the general population.
The pain at being unable to conceive is immense, it’s different but still unbearable if you already have one, two or many more children already. Whatever the couple’s circumstance or profile, wouldn’t it be great if we could hold back any judgement and instead extend support and understanding to anyone struggling to conceive?
Helen has struggled with Secondary Infertility for three years and runs the secondary infertility blog secondaryinfertilitymatters.com