After the age of 25 there are three questions women find difficult to avoid, and equally as difficult to answer:
‘When are you getting married?’ is closely followed by
‘When are you having a baby?’ which then ultimately leads to
‘When is baby number two coming along?’
Putting aside for a second that women’s aspirations are many and varied, and that families come in all shapes, sizes and timelines, the last question can often hide a painful truth few people talk about – that baby number two is dearly wanted but not forthcoming.
The medical term for this is secondary fertility, a slightly clinical description for the many couples and women who are struggling to have the number of children they desire.
The two most common stories
According to Dr Sally Reid, Fertility Specialist, there are two very common but different stories for people dealing with secondary infertility.
“Unfortunately a great number of couples who have had fertility treatment with their first child, require fertility treatment for further children,” Sally said.
“There can be an assumption from friends and family that it’s easier the second time around, but that’s often not the case.
“Even if you know you’re likely to need further treatment, due to a condition like endometriosis, polycystic ovaries or a low sperm count, it’s still a more difficult and involved journey than naturally conceiving a child.”
Sally says that couples who had no problems at all conceiving and carrying their first child can also be affected by secondary infertility – which can come as a big surprise.
“It’s a real shock for people who easily had their first baby. There is an expectation that baby number two will come in time, but for a reasonable percentage of people it’s not the case and the next baby is much more difficult to conceive.”
Reasons for secondary infertility
Fertility is neither static nor fair, and while there is a wide range of reasons for secondary infertility, the following four factors can lead to couples struggling to conceive their second child.
Women are having children later and it can have an impact on the ease of conception for a second child.
“For both women who’ve had fertility treatment in the past and those whose first child was conceived naturally, age is a factor in having a second child,” Sally said.
“It’s really important for women over 35 who want a child to seek advice after just six-months if they’re having trouble conceiving, as earlier treatment can have a big impact on success.”
Having a toddler is great fun, but also exhausting!
Diet and exercise can be put on the backburner after having your first child and it’s easy to put on weight through, and after, a pregnancy.
Maintaining a healthy and active sex life, and having sex at the right time for conception, can also be more difficult with the demands of a toddler, as well as juggling life, a home and perhaps work too.
“The advice is just to be as healthy as you can be,” Sally said.
“If you’re trying to lose weight, it’s important to aim for 2 to 3 hours a week of moderate exercise such as walking or a gym class and to eat regularly, in smaller portions. A balanced diet rich in fish, grains and vegetables is ideal when trying to conceive. Seeing your GP, a dietitian or an exercise physiologist can be very helpful.”
3. New partner
A common reason for experiencing secondary infertility is having a new partner. And with couples there is a fairly even 50:50 split of fertility issues.
“There are definitely a wider set of issues that can impact on women’s fertility, but male fertility is a factor in about 50% of couples we see, and most often it is due to sperm quality.” Sally said.
“When new partnerships form, there can be a completely new set of fertility issues to contend with.”
4. Childbirth related medical issues
Pregnancy and childbirth have an impact on women’s bodies, and can sometimes prevent a second baby. Complicated c-section births, previous ectopic pregnancies, fallopian tube damage, cysts and fibroids can all be caused by pregnancy and childbirth.
“Sometimes there are medical issues stemming from the first child, that can be solved with treatment or surgery, but women may not always realise there is an issue until they start trying for another baby,” sally said.
Don’t feel guilty or alone
Sally says struggling to conceive on your second or third time around brings an entirely new set of challenges, particularly for women.
“When you have a toddler you can’t entirely avoid play dates or childcare or children’s birthday parties. It can be really difficult to see other women having their second or third babies when you’re struggling to conceive.
“There is a new guilt at play. While women feel grateful to have a child, they feel a sense of grief that their family isn’t yet the size they’d like. And the pressure from friends and family can be intense and unhelpful.”
Getting the right advice and support
The advice for couples struggling to conceive a second child is exactly the same as those experiencing infertility for their first child.
Women under the age of 35 should see their GP if they have struggled to conceive after 12 months, and this is reduced to six-months for women over 35.
“Because there are a range of causes of infertility, there are also many different treatment options. But the important thing is to get the right advice from your GP and fertility specialist,” Sally said.