Infertility is a complex condition. Where the difficulty in having a biological child is common, the factors that can lead an individual or couple to a diagnosis of infertility are varied. In fact, a diagnosis of infertility isn't just limited to first-time parents. Secondary infertility is the inability to become pregnant or to carry a pregnancy to term following the birth of one or more biological children. Many individuals and couples battle secondary infertility, but it isn't uncommon to be unwilling to disclose it. Despite the desire to expand their family, they may believe they should simply be grateful for the child they have or fear being ostracized by others who may share this view.

An Intro to the Pain Olympics

This is likely related to a phenomenon that occurs within the fertility community (and likely reinforced by other individuals) known as the Pain Olympics. It is an unspoken competition to see who really has had it the worst and is therefore genuinely worthy of feeling sadness or disappointment. How do we see the Pain Olympics at play? Examples generally include contrasting scenarios of people who are trying to conceive and deciding who has it worst:

  • The person who has never been pregnant vs. the one who had three miscarriages.
  • The person who has undergone ten rounds of intrauterine insemination (IUI) before achieving success vs. the one who did a single cycle of in vitro fertilization (IVF).
  • The couple who easily conceived and had a stillbirth vs. the couple who struggled to conceive for years and is still not pregnant.
  • The woman with secondary infertility who has one or two children vs. the woman who has none.

Secondary Infertility Isn't as Bad as...

Rather than validating all instances of loss or infertility as painful, secondary infertility contenders tend to lose all possible scenarios. They already have a child or two and their wish to have another is diminished by those who feel they have not endured enough pain to have earned the right to complain or express dissatisfaction. They have been told:

At least you have one.
At least you know you can get pregnant.
Just be thankful for what you have.
It could be a lot worse.
It’s so much easier to have an only child.
When it’s meant to happen, it will.
Don’t stress out so much.
Kids cost SO much.
It happened once, so it will happen again.
You wouldn’t want to bring another child into this crazy world.

The Tensions of Being an Infertile Parent

Along with the fallout from the Pain Olympics, people experiencing secondary infertility are likely to also experience unique challenges due to participating in two very different worlds – one in which they are not childless and one in which they are still experiencing infertility. These challenges may include:

1. Guilt and shame of feeling like you are asking for too much.

Those with secondary infertility feel guilty they have a child, and others do not. They feel ashamed griping about wanting another, so many remain silent. Some may have gone to great lengths to have their first, but this is not typically known or recognized.

2. The desire to have a sibling for their child.

Children of those with secondary infertility often ask for a brother or sister. They tell their parents about their friend’s “babies,” and ask when they are going to get one. More guilt and shame is then generated from the inability to provide their child with a sibling.

3. The pressure of a preferred age spacing for children.

The ideal age spacing of children is frequently thought to be eighteen months to three years. Sometimes secondary infertility is age-related - perhaps it was easy to get pregnant the first time, and it is assumed it will just happen the second time. As the months and years go by, the age spacing of children increases and those with secondary infertility fear that it will impact them as well as their children.

4. The perceived mental health strain on existing children.

Enduring months or years of negative pregnancy tests and treatments can put a strain on not only a partnership but also the relationship between children and their parents. Those with secondary infertility worry that their children are being affected by their anxiety, depression, or simply sad demeanor.

5. The constant reminder of saved baby items.

Those experiencing secondary infertility have likely saved baby and toddler items in anticipation of another baby. They have stored up toys, books, clothes, nursing bras, breast pumps, cribs, changing tables, strollers, and more. It is painful to encounter these items when they are within eyesight. Parents are uncertain if they will ever have a need to use them again, and if not, what they should do with the items. Cribs can be particularly burdensome as they relive memories of their children as babies.

6. Attending appointments at a fertility clinic with a child in tow.

Those with secondary infertility must secure childcare to attend fertility appointments. If they cannot, they feel remorseful bringing their child to the facility. Some reproductive endocrinology clinics have a no child policy, and this adds to their stress - having to spend money on childcare in addition to the high cost of care. It can also trigger resentment if the first child required treatment intervention - parents feel they have a right to bring their child.

7. Available support groups may not be an ideal fit.

Parents who are proactive about taking care of themselves might choose to attend a support group in their area, if available. Not only do they have to find childcare, but they are also often the only ones in the group with a child. This can lead to refraining from disclosing to the group, or they tell the truth and risk not being accepted or taken seriously.

8. The everyday exposure to the parenting world.

Those with secondary infertility live in a world of playdates, parks, museums, swim, soccer and music classes, preschool, birthday parties, and could be members of parent groups. The general public might not be teeming with women pregnant with their second and third children, but these activities tend to be rampant with them. It can be painful to be a member of this club while simultaneously desiring a completed family.

If you are experiencing secondary infertility, allow yourself to recognize if you feel like you are in pain. Your pain is valid. Loved ones of those with secondary infertility can listen with open and nonjudgmental ears to the unique challenges mentioned. They can validate the pain their loved one is describing, and ask how they can help. Anyone who is tempted to criticize individuals experiencing secondary infertility should consider that deciding who is allowed to hurt based on who appears to have suffered the most is of no benefit to anyone. Because infertility is hard enough already, validating, loving, and supporting each other is necessary.