Secondary Infertility: What It Means and How Joanne Verkuilen Dealt With It
For families who have one or more children but who are – for any multitude of reasons – struggling to have another child, secondary infertility is just as devastating and difficult as any infertility diagnosis.
Secondary infertility is also more common than we think with the CDC estimating that 11% of couples who already have a child go on to experience secondary infertility. That means that 4 million American families – and about half of all infertility cases in total – are struggling with secondary infertility.
And yet, if infertility is spoken about too little and still lingers in the corners of social discourse, secondary infertility exists even deeper in the shadows and comes with its own challenges. But while secondary infertility is physically and emotionally challenging, it can be overcome, as Joanne Verkuilen — founder of Circle+Bloom — proves with her story.
What is secondary infertility?
Secondary infertility is the inability to conceive a child naturally after successfully giving birth to one or more children without the help of assisted reproductive technology (ART) or other fertility treatments.
Like primary infertility, or the inability to conceive a child naturally the first time, it is diagnosed after unsuccessfully trying to get pregnant for one year (if you are under age 35) or six months (if you are over age 35). While fewer people talk about secondary infertility, evidence shows that it is just as prevalent as primary infertility.
How does secondary infertility happen?
As women age, many changes can occur that may negatively impact their fertility. Age alone can make it more difficult to conceive naturally, especially if you were already over age 35 when you had your first child. You may also go on to develop (or experiencing worsening of) a medical condition that could negatively impact fertility.
It’s also possible for a woman’s partner to develop a fertility issue later in life. Male fertility does not decline as significantly with age as women’s, but they may develop ejaculatory problems or low sperm count as they get older. This can make it more difficult for a couple to conceive, even if the woman does not have any fertility issues.
How common is secondary infertility?
Many people wrongfully assume that primary infertility is more common than secondary infertility. In reality, secondary infertility is equally as common as primary infertility. It’s estimated that secondary infertility and primary infertility both occur in about 10% of couples.
Millions of parents go through a secondary infertility diagnosis. 30 to 40 percent of couples with infertility struggle with secondary infertility. This means a little less than half of all infertility cases are secondary infertility cases, rather than primary infertility cases.
Understanding Secondary Infertility
When considering how secondary infertility develops and what can be done about it, there are many factors that come into play. Secondary infertility can affect you and your partner physically, mentally, and emotionally. It’s common to experience complex emotions, such as guilt and grief, in addition to physical symptoms and psychological stress on your fertility journey.
When dealing with a secondary infertility diagnosis, you may also face a lack of social support. Many people do not understand the struggles of secondary infertility and will tell you to be grateful for the child(ren) you already have. However, as you know, secondary infertility can be just as painful as any other infertility diagnosis.
In order to truly understand secondary infertility, you need to understand the causes, treatments, and emotional supports available to a couple that is trying to conceive (TTC) with a secondary infertility diagnosis. Here is everything you need to know about dealing with secondary infertility.
Secondary Infertility Causes
Some cases of secondary infertility have a clear cause like aging or a health condition in either the mother or the father. However, like primary infertility, secondary infertility can be defined as unexplained. About 1 in 5 cases of secondary infertility are unexplained, meaning there is no clear medical reason for the infertility diagnosis.
When secondary infertility does have a clear medical cause, a wide variety of factors may be at play, including:
- Age. One of the most common causes of secondary infertility is natural aging, which results in fewer eggs and lower quality eggs in women. This is especially likely if you have your first baby after age 35, once fertility has already declined.
- Anovulation. Women can develop anovulatory or irregular cycles at any point in their lives. These changes are often due to alterable lifestyle factors, such as weight gain or extreme exercise. When you do not ovulate, an egg is not released to be fertilized, so you are unable to get pregnant.
- Sperm problems. In men, aging does not typically decrease sperm count, but it may decrease due to lifestyle factors, such as diet or extreme temperatures. Additionally, aging can lead to lower sperm quality, causing a number of problems with sperm that are linked to secondary infertility. This includes issues affecting sperm motility (its ability to travel efficiently to reach an egg) and other factors that affect fertility.
- C-section. Occasionally, a previous C-section may cause scarring in the abdomen or reproductive organs that can negatively impact fertility. This may be especially likely if the scar tissue causes a blockage in the fallopian tube, preventing an egg from leaving the ovaries.
- Polycystic ovarian syndrome (PCOS). A woman can develop PCOS — a hormonal condition causing symptoms like irregular cycles, abnormal hair growth, and weight gain — at any age. It’s also possible that her PCOS previously went undetected and has now worsened to affect her fertility.
- Endometriosis. The same is true of endometriosis, a condition where tissue similar to that of the uterine lining (or endometrium) grows outside the uterus. Endometriosis can develop or worsen at any age. When it causes scar tissue, or adhesions, to form between pelvic organs, it may negatively impact fertility by creating blockages in the fallopian tubes or other parts of the reproductive system.
When you have been trying to get pregnant naturally to no avail, your doctor may recommend assisted reproductive technology (ART) or other fertility treatments. The fertility treatments most often given for secondary infertility include:
- Clomid. Clomid is a medication designed to induce ovulation and is the most commonly prescribed fertility drug. It is often the first-line treatment for secondary infertility.
- Injectable fertility drugs. Injectable fertility drugs, or gonadotropins, are fertility medications given as an injection in the abdomen. They are used to stimulate ovulation.
- Intrauterine insemination (IUI). IUI is a procedure where sperm is injected into the vagina, close to the cervix, using a turkey baster-like instrument. This can be done with your partner’s sperm or with donor sperm to improve the chances of fertilization.
- In-vitro fertilization (IVF). When all else fails, you may try IVF, either with or without the assistance of fertility drugs. IVF can be done with your eggs or with donor eggs; with your partner’s sperm or with donor sperm. In IVF, the eggs are fertilized in a laboratory and implanted in the uterus via an invasive procedure.
- Laparoscopic surgery. If you have scarring from a C-section or from endometriosis, your doctor may recommend laparoscopic surgery — a minimally-invasive procedure — to remove the scar tissue. Many times, removing the adhesions can restore fertility.
It’s important to not only take care of your body physically but also to seek emotional support when dealing with a secondary infertility diagnosis. Secondary infertility can take a drastic toll on your mental and emotional health. When left unaddressed, this stress may have a further negative impact on your chances of conceiving.
There are a couple of things you can try to get the emotional support you need, outside of friends and family, when dealing with a secondary infertility diagnosis:
- Yoga. A special type of yoga called fertility yoga may help you reduce stress and increase emotional support by connecting you to your body and with other women facing infertility. Some yogis believe that yoga can even improve fertility by increasing blood flow to the reproductive organs, though there isn’t much research to back it up.
- Meditation. Meditation is proven to reduce stress and may make your fertility journey less emotionally challenging by teaching you to practice mindfulness and acceptance along the way. We have a special fertility meditation playlist designed to guide you through your fertility journey.
- Support groups. Online and offline fertility support groups can help you find the emotional support you need in other women and couples facing an infertility diagnosis. There are special support groups geared toward women facing secondary infertility in particular, which may make you feel less alone in your struggles.
Therapy. Some women facing infertility find talking to a therapist helpful. It can be comforting to talk to a third party who doesn’t know you or the people involved in your life. He or she will be able to listen to you talk about your emotions without judgment and teach you ways to cope with a secondary infertility diagnosis.
How Joanne Verkuilen Dealt With Second Infertility
Circle+Bloom’s founder, Joanne Verkuilen’s shares her own personal journey with secondary infertility and a deeper look into the growing cases of secondary infertility. Circle+Bloom offers guided meditation and visualizations that help women on their fertility journeys.
For families who have one or more children but who are – for any multitude of reasons – struggling to have another child, secondary infertility is just as devastating and difficult as any infertility diagnosis is.
I know. I’ve been there. For years, my husband and I tried to get pregnant again after the birth of our first daughter.
I know the frustration, anger, confusion, fear, sadness, and month after month after month after year of waiting and trying and hoping.
Secondary infertility is more common than we think. There are so many of us out there. The CDC estimates that 11 percent of couples who already have a child go on to experience secondary infertility. That means that 4 million American families – and about half of all infertility cases in total – are struggling with secondary infertility.
And yet, if infertility is spoken about too little and still lingers in the corners of social discourse, secondary infertility exists even deeper in the shadows and comes with its own challenges.
“Just be thankful for the one (or two or more) that you have.”
Yes, you think. I should be happy for the child(ren) I have. There are so many people out there who would give everything they have just to have one healthy child. But… I can feel the child who has not yet been born. The one I feel I’m supposed to have. The one I want so desperately. The one who isn’t yet here.
My Story of Secondary Infertility
Before I started Circle+Bloom, I had one daughter. She was conceived easily, and when my husband and I decided to have a second child, I expected it would go just as easily. But it didn’t.
We tried for years to conceive another child, unsuccessfully.
I had known since adolescence that I had PCOS, and that my diagnosis could make having children difficult. On an ultrasound, I was told that my ovaries looked like “swiss cheese.” The eggs don’t fully form and don’t release from the follicles – they just continue to sit there – causing the follicles to keep growing and to produce many cysts instead of healthy eggs. But it had been so easy the first time – why not again?
Over time, I became desperate. I would get a twinge in the pit of my stomach when I saw a mommy-to-be, and I swooned over adorable baby clothing and that bewitching baby-powder, new-baby scent.
A few times the pregnancy test came back positive, only to find out weeks later that the pregnancies were not viable and needed to be terminated. I don’t know whether they were a result of my PCOS, although the disorder is characterized by a higher incidence of miscarriage.
I was heartbroken. A failure.
Infertility took over my life. It became my existence, and everything I witnessed went through this lens of despair.
In an article on HelloFlo, mental health counselor Dusty Williams put words to some of my feelings about the distinct pain and challenge of secondary infertility. She said:
“Women experiencing secondary infertility often feel deprived of the right to grieve. Their desire for more children and deep sadness over not having the family they envisioned is disenfranchised by society and often judged as being ungrateful. If a women does gather the courage to share her pain, she is almost always met with some version of, ‘At least you were able to have one child.’
This invalidation often triggers feelings of guilt and social isolation… There is a unique pain in secondary infertility, particularly when your child lets you know that they want a sibling. Seeing your child wrestle with their disappointment and loss has a way of magnifying your own, especially if you feel responsible for their pain.”
It did happen eventually, and today I’m blessed with two beautiful, healthy children. But I began to notice I wasn’t the only one experiencing fertility issues; a close friend of mine was also having trouble getting pregnant.
I started thinking about the many different things that influence conception, and how we can influence our bodies and our reproductive health. I researched and read books, asked questions and reached out for conversations with doctors and specialists. All of this exploration led me to believe strongly that we do have the power to influence own own reproductive health. I believe that one of the best vehicles for this control is through the use of guided meditation.
Our kids are now 17 and 12, and I have since built Circle+Bloom and its guided meditation programs to offer help and support to other women and couples along their journey to parenthood.
What Causes Secondary Infertility?
When I was struggling with secondary infertility, one of the constant refrains in my mind was simply, “Why?”
Why me? Why us? Why now? Why wasn’t it this hard the first time? Why is it different now?
Just like for any other case of infertility, secondary infertility has a wide-ranging list of potential causes. (Not to mention the particularly vague and frustrating “unknown” diagnosis.)
It could be that an existing condition (like my PCOS) worsened over time.
It could be a new or previously undiagnosed condition – like endometriosis, uterine fibroids, diabetes, or thyroid disease.
It could be that you’re just that much older than you were before.
It could be scarring from a previous pregnancy.
It could be that you’re with a different partner than before, and there are problems with their reproductive health.
It could be that you’re overwhelmed and exhausted from caring for a young child. Or that you’re still breastfeeding.
It could be that the earlier birth threw off your hormones.
It could be that you’ve gained weight. Or lost weight. Being over or underweight can cause ovulation problems in women, and possible impact sperm health in men.
It could be that you’re taking a new medication.
Or that you’re suffering from depression.
It could be a pelvic infection.
Or scar tissue from a past c-section.
Or you may never know. Doctors often can’t figure out exactly what it is. There’s a lot about fertility that we don’t understand.
Finding Support for Secondary Infertility
I wish I had found more resources for support when I was struggling with secondary infertility. I managed to make my way through it, but I created Circle+Bloom so that other people in that situation would have another place to turn to for help.
Other ways to connect with support while you are struggling with secondary infertility may be to:
Work with a doctor who supports you.
Unfortunately, when it comes to secondary infertility, some doctors don’t take patients’ concerns seriously. Find a reproductive endocrinologist you trust who is committed to helping you expand your family.
Find a support group that welcomes women with secondary infertility.
You may be hesitant to participate in an infertility support group if you already have a child. But there are plenty of support groups out there that will welcome you and support your needs. Try out some different groups – in person or online – and be upfront about your situation and your need for empathy and support to help you find one that’s the right fit.
Communicate with your partner.
It can be challenging to walk this path with aother person who has their own emotions, feelings, and expectations. You and your partner may not be on the same page about things like your stopping point, what to consider if IVF doesn’t work, or limiting how much to spend on treatments. You may want to consider meeting with a counsellor who can mediate discussions and help guide you to an agreed plan of action.
Although you can’t control when and if you get pregnant and have another child, you can control how you take care of yourself. Consider using relaxation techniques, such as yoga, meditation or acupuncture, and other positive self-care practices like journaling or talking to a close friend.
I get emails often from people who used Circle+ loom programs and went on to have a child. These success stories always reinforce why I continue to feel the importance of our guided meditation programs, and spreading the word of the power of our minds.
If you feel a success story might be inspiring for you, you can read about Sandra who was experiencing secondary infertility and went on to have another child after using Circle+Bloom.
To try one of our Circle+Bloom guided meditation programs and see how they will support and aid you during your fertility journey, find the program that best fits your needs – such as the Natural Fertility Program, the PCOS Fertility Program, or the IVF/IUI Program. We also offer a FREE Introduction Relaxation for Fertility program you can try as well.
If you are interested in purchasing a Circle+Bloom program, we want to offer all Mira customers a special 20% off discount. Please use coupon code Miracare20 when you check out for 20% off any Circle+Bloom program.
Wishing you peace and love on your journey