by Patricia Sachs, LCSW-C

Shady Grove Fertility Counseling Staff

Secondary infertility affects those who already have one child, but are unable to conceive a second. You may have had little or no trouble conceiving a baby the first time around, and then suddenly you find that after months or even years of trying for a second, you are unable to do so.

No matter what your first story was, you may be feeling a sense of shame at your difficulty in having a second child, and a sense of failure at not having a sibling for the child you have, with the spacing between them that you desired.

Your situation can raise many new questions, and I’m here to tell you that these feelings are normal and quite common among the patients we see who are experiencing secondary infertility.

“Where do we fit in?”

Secondary infertility can leave you feeling like you’re straddling the worlds of fertile and infertile.

Similar to primary infertility, we see many patients with secondary infertility who attempt to isolate themselves from family and friends when it becomes too painful being around other people’s babies and pregnancies. However, once you have a child, you are clearly engaged in the “fertile world” and it becomes more difficult to do so. When you take your child to the playground or preschool it may mean encountering other mothers who are pregnant with their second child, newborn babies, and questions about when you will be having another.

You may feel vulnerable in these social situations and may dread having to address these issues. For some, having a script in your mind about how you will reply can help you to feel less out of control. A simple response like “maybe someday“ or “right now we are just focusing on him/her” could be a way to end the conversation politely (even though you may feel distressed at having to tolerate the intrusiveness).

It may be that friendships with those who have multiple children will grow more distant or you may feel the need to redefine boundaries while you are still struggling to complete your family—and that’s completely normal and understandable. Others may not understand your pain and how different you may feel from those who can have several children so easily, and “plan” the spacing between them.

But have hope that one day when you have moved on in whatever way you do, you may be able to rekindle some of these relationships, as your feelings will no longer be so raw. In the meantime, you may feel more comfortable befriending mothers of singletons, or inviting children to play with your child at your house so that you can avoid feeling “trapped” talking to a woman pregnant with her second at the playground. As always, finding a support group through Resolve, or your medical provider, especially one on secondary infertility, can provide a safe place to talk about your feelings.

“Aren’t you grateful for what you have?”

Those experiencing secondary infertility share common concerns.

This can be one of the most distressing questions someone may ask you. While of course you are thrilled and grateful for the child you have, it doesn’t take away from the very real feelings that may exist in longing for another. You may already be feeling guilty for spending time and energy away from the child you already have, in thinking about or undergoing treatment pursuing a second child. You may also be feeling a mix of excitement as your child reaches each new developmental stage but also sadness at the sense that you may only have one opportunity to experience that particular milestone.

Again, these feelings are completely normal, and it may be helpful for you to ready yourself with an answer that feels right to you in case this question comes up. We’ve heard some of our patients reply, “I am extremely grateful and I wouldn’t trade anything in the world for Johnny, though it doesn’t take away from the longing I feel for another.” Or to those who have multiple children, you might say “Of course, just like you, I’m grateful for the child I have, and just as you wanted more, I would love to have more too. I’d love to go through this wonderful experience again.”

“What if my spouse doesn’t want pursue treatment to have another child?”

Partners may differ in their feelings about treating secondary infertility.

It’s not uncommon for spouses to be in different places with regard to how intently to pursue having a second child. One of you may have more ambivalence, perhaps asking why you should “rock the boat” and take a risk when you already have one healthy child.

There may also be new concerns about being older parents, or about the spacing between the children: just when your child is old enough for a big family vacation, one spouse may not want to go back to the diapers and bottles stage. And if the children are too far apart in age, one spouse may question, would they really be playmates anyway? As older parents, you may also worry about your future health and your ability to be actively involved as your children reach important milestones.

If you ultimately build your family through adoption or egg donation, you may worry that your second child might not feel as fully connected to the family as your first, or that your feelings towards him or her may be unequal. Again, we have heard these same concerns expressed by other patients in similar situations. You are not alone. However, as mental health professionals, we know when patients return to show us how they have built their families, be it by their own eggs and sperm, by gamete donation, or by adoption, that they are uniformly thrilled and adore all of their children.

Infertility treatment (as well as adoption) can take a significant amount of effort and energy, let alone money. We encourage patients to have a conversation early on about the lengths you are willing to go, as a couple, in pursuit of the goal of adding a child to your family.

More questions to ask yourself:

As you contemplate the complicated emotions that surround secondary infertility, you might ask yourself:

Has your current child put any pressure on you to have a second child?

Children will often ask for a sibling just like they ask for a new toy, or because a friend just got one. Rest assured, we know that children can adjust to whatever type of family structure they have, as long as they sense that their parents are content with it as well.

Children will often ask for a sibling just like they ask for a new toy, or because a friend just got one. Rest assured, we know that children can adjust to whatever type of family structure they have, as long as they sense that their parents are content with it as well. Some patients have told us that they have feelings/biases about “only” children. Could this be you?

To you, does the word ”only” carry the connotation of “not enough?” If so, perhaps it’s time to challenge your own biases. As part of this, some patients have told us it’s been helpful to come up with examples of singletons who grew up to be fantastic leaders or tremendously talented artists. In fact, the research literature about singletons is quite positive. Many studies report that, among other things, they have good self-esteem, are self-reliant, and high-achieving. This makes sense because parents can devote more energy to them, and encourage their talents, abilities, etc. It may also mean, however, that parents may need to work harder to be sure their child has plenty of opportunities to interact with peers.

Ultimately, whatever you decide and whatever the outcome, it will be important to find closure and put boundaries around how you define your family. Meeting with a mental health professional with expertise in infertility counseling can be beneficial in giving you and your partner a space to talk about these issues. Whether you ultimately have one, two, or more children, give yourself credit for all your hard work in creating the special family that is yours alone, and enjoy.

If you think you may be experiencing secondary infertility, please schedule an appointment or call our New Patient Center 877-971-7755.



Patricia Sachs, LCSW-C is a clinical social worker on the staff of Shady Grove Fertility . If you are interested in counseling or in joining a secondary infertility support group, please contact her at 301-951-0206, or patricia.sachs@integramed.com.

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