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Secondary Infertility and Miscarriages – Why Doesn’t Anyone Talk About It?

Karen*, 40, could get pregnant, but she couldn’t stay pregnant. After five miscarriages, she and her husband decided they couldn’t take it any more. So about nine months ago, they simply stopped trying.

Karen is relieved to be out of that emotionally and physically draining limbo, but part of her continues to grieve. “We’ll always wonder what it would have been like to have the family we intended,” says Karen, a lawyer who lives near Washington, D.C. “The pregnancy that lasted the longest had a due date in June, and I’m guessing I’ll always think of that in June.”

Karen went through the classic trauma of infertility – seesawing from hope to despair, wanting to run screaming from all pregnant women – but with one twist: She already has a five-year-old biological daughter.

Karen suffers from “secondary infertility,” defined by RESOLVE, the national infertility association, as the inability to become pregnant or to carry a pregnancy to term following the birth (without assisted reproductive medications or technologies) of one or more biological children.

“Inability” is generally measured as no success after one year of trying if you’re under 35 or six months of trying if you’re over 35, and can be caused by reductions in fertility due to age or to such things as thyroid problems, an STI, tubal blockage, or ovarian cysts. Or, more troublingly, the causes can go unexplained.

According to estimates by RESOLVE, over three million Americans are affected by secondary infertility. While they outnumber those who experience primary infertility, they are less likely to seek medical or psychological help.

“Secondary infertility is very common, but often invisible,” says Barbara Collura, RESOLVE’s executive director, in part because of the common response: “You already have a kid – what are you complaining about?”

That’s the problem, say those who’ve gone through it: They know what they’re missing and, by the very same token, don’t feel entitled to complain.

“I felt self-conscious around people who were struggling to have their first,” says Gayle Greene, 40, a stay-at-home-mother in Vienna, VA, who finally conceived her second child through IVF (and then conceived again without intervention – go figure.)

Karen agrees: “I definitely felt like, ‘What right do I have to be sad?’ I know people who were not able to have children at all.”

Experts say this could-be-worse comparison weighs one down with an added layer of guilt. “Secondary infertility patients feel like they don’t belong in the world of the fertile and they don’t belong in the world of the infertile,” says Elaine R. Gordon, Ph.D., a clinical psychologist in Santa Monica, CA, who specializes in reproductive issues. “When they need support, they feel like they have no place to go.”

Kelcey Kintner of the The Mama Bird Diaries blog is a mother of two who is now, after much difficulty, pregnant with twins. She recalls the time a nurse at her OB/GYN’s office said, “You should be grateful you have two. There are many women who come through here who may never have one.” Kintner was speechless: “I was like, ‘Do you think I lack gratitude for my girls?’ Why can’t both feelings co-exist?”

But there’s another side of the coin as well: Backlash against parents who seem content only having one child. For everyone who says “Why aren’t you grateful for what you have?” there’s someone else who says, “Why aren’t you having another?” One can imagine how hurtful and frustrating this would be for parents attempting, but failing, to give their child siblings.

Karen experienced both kinds of criticism, both for being frustrated at not being able to have a second child and for seeming, when she didn’t lament, like she wasn’t trying. “I feel like other people look at our family and think it’s not ‘finished,’” Karen says. “There’s a perception that a family with one child is not enough.”

But now, since officially “giving up,” Karen has turned the would-be-nursery into a playroom for her daughter and is starting to say, at least to herself, “We are a family of three. This is our family.”

Amid all the criticisms, people tend not to realize just how blindsided parents with secondary infertility tend to feel. “The experience of having been ‘successful’ before can make subsequent ‘failure’ more frustrating and painful,” says Deanna Pledge, Ph.D., a psychologist in Columbia, MO, who specializes in women’s sexual health and family issues. “Women say, ‘I’ve already done it once, so what happened? What’s wrong with me?’”

One final element makes being a parent with secondary infertility different from, and in some ways harder than, people struggling to have a first child: The fact that it’s even harder to escape the reminders of what you don’t have. Those yearning for No. 1 can skip baby showers, but parents with kids can’t skip pre-school pickup or play dates. (Some say that seeing siblings playing happily together has a particularly sharp sting.)

The pressure can even come from within the family itself, making it that much more painful. As one online commenter wrote at AskMoxie.org: “This second time around, I have my son around reminding me that he doesn’t have a sibling.”

*Name has been changed

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