The Unique Struggles of Secondary Infertility, and Why It May Be More Common Than You Think
Secondary infertility is something a couple never expects to be googling when trying to conceive after an easy prior conception and pregnancy. I certainly never thought that secondary infertility would happen to me, but it was and will always be a part of our family’s story.
In 2019, my daughter had just turned one and we started to try to conceive our second child. Since my daughter had been conceived easily and I had a relatively uneventful pregnancy with her, we fully expected that everything would happen just the same as it did before. Never did I imagine that the road to another pregnancy would take three years, months of failed fertility treatments, and four consecutive miscarriages, including one partial molar pregnancy requiring an extended time off from trying to conceive.
We were shocked and heartbroken as our story unfolded this way, but as tough journeys have a way of doing, it also completely transformed our lives for the better by allowing us to step back and examine what was and was not working in our lives.
How Common Is Secondary Infertility?
It’s estimated that about 50% of all cases of infertility are due to secondary infertility, but it rarely gets the attention that primary infertility does, even though it carries with it many unique challenges.
Secondary infertility is defined as the inability to conceive or carry a baby to term after previously conceiving and carrying a child in the past. Because it is so rarely talked about, it often shocks couples when having another baby is not as easy as before.
And of course, you already have another kiddo(s) running around — who brings you so much joy. But for many, secondary infertility is about experiencing immense joy and immense grief/pain at the same time. It's about coping with the broken dreams of what your family would look like and finding it hard to escape reminders of your struggles.
Triggers and Guilt
For couples experiencing secondary infertility, removing themselves from emotionally difficult situations can become next to impossible now that children are woven into their daily lives. Birthday parties, daycare drop off, and playtime at the park can be just another reminder that their family is not shaping up the way they expected it to. And finding time for the frequent appointments required in fertility evaluation and treatment can be like moving mountains now that the schedule revolves around childcare.
But the most difficult challenge of all may be the guilt that many parents feel when they spend time trying to conceive again: guilt due to time spent away from your current child at doctor’s appointments, guilt that your journey is taking up your energy and mental space, guilt that your current child will not have a sibling as close in age as you originally wanted, guilt for even wanting another in the first place.
Why Does Secondary Infertility Happen?
So all this begs the question — what changed? If it “worked” before, why or how could things be so different just a few years later? When we started trying for our second I had just turned 31, I was healthy, and nothing in my health history had changed. Well except, you know, creating another human being, breastfeeding her for a year, and completely readjusting life and my career to care for a child.
If you have been trying to conceive again for over a year — 6 months if you’re over 35 — getting a routine fertility evaluation for you and your partner can be a great way to pinpoint any specific diagnoses. Regardless of whether a healthy pregnancy was achieved relatively easily before, it can also be helpful to zoom out and take a look at the bigger picture of what has changed since your previous child and how your current life stage may be affecting your fertility.
While women’s bodies are beautifully designed to carry children, pregnancy is a major stress on the body. Nutrient and mineral demands increase by up to 50% during pregnancy and with each pregnancy, the female body loses about 10% of its mineral stores. Prenatal vitamins and other targeted supplements can help in meeting these needs but must be accompanied by a diet rich in nutrients and minerals. As a surprise to many, the postpartum period, especially for a mother who is breastfeeding, is even more nutritionally demanding than pregnancy itself. The body is working hard to repair tissue and rearrange organs that moved during pregnancy and birth, and to make nutritious breastmilk to support the development of a newborn.
Going through my third pregnancy loss due to a partial molar pregnancy and the 10-month waiting period that followed was one of the hardest times in my life, but it gifted me with space — the space to take a break from the hustle of fertility treatments and to examine what my body had been through the past few years. Yes, I had a healthy pregnancy, but I immediately went into breastfeeding and postpartum with little to no attention given to my own nutrient needs, while simultaneously experiencing immense stress from working as an attorney at a corporate law firm while caring for a toddler.
If you are struggling with secondary infertility, I encourage you to take inventory of how you’ve handled the stresses of new parenthood, whether you have been prioritizing your needs alongside those of your new baby, or if you have been burning the candle at both ends. Many women try to eat a nutritionally dense diet during pregnancy but often find themselves succumbing to the pressure of losing the baby weight quickly, struggling to find time to prepare food for themselves with a new baby in the picture, or surviving on coffee alone once the baby comes.
On top of this, many parents find themselves in a stressful period as they navigate changes to their work and home life to accommodate their new baby — perhaps getting even less sleep to get work done late at night. Stress — whether it be physical or emotional — can deplete the body of key nutrients and minerals that are important for a woman’s overall health and fertility, such as magnesium, B Vitamins, sodium, and potassium.
Nutrition for Optimal Fertility
While you’re taking care of your first child, it’s important not to neglect your own health. Here are a few nutritional habits that are easily overlooked, but are essential to have in place for optimal fertility.
Take a close (and honest!) look at how much you are eating and make sure you are eating enough — consider factors such as whether you are still breastfeeding, for how long you breastfed, whether you are still physically recovering from birth, your stress levels, and how physically active you are. Using a free app such as Cronometer for a few days can help you figure out what nutrients you may be missing out on and how much food you should actually be eating every day.
Focus on eating at regular intervals throughout the day, every three to four hours, to maintain healthy blood sugar levels required for egg development and optimal progesterone utilization and production. As tempting as it may be when your little one is up at 5:00 am, don’t live on coffee alone. To keep stress hormones at bay, start your day by eating a breakfast of protein and nutrient-dense carbohydrates such as fruit or root vegetables.
Focus on nutrient-dense animal proteins, including shellfish and dairy (if you do not have problems tolerating dairy). Protein paired with whole-food carbohydrates such as fruits and root vegetables can go a long way in restoring nutrients and minerals needed for healthy fertility.
Secondary infertility is a devastating shock to many couples, but it doesn’t mean that your body is now broken or that it has turned its back on you. For me, taking a hard look at what was and was not working in my life (which ultimately led me to a new passion and a career change!) and focusing on nourishing my body without reservation were what I needed to conceive again and carry a healthy pregnancy. Above all, make sure you are taking care of yourself and listening to your body during this time. And remember, you are not alone.
Kristin Santamaria is a Nutritional Therapy Practitioner who specializes in helping couples reclaim their fertility. She lives in the Dallas area with her husband and daughter (with another one the way!). Outside of the Texas summers, she loves spending her time outdoors with her family and friends. You can connect with her or schedule a consultation at KristinElleWellness.com.