The overwhelming feelings of excitement, warmth, and tenderness that you experience with your first child are incomparable to any other feeling in this world. The intense love that a mother feels for her child is unlike any other love. Getting to hold your baby girl or baby boy for the first time is emotional in the best way possible. For many couples, having another child can feel just as exciting as the first. The possibility of further spreading your love with another tiny human that is half you and half your partner is an incredible feeling.
For some parents, secondary fertility occurs, which can cause emotional turmoil. Secondary fertility is just as common as primary fertility—impacting roughly 11 percent of couples each year. To have your life be filled with so much love and light from your first child to then struggle to conceive a second child can be heartbreaking and devastating.
As a couple, it may feel like you’ve tried everything. You might’ve switched up your diet, tracked your cycle, avoided alcohol, taken your prenatal vitamins, and even undergone IVF treatments. To continually put so much effort into something that you and your partner desire so deeply can surely leave you feeling hopeless and isolated. Watching new mothers and fathers on social media certainly doesn’t help in this situation and can even further put you into an emotional spiral. Although secondary fertility is challenging mentally, physically, and emotionally, there are ways to cope with it in a healthy way.
In this article, I will discuss what primary and secondary infertility are, some signs of secondary infertility, and techniques for coping with it.
What is Secondary Infertility?
To begin, let’s quickly differentiate between primary and secondary infertility. Infertility itself is defined by the “failure to establish a clinical pregnancy after 12 months of regular and unprotected sexual intercourse.” Infertility impacts 8-12 percent of relationships worldwide, according to the World Health Organization.
With this, there is primary and secondary infertility—both of which deal with infertility, just in different situations. Primary fertility occurs whenever someone has never been pregnant before and is trying to conceive for 12 months or longer. Secondary infertility occurs whenever an individual struggles to conceive another child after having one successful pregnancy. Medically, secondary infertility is typically diagnosed after a couple has been trying to conceive for six months to a year.
Aside from the inability to conceive, other signs may point to secondary infertility. According to the Cleveland Clinic, some of the signs and symptoms include:
- Age
- Medications
- Medical Conditions
- An increase in BMI
- Previous complications with pregnancy
- Impaired eggs or sperm
- Sexually transmitted infections
Conditions such as endometriosis, PCOS, pelvic inflammatory disease, and autoimmune conditions may also make it more complicated to conceive the second time around. Research has found that secondary infertility in females is most often due to reproductive tract infections.
Emotional and Mental Impact of Secondary Infertility
Now that we’ve laid a foundation as to what secondary infertility is and reasons why it may occur, let’s now talk about the emotional side of infertility and the additional challenges it brings.
Infertility can evoke stressful feelings in many women. The stress of infertility may seep into relationships, work, daily activities, finances, etc. Many research studies have aimed to discover the relationship between mental health disorders and infertility. According to a study published in the Iranian Journal of Reproductive Medicine, looking at the emotional and physiological consequences of infertility in women, various psychological disorders and emotions may develop including:
- Anxiety
- Depression
- Feelings of hopelessness
- Guilty
- Frustration
- Turmoil
According to research published in the journal Fertility Research and Practice, as many as 21-52 percent of women struggling with infertility struggle with depression. Mental health concerns continue to rise among infertile women; however, these physiological consequences are often overlooked.
For some women, the emotional impact of secondary infertility does not go unnoticed and certainly interferes with day-to-day responsibilities. Finding ways to cope with and manage these mental complications and emotions can help tremendously.
Managing and Coping with Secondary Infertility
A recent paper published in the journal Nursing Open, looked at the factors that help the coping of infertile women and found that outward orientation, a positive attitude towards life, a fighting attitude, accepting negative emotions, and having emotional control were all viewed as good abilities to deal with infertility. Let’s discuss different ways to cope with the emotional toll that secondary infertility brings.
Let’s discuss different ways to cope with the emotional toll that secondary infertility brings.
Make an appointment with a reproductive endocrinologist
Although infertility treatments may not be the very first action you take, it is certainly an option that has helped countless couples find hope and successfully conceive. One in every 8 women ages 15 to 49 seek infertility services, according to a study published in JAMA.
Although there are various fertility treatment options to choose from and success rates vary, effective therapy can assist in meeting fertility goals and many successes have been seen in couples who seek treatment. Treatment options include ovulation induction and ovarian stimulation.
Ovulation induction uses pharmacological treatment to induce ovulation. On the other hand, ovarian stimulation is done to induce multiple mature ovarian follicles. Intrauterine insemination and IVF may be used; however, these treatments can be costly.
Lean on your support system
As with any difficult time period in life, having a good support system can make all the difference. Confiding in your spouse, family, or friends during this time can assist in supporting you mentally, emotionally, and physically. In particular, support groups may be beneficial as they tend to fill the gaps of support that you may need when managing the emotions that secondary infertility brings. Joining groups of women who are going through a similar situation can help you feel supported and find relief in knowing you are not alone in your experiences.
Communicate with your partner
When enduring the stress of infertility, tension and negative emotions may arise between you and your partner. It is important to find time to communicate your feelings and emotions with your partner to ensure you both understand each other’s feelings and emotions.
Secondary infertility can be challenging for both partners in the relationship, so making it a priority to share those emotions can strengthen your relationship and prevent any miscommunication.
Focus on bonding with your child
Although you may have dreams of expanding your family, it is important to not forget to spend time with your child. Once you and your partner are able to conceive another child, your little one won’t be the only child anymore and another sibling may enter the mix. With this in mind, it is important to soak up all the time you can with your child and make them feel the intense love and care that you have for them.
Planning a family date or outing can be a great way to enjoy these little moments in life before your family does eventually expand.
Engage in self-care activities
Coping with any type of intense emotions or mental illness can be challenging and stressful. Engaging in healthy activities can assist in managing the emotional feelings of depression, anxiety, stress, and hopelessness that you may encounter. Examples of healthy activities that may assist in managing your mental health and emotions include:
- Physical activity
- Practice gratitude
- Engage in healthy eating behaviors
- Adequate sleep at night
- Engage in quality time with friends and family
- Practice mindfulness/meditation
- Engage in relaxation techniques
- Breathing techniques
- Spend time in nature
Don’t neglect nutrition
When thinking about fertility, nutrition is often overlooked. Research shows that dietary factors can impact fertility. In fact, research shows that a diet high in trans fats, refined carbohydrates, and added sugars can negatively impact the ability to conceive.
On the flip side, research has found that a diet that is rich in omega 3 fatty acids, dietary fiber, plant-based protein sources, vitamins, and minerals positively impacts fertility status in females. Although nutrition is not black and white and various factors play into achieving an optimal nutrition status to promote fertility, new research points to the fact that nutrition does play a role in fertility and should not be overlooked.
Further research is needed to determine a standard approach to nutrition recommendations for fertility; however, avoiding excessive amounts of added sugars, trans fatty acids, saturated fats, animal protein/processed meats, alcohol, caffeine, and high fat dairy may be beneficial in promoting fertility.
Research also shows that consuming plant-based protein options, adequate iodine, and adequate folic acid can positively impact fertility. It is important to note that before incorporating any supplementation in your diet, you should always speak with your doctor. Working with a registered dietitian nutritionist can be impactful in your journey to achieving an enhanced nutrition status and increasing your fertility.
Navigating Comments from Others
After the news of your first child settles down, there’s a good chance you may get questions and comments from friends and family asking, “So, when are you having the next one?” Although friends and family may mean well, this can certainly add additional stress and negative emotions to an already stressful situation.
These situations can become challenging to navigate. One way to respond to this scenario would be to clearly say, “I am not in a place to discuss that topic right now; I hope you understand.” Although responding in this way may be easier said than done, it will allow you to effectively communicate with your loved ones to back off a little until you’re ready to discuss the topic.
It can also be helpful to switch the topic in these moments to something that does not have to do with pregnancy, fertility, or children. It is important to remember that you do not owe anyone answers or explanations regarding future pregnancies or your desire to become pregnant. Don’t be afraid to stand up for yourself in these situations—you deserve respect and privacy.
Secondary infertility results in a complex variety of emotions and feelings. Although it can be easy to fall into feelings of anxiety, depression, hopelessness, and guilt, learning to manage and cope with the emotions that arise can positively impact your mental state.
Adapted from Dr. Avena’s book, What to Eat When You Want to Get Pregnant, which is a great resource for understanding how nutrition can support (or harm) your fertility (for both women and men).
Author
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Dr. Nicole Avena is a research neuroscientist, author and expert in the fields of nutrition, diet and addiction. She received a Ph.D. in Neuroscience and Psychology from Princeton University, followed by a postdoctoral fellowship in molecular biology at The Rockefeller University in New York City. She is the author of <a href=https://amzn.to/4ahflEd new_target+What to Eat When You Want to Get Pregnant
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