We need to talk about secondary infertility

With reproductive medicine under political attack, this long-overdue conversation is more necessary than ever.

- Christen A Johnson

Danielle always thought she’d have her ideal number of kids—three, to be exact—by the time she turned 35. But as it does, life happened, and she and her husband didn’t welcome their first child until Danielle was 36. That was more than two years ago.

For the past eight months, the couple has been actively working on having a second baby. Danielle had an ectopic pregnancy (when a fertilised egg implants anywhere other than the uterus, often in a fallopian tube) last October. “That, and the fact that we’ve been trying for more than six months, means our doctors are now advising IVF,” she says. She always knew that getting older could affect her chances, but still: They’d conceived their first baby naturally; this felt like a surprise.

“People assume that since they’ve been pregnant before, it’s going to be easy again,” says reproductive endocrinologist Amanda Adeleye, MD, founding partner and medical director of CCRM Fertility Chicago. “That’s not necessarily the case. Secondary infertility can happen to anyone.” And it does.

While almost all of us are aware of infertility as a concept (it may impact up to 15 per cent of couples, according to the National Institutes of Health), many have never even heard the phrase ‘secondary infertility’—even though it affects some 11 per cent of hetero partners trying for more kids.

WHAT IS THIS REALLY ABOUT?

The simplest way to think of secondary infertility is as an umbrella term. Rather than a hard-and-fast diagnosis, it’s more of a category for a collection of separate (but sometimes linked) causes that prevent someone from conceiving (after trying for six months to a year) or carrying a pregnancy to term after already having given birth at least once without fertility treatments.