Secondary Infertility: More Common than You Would Think
After making a baby the first month we tried, I thought infertility was something I would never have to worry about. My cycles had been irregular after I went off the birth control pill but after visiting my gynecologist I felt reassured that either my cycle would regulate or if it didn’t, she would help me get pregnant after 6 months instead of the standard one year. But I got pregnant right away so I stopped thinking about it. I had my son, breastfed him for a year, weaned, then 4 months later we were ready to try for another baby. But now it is 8 months later and still no baby. Here is what I have learned.
Secondary infertility accounts for 50% of all cases of infertility meaning your chances of infertility never reduces if you have previously gotten pregnant. This also means that 1 in 8 couples suffer from secondary infertility. There are many reasons for this, a common one being that as women age their fertility decreases so since you are older for each kid your chances of infertility increases. Another common cause is complications from prior pregnancies. Sometimes it could be retained tissue, or scars from a cesarean, or even stress and lack of sleep from caring for a child. There are so many reasons for any type of infertility but they seem to just increase after you have had a baby so it is no wonder secondary infertility is just as common as primary infertility.
So what can you do about it? You cannot be diagnosed with any form of infertility until at least 6 months of trying. But if you already have a kid I would recommend making an appointment with a reproductive endocrinologist (infertility doctor) at 6 months. I would not recommend going to an OB/GYN first because they might run tests, tell you to wait until one year, and then run tests again, refer you to an RE who would run tests again. Just go straight to the RE, the worst thing they can do is tell you to come back later. I would recommend tracking your cycles using ovulation strips. This can help with most couples struggling to conceive as it can tell you your best days to try. I would also recommend getting early detection pregnancy test. The early detection pregnancy test are great to tell you the second you get pregnant as they need less human chorionic gonadotropin (hcg, the hormone used to detect pregnancy) than regular tests. They can help all of us infertile women who obsess with tests see that second line the earliest we possibly could instead of having to wait until we miss our period. I would also recommend joining a group like the MomMed TTC Support Group to talk to others like you.
I weaned my son at 12.5 months. I wanted to give my body a few months to recover because I still had not had a period yet. 2 weeks later I got my first period but that first cycle ended up being 45 days. The next cycle I started watching my cervical mucus and other indicators of ovulation and once again my next 2 cycles were over 40 days. We started trying that 4th cycle after weaning and sadly that ended in an early loss. Since then we have not been able to conceive and have tried everything possible without medical intervention. After 6 months of trying we went to our first Reproductive Endocrinologist and he ran a whole host of tests. I was diagnosed with ovulation dysfunction but, thankfully, high ovarian reserve. At the time of writing I am at the beginning of my first cycle using letrozole to induce ovulation sooner than my body would naturally. My doctor recommended we go straight to IVF to reduce our chance of multiples but we opted for two medicated and unmonitored cycles before starting IVF because we hope it can save us money. I will use ovulation strips to figure out when exactly I am ovulating to make sure sperm meets egg at the right time. And then I will obsessively use early detection pregnancy test so I know as soon as possible if it worked.
Secondary infertility is super frustrating but also normal. If you are having trouble please seek out help. In many cases the solution is easy: adding vitamin D, looser underwear for your partner, or possibly even surgery to remove a cyst. But if the solution is not as easy as those you are on the road to your baby. And I encourage you to reach out to others whether it is a friend or a support group because you are not alone. And when you have questions it can be easier to ask a Facebook group than it is to google or reach out to your doctor with every little worry.