For most people, infertility conjures
up the image of a couple without a child. But what about
the couple who has borne a child, and now wants to extend
their family but find they are unable to do so?
Secondary infertility, is the inability to conceive
after one or more successful pregnancies. The medical
causes are similar to those of primary infertility,
and include sperm problems, tubal factors, endometriosis,
and ovulation difficulties. However, there are differences.
For one thing, the couple is older, which is why time
is at a premium!
Moreover, there are emotional aspects that are unique.
The couple experiencing secondary infertility often
finds it difficult to gain understanding or sympathy
from family, friends and relatives. Since they have
one child, most people assume that the couple will have
no problem having another. Even other infertile couples
offer little sympathy! Patients with primary infertility
often resent couples who have a baby, and believe their
own pain would disappear if only they too could bear
one child. A common remark is, "You have one child,
you should be grateful for that." These couples
are caught between two worlds, fertile and infertile
- and are excluded from both!
Guilt and frustration are common emotional responses.
The frustration is borne out of surprise because the
couple didn't think it would be difficult to conceive
a second time (unless they had difficulty in getting
pregnant the first time as well). However, just because
they have got pregnant once doesn't make them immune
to all the illnesses which can cause infertility - and
tubes can get blocked and sperm counts drop as time
goes by!
Secondarily infertile couples who had an elective abortion
done for the first pregnancy and cannot conceive a second
time around have a very hard time coping with their
feelings of guilt. They often feel they are being punished
for their sin of rejecting the child when they had it.
Couples with a child at home may also feel guilty.
This arises because they catch themselves feeling that
their one child isn't good enough for them; and also
for their inability to provide their child with a sibling.
The child of a secondarily infertile couple may also
bring unwitting pressure on his parents by asking when
he 'll have a baby brother or sister. This is especially
difficult when the child is being asked by his friends
why he doesn't have a baby brother or sister and then
begs his parents for a baby.
Parents may become very overprotective, fearing that
something may happen to the one child they do have.
They may also push pin all their hopes on their one
child, and may push him to be a high achiever.
Many couples with secondary subfertility choose never
to take medical treatment; often, this is because they
are unsure about whether they do have a problem - and
they keep on trying, hoping to hit the jackpot once
again (after all, if they could do it once, why can't
they do it again?)
What are the chances of a couple with secondary subfertility
conceiving with medical treatment? While this would
depend on the individual's problem, their chances are
really about the same as a couple with primary subfertility.
While they have the benefit of having "proven"
their fertility once, they usually have the handicap
of an increased age against them.
If the couple chooses to seek medical intervention,
they also must decide what to tell their child about
medical procedures. The presence of a child at home
can make coping with the demands of infertility treatment
much more difficult!
The financial burden of taking treatment can also add
to the emotional burden of the couple and they may wonder
if they shouldn't be spending the money on the child
they already have rather than pursuing the hope of expanding
their family.
Adoption can be a choice for some of these couples
- but it's often more complicated because they worry
about the possibility of "favoritism" ; and
may also feel that it is unfair to their biological
child to bring an adopted child into the family.
Coming to terms with secondary infertility is no easier
than coming to terms with primary infertility - and
it's important that the family of the secondarily infertile
couple share their feelings together and maintain a
positive attitude.
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