We’ve all been there: gathered around a family dinner, catching up with old friends, or mingling at a party, when someone inevitably turns to the woman with one child and asks, “So, when are you having another? Do you want more?” These seemingly harmless questions are often meant to show interest or spark conversation. However, for many women, these words can stir up deep emotions and unspoken pain.

The Unseen Struggle of Secondary Infertility

Secondary infertility, defined as the inability to become pregnant or carry a pregnancy to term after previously giving birth, affects millions of women globally. According to the CDC, around 11% of couples experience secondary infertility. Despite its prevalence, it is often misunderstood because of the assumption that if you’ve had one child, conceiving again should be easy.

In reality, struggles to conceive a second child are common—about 50% of infertility cases are secondary infertility. Society’s expectation that women can easily have more children ignores the complexities and deeply personal challenges many face.

When we ask women if they want more children, we assume they can conceive again without difficulty, that they want to, and that they aren’t dealing with other struggles. These assumptions can be inaccurate and harmful, especially for women experiencing secondary infertility, as they serve as reminders of what they long for but can’t achieve, triggering feelings of frustration, shame, and inadequacy.

Common Causes of Secondary Infertility

Secondary infertility can result from both female and male factors, often involving a complex combination of issues.

The Breakdown:

• Female Partner: About 33% of infertility cases are due to issues with the woman.
• Male Partner: Another 33% of cases are linked to the man.
• Both Partners: The remaining 33% arise from a combination of issues in both partners.

Women and Secondary Infertility

1. 1Egg Quality or Quantity: Women are born with a finite number of eggs, and both egg quality and quantity decline with age. A woman may struggle to conceive a second child simply because she is older, as fertility significantly drops after age 35.
2. Fallopian Tube Issues: Damage or blockages in the fallopian tubes—often caused by infections, surgeries, or endometriosis—can prevent eggs from reaching the uterus.
3. Uterine Problems: Scarring from a C-section or the presence of fibroids can interfere with embryo implantation and successful pregnancy.
4. Endometriosis: This condition can affect the ovaries and other reproductive organs, making conception difficult.
5. Polycystic Ovary Syndrome (PCOS): PCOS causes irregular cycles and hormonal imbalances, potentially preventing ovulation.
6. Lifestyle Factors: Increased BMI, depletion, or certain medications can disrupt ovarian function and reduce fertility.
   
   

Men and Secondary Infertility

1. Sperm Issues: Male infertility is often due to low sperm count or poor sperm quality, which may be caused by low testosterone levels, blocked ducts, or certain medications.
2. Sperm Abnormalities: Abnormal sperm shape or motility can make it difficult for sperm to fertilize an egg.
3. Azoospermia: This condition occurs when no viable sperm are present, often due to genetic issues, hormonal imbalances, or blockages.
4. Varicocele: A varicose vein in the scrotum that raises the temperature of the testes, potentially disrupting sperm production.
5. Anti-Sperm Antibodies: Both men and women can develop antibodies that attack sperm, making conception difficult.

Breaking the Silence Around Secondary Infertility

Secondary infertility is often left out of mainstream conversations. While primary infertility has gained more awareness, those experiencing secondary infertility frequently suffer in silence. The pressure from society to have more children—paired with the stigma of “only children”—adds to the emotional burden many women carry.

So, how can we shift this narrative? It starts with empathy and mindfulness. Before asking someone about their family planning, consider how your question might affect them. Instead of asking, “When are you having another?” try a more inclusive approach like, “Tell me about your family!” This opens space for someone to share as much or as little as they feel comfortable with, without the pressure of expectations.

Fostering a Supportive Environment

Educating ourselves and others about secondary infertility is crucial to creating a supportive and compassionate society. Celebrities like Courteney Cox and Brooke Shields have helped pave the way by openly discussing their struggles with secondary infertility, bringing visibility to the issue. Support groups, both online and in person, such as those from organizations like REVOLVE, provide valuable resources and emotional support for those navigating this journey.

The Bottom Line

In our quest to connect with others, let’s be mindful of the questions we ask and the potential impact they carry. By normalizing conversations around secondary infertility and approaching family planning topics with sensitivity and respect, we can create a more compassionate society.

Every woman’s journey to and through motherhood is unique. Let’s honor that journey by listening with empathy, offering support, and reframing how we ask about family plans. Sometimes, the best way to show we care is by simply being there.