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Secondary infertility: What you need to know, mama

An estimated three million women in the U.S. struggle with secondary infertility,

secondary-infertility

Secondary infertility comes with a unique set of challenges.

Women and couples who already have at least one child and are trying to get pregnant again often hear "don't worry, it will happen just like last time" from family, friends and sometimes even physicians.

Then, if they're having trouble getting pregnant, they'll hear: "You should feel blessed you have at least one," or "just keep trying, it'll happen."

Sound familiar? If so, then welcome to the world of secondary infertility.

While primary infertility (the inability to have a live birth after one year of conception attempts) is often the more focused on version infertility, secondary infertility has a significant impact and should not be ignored.

When you have one child but are having difficulty conceiving another, this is called secondary infertility—the inability to conceive after six months of attempts and no risk factors.

An estimated three million women in the U.S. struggle with secondary infertility, according to the National Center for Health Statistics.

Actor Anne Hathaway, who recently announced she is pregnant with her second child, said in an Associated Press interview that pregnancy has not come easily. Today Show host Dylan Dreyer has talked candidly about having secondary infertility—she also recently announced she is pregnant with her second child.

Causes of secondary infertility

Secondary infertility is usually due to changes since your prior conception. Reasons might include:

Advancing age

Usually, the age of the woman is most significant, but more evidence is accumulating on the impacts of the male partner or sperm donor's age. There is simply no escaping the male or female biological clock. With age, fertility declines and miscarriages increase (mostly due to chromosomal abnormalities of the aging egg).

Female or male significant weight gain

It's not uncommon for people to gain weight after a baby enters their lives, and weight gain can impact male and female fertility.

Pelvic or uterine scarring

If your first birth was a C-section, if you've had others forms of surgery, or perhaps experienced uterine scarring following D&C for miscarriage, you may be at a higher risk for secondary infertility.

When to see a specialist about secondary infertility

Since you already have a child, your doctor may delay in referring you to a fertility specialist because they presume you will readily conceive again.

However, when you feel there is a problem, we as fertility specialists need to address those concerns to reduce your stress, shatter myths, and direct you quickly toward evidence-based treatment.

With secondary infertility, you should see a fertility specialist if you are:

  • under the age of 35 and have been trying to conceive for six months to a year
  • age 35 to 39 and have been trying to conceive for three to six months
  • over the age of 39 and unable to conceive no longer than three months
  • sooner for all scenarios if you are without regular periods or if there are risk factors.

The evaluation for secondary infertility is the same as for primary infertility: blood work, a pelvic exam and an ultrasound will likely be the first steps. Reproductive specialists should not assume just because all was normal prior to the first baby that all will remain normal.

Secondary infertility treatment

As with primary infertility, if the woman has at least one open fallopian tube, is ovulating monthly, and the sperm (partner's or donor) is adequate, treatment begins with fertility medication combined with intrauterine insemination (IUI). If she does not ovulate, IUI may not be necessary. Following three to six unsuccessful cycles of IUI, IVF would be the next step.

Check out Motherly's guide to assisted reproductive technologies

Lifestyle changes can make a big difference. As I mentioned, weight gain is a common change that occurs after having a child. The problems resulting from an increased body mass index include reduced fertility and ovulation disturbances, as well as reduced sperm counts in men. Studies have also found that high BMI can increase the risk of miscarriage.

Tobacco use, either directly or second hand can reduce egg and sperm function.

Other factors of importance for the man and the woman are level of exercise and nutrition.

Check out Motherly's guides to these concerns here:

Staying positive and focused during secondary infertility

Women and couples experiencing secondary infertility feel the same disappointment, frustration and void as those struggling to have their first child. However, they often receive much less social support.

One of the most difficult aspects of infertility is acceptance. Whether the reason is known or unexplained, I find that many people struggle with accepting that they may need treatment. Unique to infertility, many consider treatment a personal failure rather than a possible road to success.

Add this feeling of inadequacy to the unintentionally hurtful and insensitive comments of others, and those struggling with secondary infertility can feel alone and lost. Whether dealing with primary or secondary infertility, the psychological impact can be significant. Therapy and support groups can make a big difference.

Please hear me when I say that infertility is in no way a failure. Your emotions here are completely valid. Many find comfort by knowing they aren't alone and that treatments continue to advance.

While it's hard to pinpoint statistics around success rates of secondary infertility treatment, many families do go on to grow their families. I highly encourage you to meet with a fertility specialist to discuss your specific scenario.

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After 4 kids, this is still the best baby gear item I’ve ever purchased

I wouldn't be swooning over the BABYBJÖRN bouncer after eight years and four kids if it didn't work.

I have four kids 8 and under, so you might expect that my house is teeming with baby gear and kid toys.

But it turns out that for me, the more kids I have, the more I simplify our stuff. At this point, I'm down to the absolute essentials, the gear that I can't live without and the toys my kids actually play with. And so when a mama-to-be asks me what things are worth registering for, there are only a few must-haves on my list.

The BABYBJÖRN bouncer seat is on the top of my list—totally worth it and an absolute must-have for any new mama.

In fact, since I first splurged on my first BABYBJÖRN bouncer eight years ago (it definitely felt like a splurge at the time, but the five star reviews were really compelling), the bouncer seat has become the most-used product in our house for baby's first year.

We've actually invested in a second one so that we didn't have to keep moving ours from the bedroom to the living room when we change locations.

BABYBJÖRN bouncer bliss

baby bjorn bouncer

The utility of the seat might seem counterintuitive—it has no mechanical parts, so your baby is instead gently bounced by her own movements. In a world where many baby products are touted for their ability to mechanically rock baby to sleep, I get that many moms might not find the "no-motion" bouncer that compelling. But it turns out that the seat is quite reactive to baby's little kicks, and it has helped my kids to learn how to self-soothe.

$200

Lightweight + compact:

The BABYBJÖRN bouncer is super lightweight, and it also folds flat in a second. Because of those features, we've frequently stored it under the couch, in a suitcase or in the back of the car. It folds completely flat, which I love.

Entertainment zone:

Is the toy bar worth it? The toy bar is totally worth it. Not only is the toy bar adorable, but it's one of the first toys that my babies actually play with once they discover the world beyond my boobs. The toys spin and are close to eye level so they have frequently kept my baby entertained while I cook or take a quick shower.

Great style:

This is not a small detail to me–the BABYBJÖRN bouncer is seriously stylish. I am done with baby gear and toys that make my house look like a theme park. The elegant European design honestly just looks good in my living room and I appreciate that parents can enjoy it as much as baby.

It's adjustable:

With three height settings that let you prop baby up to be entertained, or lay back to rest, we get years of use. And the bouncer can actually be adjusted for bigger kids and used from newborn to toddler age. It's that good.

It just works:

I wouldn't be swooning over the BABYBJÖRN bouncer after eight years and four kids if it didn't work. But I have used the seat as a safe space to put baby while I've worked (I once rocked my baby in it with my foot while I reported on a breaking news story for the Washington Post), and as a cozy spot for my second child to lay while his big brother played nearby. It's held up for almost a decade with almost-constant use.

So for me, looking back on what I thought was a splurge eight years ago, was actually one of the best investments in baby gear I ever made.

We independently select and share the products we love—and may receive a commission if you choose to buy. You've got this.

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Motherly editors’ 7 favorite hacks for organizing their diaper bags

Make frantically fishing around for a diaper a thing of the past!

As any parent knows, the term "diaper bag" only scratches the surface. In reality, this catchall holds so much more: a change of clothes, bottles, snacks, wipes and probably about a dozen more essential items.

Which makes finding the exact item you need, when you need it (read: A diaper when you're in public with a blowout on your hands) kind of tricky.

That's why organization is the name of the game when it comes to outings with your littles. We pooled the Motherly team of editors to learn some favorite hacks for organizing diaper bags. Here are our top tips.

1. Divide and conquer with small bags

Here's a tip we heard more than a few times: Use smaller storage bags to organize your stuff. Not only is this helpful for keeping related items together, but it can also help keep things from floating around in the expanse of the larger diaper bag. These bags don't have to be anything particularly fancy: an unused toiletry bag, pencil case or even plastic baggies will work.

2. Have an emergency changing kit

When you're dealing with a diaper blowout situation, it's not the time to go searching for a pack of wipes. Instead, assemble an emergency changing kit ahead of time by bundling a change of baby clothes, a fresh diaper, plenty of wipes and hand sanitizer in a bag you can quickly grab. We're partial to pop-top wipes that don't dry out or get dirty inside the diaper bag.

3. Simplify bottle prep

Organization isn't just being able to find what you need, but also having what you need. For formula-feeding on the go, keep an extra bottle with the formula you need measured out along with water to mix it up. You never know when your outing will take longer than expected—especially with a baby in the mix!

4. Get resealable snacks

When getting out with toddlers and older kids, snacks are the key to success. Still, it isn't fun to constantly dig crumbs out of the bottom of your diaper bag. Our editors love pouches with resealable caps and snacks that come in their own sealable containers. Travel-sized snacks like freeze-dried fruit crisps or meal-ready pouches can get an unfair reputation for being more expensive, but that isn't the case with the budget-friendly Comforts line.

5. Keep a carabiner on your keychain

You'll think a lot about what your child needs for an outing, but you can't forget this must-have: your keys. Add a carabiner to your keychain so you can hook them onto a loop inside your diaper bag. Trust us when we say it's a much better option than dumping out the bag's contents on your front step to find your house key!

6. Bundle your essentials

If your diaper bag doubles as your purse (and we bet it does) you're going to want easy access to your essentials, too. Dedicate a smaller storage bag of your diaper bag to items like your phone, wallet and lip balm. Then, when you're ready to transfer your items to a real purse, you don't have to look for them individually.

7. Keep wipes in an outer compartment

Baby wipes aren't just for diaper changes: They're also great for cleaning up messy faces, wiping off smudges, touching up your makeup and more. Since you'll be reaching for them time and time again, keep a container of sensitive baby wipes in an easily accessible outer compartment of your bag.

Another great tip? Shop the Comforts line on www.comfortsforbaby.com to find premium baby products for a fraction of competitors' prices. Or, follow @comfortsforbaby for more information!

This article was sponsored by The Kroger Co. Thank you for supporting the brands that supporting Motherly and mamas.

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It's science: Why your baby stops crying when you stand up

A fascinating study explains why.

When your baby is crying, it feels nearly instinctual to stand up to rock, sway and soothe them. That's because standing up to calm babies is instinctual—driven by centuries of positive feedback from calmed babies, researchers have found.

"Infants under 6 months of age carried by a walking mother immediately stopped voluntary movement and crying and exhibited a rapid heart rate decrease, compared with holding by a sitting mother," say authors of a 2013 study published in Current Biology.

Even more striking: This coordinated set of actions—the mother standing and the baby calming—is observed in other mammal species, too. Using pharmacologic and genetic interventions with mice, the authors say, "We identified strikingly similar responses in mouse pups as defined by immobility and diminished ultrasonic vocalizations and heart rate."

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