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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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Chrissy Teigen is one of the most famous moms in the world and definitely one of the most famous moms on social media.

She's the Queen of Twitter and at least the Duchess of Instagram but with a massive following comes a massive dose of mom-shame, and Teigen admits the online comments criticizing her parenting affects her.

"It's pretty much everything," Teigen told Today, noting that the bulk of the criticism falls into three categories: How she feeds her kids, how she uses her car seats and screen time.

"Any time I post a picture of them holding ribs or eating sausage, I get a lot of criticism," she explained. "Vegans and vegetarians are mad and feel that we're forcing meat upon them at a young age. They freak out."


Teigen continues: "If they get a glimpse of the car seat there is a lot of buckle talk. Maybe for one half of a second, the strap slipped down. And TV is another big one. We have TV on a lot in my house. John and I work on television; we love watching television."

Teigen wants the shame to stop, not just for herself but for all the other moms who feel it. (And we agree.)

"Hearing that nine out of 10 moms don't feel like they're doing a good enough job is terrible," she said. "We're all so worried that we're not doing all that we can, when we really are."

The inspiration for Teigen talking publicly about mom-shame may be in part because of her participation in Pampers' "Share the Love" campaign. But even though Teigen's discussion coincides with this campaign, the message remains equally important. Advertising can be a powerful tool for shifting the way society thinks about what's "normal" and we would much rather see companies speaking out against mom-shame than inducing it to sell more stuff.

Calling out mom-shame in our culture is worth doing in our lives, our communities and yes, our diaper commercials. Thank you Chrissy (and thank you, Pampers).


Dear fellow mama,

I was thinking about the past the other day. About the time I had three small boys—a newborn, his 2-year-old brother and his 5-year-old brother.

How I was always drowning.

How I could never catch my breath between the constant requests.

How I always felt guilty no matter how hard I tried.

How hard it was—the constant exhaustion, struggling to keep my home any kind of clean or tidy, how I struggled to feed my kids nutritious meals, to bathe them and clean them and keep them warmly dressed in clean clothing, to love them well or enough or well enough.


Those years were some of the toughest years I have ever encountered.

But mama, I am here to tell you that it doesn't last forever. Slowly, incrementally, without you even noticing, it gets easier. First, one child is toilet trained, then the bigger one can tie his own shoelaces, then finally they are all sleeping through the night.

It's hard to imagine; I really really get it.

It is going to get easier. I swear it. I'm not saying that there won't be new parenting challenges, that it won't be the hardest thing you have ever done in your life. It will be. But it will get easier.

These days, all of my kids get the bus to school and back. Most of them dress themselves. They can all eat independently and use the toilet. Sometimes they play with each other for hours leaving me time to do whatever I need to do that day.

I sleep through the night. I am not constantly in a haze of exhaustion. I am not overwhelmed by three tiny little people needing me to help them with their basic needs, all at the same time.

I can drink a hot cup of coffee. I do not wish with every fiber of my being that I was an octopus, able to help each tiny person at the same time.

I am not tugged in opposite directions. I don't have to disappoint my 3-year-old who desperately wants to play with me while I am helping his first grade bother with his first grade reading homework.

And one day, you will be here too.

It's going to get easier. I promise. And while it may not happen today or even next week or even next month, it will happen. And you will look around in wonder at the magnificent people you helped to create and nurture and sustain.

Until then, you are stronger and more resilient than you can even imagine.

You've got this. Today and always.


A fellow mama


I am broken.

It has happened again and I am breaking even more. Soon, the pieces will be too small to put back together.

The negative pregnancy test sits on my bathroom sink like a smug ex-lover. I am left pleading, How could you do this to me again? I thought it would be different this time. I had hope.

We are still trying. It has been 11 months and 13 days and there has been no progress. No forward momentum. No double solid lines. The emptiness of the space where the line should be mocks me.

I am broken.


No amount of planning and scheming and effort is enough. I am not enough because I cannot make a chemical reaction happen at the exact moment it needs to happen. I cannot do what I want but oh how I wish I could.

It almost happened once. Two months ago, I felt different. Sore breasts and aware of the world like never before. I felt not empty. The blankness had been replaced by someone. I was sure of it. And I was late. Six days late and I thought this is it.

I didn't rush to test because I didn't want to jinx it. Or perhaps I just didn't want to let go of that string of hope. Without evidence that you're not actually here, I can pretend that you are.

So I waited. And I Googled early pregnancy symptoms and I kept an eye out for red spots I hoped I would never see. I finally couldn't wait any longer and decided the next morning would be the test.

But when I woke up, I knew it was just me. The feeling I had been feeling was gone and I knew, just knew, what I would find.

This test had words instead of lines. 'Not pregnant' it blared loudly, obnoxiously, insensitively.

I am broken.

It was four in the morning and I stood in my tiny bathroom apartment silently sobbing. Alone.

Perhaps you were there for a brief moment, but then you were gone.

I stared again at the stick.

Not pregnant.

Not pregnant.

Not pregnant.

It was taunting me now.

I wrapped it in a paper towel. Walked down three flights of stairs to the front of my building and threw it in the garbage can outside.

Later, when my husband woke, I told him I was wrong. There was nothing there after all.

And I mourned. All day long, I mourned. While I walked to work. While I said hello to my co-workers. While I answered questions and pretended to smile and tried not to think of the broken body I was living in.

The next day the blood arrived. Furious. Both of us infuriated it was there once again.

Can I keep doing this?

Am I broken?

Will I get to the point where I just… stop? Stop hoping. Stop praying. Stop wishing. Stop. Trying.

Am I broken? Or can I keep going?


One of my biggest jobs as a mama is to create a foundation for my kids to become trailblazers and problem-solvers. It's not an easy task. I'm constantly wondering what type of person they'll become and how I can ensure they'll be awesome citizens of the world. For me, part of raising and encouraging future leaders starts with exposure—the more I introduce them to notable leaders in history, the better they can envision their own future.

This is why I love when brands create inspirational clothing and accessories for kids. And this month, Piccolina, a lifestyle brand for littles, added an exclusive Black History Month capsule collection to their trailblazer tees series and they are too cute for words.

The Black History Month line honors heroic leaders like Harriet Tubman, Maya Angelou, Katherine Johnson and Rosa Parks on colorful tees. It even features illustrations by emerging artists of color like Monica Ahanonu, Erin Robinson and Joelle Avelino who are, in my opinion, just as important.

In addition to the tops, the collection features art prints that coincide with the shirts, making this a perfect addition to any kids room—and even mama's office. Perhaps even more exciting are the price points: The limited-edition tees retail for $28 and framed art prints are $60.

Maya Angelou trailblazer tee

Maya Angelou trailblazer tee

This cotton tee features a portrait of the award-winning author, poet and civil rights activist and is the perfect way for your little one to celebrate her inner storyteller. A portion of the shirts proceeds benefit non-profit organizations that support girls' education and empowerment, such as the Malala Fund and Step Up.


While I'm not sure what type of person my little ones will become, I'm certain that introducing them to leaders will help them have greater self-confidence and reinforce that they are competent and resilient, too. And what mama can't get behind that? Now the hardest part is deciding which ones to purchase.

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