Secondary infertility is defined as the inability to become pregnant, or to carry a pregnancy to term, following the birth of one or more biological children. The birth of the first child did not involve any assisted reproductive technologies or fertility medications.
Too often, doctors and medical professionals downplay the possibility of secondary infertility and instruct patients to keep trying, follow menstrual cycle patterns, get ovulation kits and keep on without medical intervention. Feelings experienced by those trying to get pregnant include anger, grief, depression, isolation, guilt, jealousy, self-blame, and being out of control. You may feel jealous of friends who are able to have multiple children and depressed that you cannot provide a sibling for your child.
Many couples with secondary infertility report receiving less support from their family and friends than those who have primary infertility. Too often couples are told instead that they should be happy and grateful for their one healthy child and diminish the pain expressed by comparing them to childless couples. This can enhance the shame, guilt, and grief felt during a secondary infertility diagnosis. This can be further damaging when couples seek out infertility treatments and they miscarry or a live birth does not result.
Women and men undergoing in vitro fertilization and fertility treatments face emotional challenges especially when the treatments are unsuccessful. Clinical interventions can strengthen depressed and grieving women and men after unsuccessful fertility treatments resulting in miscarriages or no pregnancy. It is also important for medical and psychotherapists to consider diversity in the field of IVF. The role of culture and religion can play a profound role in infertility for couples (Wischmann, 2008). Future research is the area of diversity including same sex couples, diverse cultural groups, and different subsamples would be beneficial when looking at infertile men and women (Peloquin, Sabourin, & Wright, 2013).
The degree of distress in infertile heterosexual couples during and after unsuccessful in vitro fertilization and fertility treatments can be quite high. With approximately 80 million people worldwide affected by infertility, psychotherapy is needed to support infertile men and women (Domar, 2007).
With IVF and infertility failure rates being around seventy-five percent, mental health services are needed in the field of infertility (Lord & Robertson, 2005). Infertile couples often experience depression, anxiety and grief. (Chochovski, Moss & Simon, 2014). Infertility psychotherapy is an emerging field without a consistent mental health treatment plan (Gorayeb, Borsari, Rosa-e-Silva, & Ferriani, R. A. 2012). Anxiety and depression also play significant roles in heterosexual couples seeking fertility treatment both during and after unsuccessful treatments. Infertility may lead to a sleuth of other problems that can be helped in therapy (Hart, 2011).
Find a supportive mental health therapist or counselor to help you during this time. Infertility support groups can be especially helpful. Proven psychological tools and interventions can help you create coping strategies, regulate the nervous system and assist in building a strong foundation. Both individual and couple’s counseling can be incredibly helpful in preparing both physically and emotionally during family planning and fertility treatments. Ask your physician for a mental health referral or ask your community of friends and family. It is especially helpful to find a therapist who has experience with fertility counseling, grief and loss.
The author, Stacey Inal, is a CA state Licensed Marriage and Family Therapist and has a psychotherapy private practice specializing in family planning and fertility in the Los Angeles area.