You’ve settled into a new family routine with baby number one in your life, and now you and your husband are thinking of adding to your brood to complete the family. It seems like an experience less daunting than it was the first time, because hey, you’ve got proof of your fertility right there in front of you. It’s just a matter of time, right?
For some families, this might be the case. Other couples try for a second baby for months or even years to no avail. If you find yourself falling into the latter category, you’re not alone in contending with that stubborn negative line on the pregnancy test kit.
Struggles In Conceiving Again
The term secondary infertility is used by doctors to describe the difficulty in conceiving a second time around. While previous studies have estimated that about one in seven couples are affected, doctors note that it is becoming more common, perhaps due in part to the fact that couples are having their first child when they’re older.
It’s a well-known fact that age impacts fertility negatively, and it isn’t any different when it comes to secondary infertility. In fact, a couple’s age is one of the main reasons for secondary infertility, with underlying medical issues being the other key reason. “Women are born with a fixed number of eggs. With increasing age, there is a fall in ovarian reserve – this is the number of functioning follicles or eggs left in the ovaries,” explains Dr Kelly Loi, an obstetrician & gynaecologist at Mount Elizabeth Hospital.
But don’t think that it’s solely mum’s fault. Dr Loi continues, “In men, quantity and quality of sperm may deteriorate with time, making it difficult for them to reach and fertilise an egg. This can occur as a result of poor diet or lifestyle habits such as diabetes and raised blood pressure.”
Besides the age factor, health problems can also lead to secondary infertility. It’s possible that you had an underlying health problem that did not affect your first pregnancy. Your first pregnancy might also have affected your subsequent attempts to get pregnant. A Caesarean may have caused uterine adhesions, while a womb infection or retained placenta could have caused scarring, which makes it harder to conceive.
Besides these reasons, it’s also worth considering if your lifestyle has radically changed since your first pregnancy. Weight gain can affect your ovulation, as can stress from your first pregnancy and having to look after kid number one. It could also come down to the plain simple reason that you’re having sex less — it’s never easy when you have a small one hovering around.
Managing Secondary Infertility
Before enlisting the help of the doctor, there are some ways to try and improve your chances of conceiving. First and foremost, you should be giving your body time to recover from your first pregnancy. Dr Christopher Chong, a urogynecologist and obstetrician & gynaecologist practicing at Gleneagles Hospital says, “My advice is for women to let their body rest for at least a year before trying to get pregnant again.” In fact, experts in the US recommend waiting for 18 months before trying for a second baby. This is not just for fertility, but also for the foetus’s health. A gap of less than 18 months between pregnancies is linked to an increased risk of premature babies, as well as babies who are born with low birth weight or being too small for their gestational age.
Once the 18-month window has passed, try to take some time to lay out a conception plan. There’s only a small window in which you have a chance of getting pregnant each cycle, so tracking your ovulation cycles and planning around those will help to increase the chances of successful conception.
To complement your planning, you should look at your lifestyle as a couple. Too little sleep, unhealthy weight gain, drinking too much caffeine or alcohol, and eating unhealthily are all things that can affect your fertility. Improving your diet and working proper sleep and exercise into your routine are all ways that you can increase your chances of conceiving.
During this period, it is important to deal with your emotions, as well as your partner’s. Being faced with secondary infertility can be stressful for both of you, so don’t avoid talking about the issue and your feelings. Don’t make yourself believe you have to feel guilty about your emotions just because you have one child, while others are still trying to get pregnant for the first time. Your feelings are valid and taking care of your mental state is just as important in your journey with secondary infertility.
Most experts recommend seeing a doctor if you’ve been trying to conceive for a year and are under the age of 35. For women who are over 35, you should consult a doctor after you’ve been trying for six months. These are not arbitrary numbers, and there is no harm in raising your concerns with a doctor earlier if you’re concerned. They might be able to give you tips on your conception plan or recommend if fertility tests should be conducted.
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Preparing To Get Pregnant Again
Before you start trying for another baby, it’s important to know if your body is ready for a second pregnancy. Research suggests the risk of babies being born early or with low birth weight was lower in babies conceived between 18 and 23 months after the birth of the first child. Most experts recommend waiting for a year at the minimum, and even two if you had a complicated birth.
Here are some other tips to prepare your body for a second pregnancy.
Let your hormones get back in order
Pregnancy hormones like oestrogen and progesterone will take some time to stabilise after birth. These hormones control ovulation, and the time they take to settle differs from person to person. Breastfeeding also affects these hormones, and it’s recommended that you wait two to three menstrual cycles after you’ve stopped breastfeeding before you try again. If you stopped breastfeeding exclusively early on, the recommended one-year gap still stands.
Eat healthily and get enough exercise
When you’re pregnant, your body prioritises giving the foetus the nutrients it needs to develop. The best way to restock your body’s store of these nutrients is to eat healthily. On top of eating well, exercising regularly once your doctor has given you the green light is important. Don’t just watch the numbers on the scale though. Make sure your body fat is at a healthy level; the most common way of measuring this is through your Body Mass Index (BMI).
Mind your health
Health conditions can result in complications in your pregnancy. If you have any pre-existing conditions, you’ll want to speak with your doctor who can advise you on ways to resolve or get your condition under control. As a bonus, giving your mental state time to recover from the fatigue of looking after a young child is a great idea as well. Being in a good place mentally will put you in a better position to deal with a second pregnancy and more late-night feeds.
This article was published in the Parents World Magazine, issue 72