Some couples easily conceive their first child only to face secondary infertility. We follow one New Orleans mom through her experience.

When Mary Margaret Gorman first stopped using birth control, she had to wait only two months before becoming pregnant. She and her husband, Joe, were both in their late twenties and in good health. There were no complications with the pregnancy. She had every reason to assume that she was fertile and that having more children would be a smooth and relatively easy process.

It was when Mary Margaret began trying to give her daughter, Molly, a sibling that she realized a quick and easy experience of pregnancy was not guaranteed a second time.

“It just wasn’t working,” Mary Margaret recounts of the months during which she and Joe tried to become pregnant with a second child.

After six months of failed attempts, she sought the advice of her OB. The feedback she received, however, did little to quell her frustration or provide an explanation.

“She just said, ‘oh, I wouldn’t worry about it!’” Mary Margaret remembers. “‘You’re still young!’”

Her follicle-stimulating hormone (FSH) levels were tested to evaluate her egg supply. FSH levels in women rise when ovaries stop producing estrogen, and thus higher levels may indicate a woman is entering menopause.

Though her FSH levels were slightly elevated for her age, which was now 31, her OB simply told her to relax and keep trying.

“Of course every time someone tells you to relax, you just want to kill them!” she says, laughing. “People just sort of dismiss it, like it’s not a big deal,” she says more seriously. “But it really is a big deal. You’re in the zone [of having children]. You’re already entrenched in it.”

Mary Margaret, like most women in her situation, was anxious. She was an only child. Her parents, too, were only-children. Her family was small. She had always known she wanted more than one child.

After a year of trying, Mary Margaret switched from her OB to a fertility specialist and soon realized she was experiencing secondary infertility, infertility that occurs after a first child is born. The majority of women who experience secondary infertility are able to conceive a first child easily, without complications or the aid of hormones, but often find their second attempt much more difficult, sometimes impossible.

According to reproductive endocrinologist Ron Clisham. M.D., at The Fertility Institute, secondary infertility is most often a result of age.

“Second fertility occurs most often in people who delay fertility options,” he says. “They may have gotten pregnant early in their lives, and for whatever reason decided not to have a second child right away, or maybe they are in a second marriage. And then later on, they start trying again, and have a difficult time.”

Though age may be the most common contributor, Dr. Clisham says that there are several other possible explanations. He notes endometriosis—a disorder in which the tissue that normally lines the inside of the uterus grows outside the uterus, often on the ovaries—is a fairly common reason women experience secondary infertility.

Only 31, Mary Margaret was confident there was still more she could be doing to better her health and possibly help her chances. She wanted to be proactive.

“Being in control of your own health care is really important. You have a tendency to feel like all this is out of your control,” she said.

There were, in fact, many things Mary Margaret was able do that gave her a sense of autonomy and independence in her reproductive health. She started seeing an acupuncturist who specialized in fertility treatments, practiced yoga that focused on increasing fertility, took herbal supplements, and made dietary changes, becoming a vegetarian while she and her husband continued trying to conceive. These changes, she said, felt like they were helping. 

Mary Margaret stresses the importance of having someone in your life, especially a spouse or significant other, to talk to about the emotional and physical stress, and the unique feeling of loneliness that accompanies secondary infertility.

“I feel women with secondary infertility seem more alone than those with first time issues [because] you cannot talk to the people who are experiencing it for the first time because they look at you and say, ‘hey you already have a baby,’ and then your friends who are getting pregnant for the second and third times say stuff like, ‘oh you did it once and it will happen again.’ And those who don’t know what is going on in your life say stuff like, ‘it’s time for number two,’ or ‘Molly wants a little brother or sister.’ And then the worst was when Molly turned two, she told me she wanted a little sister. I felt so guilty that I could not give that to her.”

“Having a good relationship with my husband and being able to talk about it with him was very helpful,” she says. “I had a lot of friends whose husbands did not want to talk about it, and that can be very isolating.”

For Mary Margaret, the rough road through secondary infertility ended happily. After 18 months of failed attempts, she conceived her second daughter, Stella. For many women, the road is longer. Often, women must endure repeated miscarriages and extreme emotional highs and lows. Often, the process remains out of the parent’s, and doctor’s, control.

Dr. Clisham urges parents to keep an open mind when confronting fertility problems. If finances allow, in vitro fertilization (IVF) is an option that can have high success rates. And of course, there are many other options, such as surrogacy, and adoption, that will allow a couple to add to their family.

For Mary Margaret, the most important thing for parents battling secondary infertility is to remember they are not alone. She stresses that there is no shame in wanting more than one biological child, or seeking fertility treatments. Most importantly, she believes women should tailor their healthcare regimen to suit their individual needs—both physical and emotional.

“I tell people all the time that it is important to find a doctor that matches your personality and gives you hope.”