“Mommy, when am I going to be a big sister?” our four-year-old daughter asked out of the blue one random Saturday morning.
She didn’t know about the two failed embryo transfers earlier in the year. Or the litany of procedures I’d undergone to get my uterus into tip-top shape. Or the upcoming back-to-back egg retrievals we had scheduled due to my “advanced maternal age” and diminishing ovarian reserve.
“Well, we’re working on it,” I said in an effort to reassure her (and myself).
“Is it going to be a boy or a girl?” she asked.
“We don’t know yet,” I told her. “It’s going to be a surprise.”
“I think a girl,” she said confidently, before moving on to the far more pressing matter of convincing her dad to make French toast for breakfast.
A quintessential Libra, our daughter is very observant. She’s well aware of the fact that she’s one of the few kids in her class without a sibling. She notices the rounded bellies that float in and out of her school at drop-off and pick-up. I see them, too.
One morning, after one of the class moms mentioned she was due with another girl—their third—in the spring, I couldn’t help but cry in my car in the daycare parking lot. First came a wave of envy. Then grief. Then gratitude. All of this before my morning coffee.
When it isn’t easier the second time around
Our daughter was born via IVF in 2021 after multiple failed cycles. We knew we would likely need IVF to conceive a second child, but I naively thought it would be easier this time around. After all, my doctor had figured out a protocol that worked and my body had already successfully carried a baby to term once. Surely, it could do it again. But I was mistaken. We quickly found ourselves among the 11% of American couples that experience secondary infertility.
Secondary infertility refers to infertility after a prior live birth, explains Amanda Adeleye, MD, founder and medical director of CCRM in Chicago. “Acquired conditions like the development of uterine fibroids or polyps, hormonal conditions can make it more challenging to conceive as we age,” she says.
For people under 35 who’ve been trying for a year to conceive another child with no luck, Dr. Adeleye recommends seeing a reproductive endocrinologist and infertility specialist. If you’re between 35 and 39 years old, that time window shrinks to six months. Women who are 40 or older, or have a condition that might impact infertility, should consult an expert “right away.”
The trauma of trying again—and failing
With so much emphasis on timelines, tests, and treatment plans, it’s easy for the emotional toll of secondary infertility to take a backseat. But for me, the medical aspects didn’t impact me nearly as much as the loneliness. I didn’t know where I could safely share my experience with fear of judgment. In the infertility groups I’d found solace in many years ago, I felt guilty because I already had a child. In my mom group, everyone already had their families of four. I felt like an outlier—suspended between two worlds, belonging fully to neither.
“Secondary infertility kind of hurts the worst sometimes because you already have a child, so you feel like you know how this works,” says Marissa Nelson, a Washington, D.C.-based author and licensed therapist who has experienced it herself. “Now when you’re ready to expand your family, it’s not happening.”
I was mindful not to complain too much in the infertility group lest they (rightfully) retort, “Well, at least you already have one.” And they weren’t wrong. I’m so grateful for my daughter. However, I’d be lying if I said I didn’t envision us as a family of four. In a way, I felt greedy asking for another child when these women were struggling to have one. Why couldn’t I just be content with our one?
“Pause,” Nelson says. “You are allowed to have more. You’re allowed to want whatever it is that your heart desires.” She frames this tension not as being ungrateful, but as a question of worthiness and whether we believe we’re allowed to fully name our desires without shrinking or apologizing for them.
“Traditionally, Black women and people of color have been conditioned to want less and be grateful for what we get while others are allowed to dream as big as they’d like to dream and have everything their heart desires,” she continues. Nelson links this to worthiness and the discomfort many high-achieving women have with ease and receiving.
Those beliefs don’t just shape how we feel. They also shape the choices we make. Trying for a second child means returning to a cacophony of appointments, procedures and waiting. It looks like receiving a negative pregnancy test while on a work trip across the country and constantly asking ourselves whether we keep going.
“Having a child at home can increase the drive to be successful again,” Adeleye says, but it can also introduce practical hurdles, like figuring out who can handle daycare drop-off on mornings with monitoring appointments.
Infertility, in general, is traumatic and undergoing IVF again feels like reopening old wounds.
But secondary infertility has taught me that grief doesn’t disappear overnight, just because you’ve already experienced joy. It simply changes shape. It shows up quietly, in parking lots and waiting rooms, in the space between hope and acceptance.
It remains to be seen how this chapter will end and our daughter will become a big sister. What I do know, however, is that secondary infertility deserves to be named and not minimized, and that it cannot be erased by gratitude alone.
I can love the child I have while still wanting another and that doing so doesn’t make me a bad person. And in finally allowing myself to hold that grief without shame, without guilt or apology, I’ve learned that tending to myself—mind, body, and spirit—is not indulgent. It’s necessary. This grief may be quiet, but it still deserves to take up space.
Related:
- I Could Not Goop My Way Out of Infertility
- Even More Research Finds That Tylenol Use During Pregnancy Does Not Cause Autism
- I Got a ‘Mommy Makeover.’ Here’s What You Should Know Before Yours
Get more of SELF’s great fitness and nutrition reporting delivered right to your inbox (for free!).
