10/29/2014 01:19 EDT | Updated 12/29/2014 05:59 EST

The Kind of Fertility We're Not Talking About

Next time you meet someone who is dealing with any kind of infertility, please remember this and be kind. Also, think twice before making any assumptions about a person based on how many children they have, whether its none or 10. Not everyone has the luxury of choosing what they end up with.


If you are currently struggling with primary infertility (i.e. you have no children), then you might have difficulty believing this, but dealing with secondary infertility (i.e. you already have at least one child) can be just as difficult. If you have never dealt with infertility, well then, no offence, but you won't really understand what it's like to deal with either. Nonetheless, please read on, if not for your own sake, then perhaps for the sake of someone you know who is, or one day may be, dealing with some form of infertility.

It might surprise those on the outside that folks in the infertility world are not a homogeneous group, and often there are resentments and a lack of understanding that comes even from within. Those with primary infertility sometimes resent those struggling with secondary. Women who have had multiple miscarriages don't feel that a woman who has had just one can compare her experience to theirs. Those who have had a late stage loss do not feel their experience compares to those who have had an early miscarriage.

I understand this, of course, both as a person who has experienced pregnancy loss and secondary infertility, and as an infertility counsellor. In the case of primary versus secondary infertility, the disparity is obvious. When you have no children and experience pregnancy loss and/or infertility, you are absolutely terrified by the idea that you may never have children. You can't imagine how infertility could be as painful or frightening to someone who already has a child...but it often is.

I have many clients dealing with secondary infertility and while it is, absolutely, and without a doubt, different than primary infertility, it is still incredibly painful. Why? Because any time the reality of our lives does not meet our hopes and expectations, we are devastated, and this is particularly true when it comes to creating our families.

Many of us grow up with a picture in our minds of how we want our future family to look like. Usually it is pretty conventional: We marry our soul mate at a relatively young age, and without any difficulty conceive x-number of perfectly healthy (and well-behaved) children. Unfortunately, things often do not go according to plan.

But when it comes to reproduction, there are intense, deep-seated primal instincts driving the plan. We often forget this, but we are, after all, mammals designed to procreate. For those of us who want children, the longing is all consuming and only heightens when this possibility is threatened. Remember, it is not rationality that drives our desire to procreate, so you cannot rationalize away this desire. This is still true if you have a healthy child, if you always imagined you would have two children, or you have two and you always thought you would have three. When you are unable to attain your desired number, you grieve, as if you have lost a person. And in a way you have. In addition, our perspectives on family are shaped by our own family and by culture and social norms. Even if a person is uncertain whether they want one or more children, there is often pressure to have a big family and misconceptions about only children and the importance of siblings are still common place.

Many of my clients dealing with secondary infertility get to a point in their journey when they start to wonder how much further they should go -- limited by what they are willing to do to have another child, or are able to do based on their financial situation. How, they often ask me, will they be able to come to terms with not having another child?

I was fortunate to end up with my two beautiful daughters, so I never know how to answer this question. For this reason, I asked a friend of mine, who has one daughter, to share her secondary infertility journey which ultimately ended a few years ago.

Christina* was married at 38. She and her husband experienced an early pregnancy loss but then quickly and easily conceived their now eight-year-old daughter. They began to try for another child when she was 40, assuming it would happen easily once more. Instead, she had another miscarriage. Eventually they tried a number of IUIs followed by IVF. The unfortunate outcome was an ectopic pregnancy. Another round of IVF led to another miscarriage. Now 44, the couple began to investigate using an egg donor. Unfortunately, they were unable to conceive this way. After a year, she and her husband finally gave up. It came down to not wanting to sacrifice any more of what they had, in terms of both financial and emotional resources, to keep going down this path.

So how did she come to terms with it? Simply from exhausting the options that she and her husband were willing to take. The feeling was that the choice was more of less being made for them. But coming to terms with it doesn't mean the desire has gone away completely. Christina still feels a sense of loss, like something is missing. Perhaps this feeling will lesson, but there are no guarantees. She still thinks about it and wonders whether it could still be possible despite her current age, although with time, such thoughts have begun to cross her mind less often.

If her experience is representative of many women's then I guess I will have to tell my clients that while there may eventually be acceptance, there may always be a sense of loss or a degree of grieving. I don't think anything can possibly compare to the pain of losing a living child, but never having a child you wished to have is also a painful reality and one that many people likely carry with them for the rest of their lives.

Next time you meet someone who is dealing with any kind of infertility, please remember this and be kind. Also, think twice before making any assumptions about a person based on how many children they have, whether its none or 10. Not everyone has the luxury of choosing what they end up with.

*Name has been changed to protect her identity.


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