While the “It’s like riding a bike” saying always seems somewhat perplexing (You mean that, after 20 years, I am going to hop on that two-wheeled thing, balance, and ride?), it’s pretty spot on. Even the worst childhood bike riders amongst us are able to pull it together as adults for a ride to the beach. And while you may not enjoy any of it, you can certainly do it. The same can be said, or seemingly should be said, about having a second (a third or even a fourth baby). You did it before; how hard can it be to do it again? And while having a little one will mess with your sleep schedule (and sex schedule!), most couples can find at least a few minutes to give the baby-making thing a go. Unfortunately, unlike the infamous bike, sometimes the second time around isn’t so easy. Sometimes, it is way harder.
Medically speaking, fertility problems when you try for your second, third, or fourth child is called secondary infertility. And although you may have never heard of the words secondary and infertility in the same sentence, you have for sure heard your friends say, “It is so much harder to get pregnant the second time!” “Why?” you may ask. For most couples, the answer is, simply, “time.” No matter how long you put your baby-making efforts on the shelf, time can do some terrible things to our ovaries (decrease in egg quality and quantity). It can also allow GYN problems (fibroids, endometriosis, scar tissue, cysts) time to regroup and regrow. Furthermore, general medical issues occur more frequently as we age. Therefore, while things like high blood pressure and obesity may not cause our reproductive systems any problems per se, they can impact our overall health and your ability to carry a pregnancy.
Much to our dismay, secondary infertility is not uncommon. Nearly three million women in the US find getting back on that bike to be a challenge. All of the potential problems that caused primary infertility (infertility for a first child) are at play in secondary infertility (ovulatory dysfunction, poor egg quality, blocked tubes, low sperm count) and then some…. In fact, with secondary infertility, we are particularly interested in what went down during your first delivery (emergency C-Section, fever/infection, heavy bleeding, retained placental tissue). These factors can be the cause of some serious problems and prevent another pregnancy from progressing. While surgery can fix a lot of what has gone flat, oftentimes, fertility treatments are needed.
The good thing about secondary infertility is that we know that the system(s) worked at some point. Eggs were being released. Tube(s) were open. A sperm was able to fertilize an egg, and the uterus was willing and able. All good news. And while things may not be running so smoothly now, knowing that they did in the past and that you were able to carry a plus one is positive. Whether we can return the system to its previous functionality is debatable (often decided by a slew of fertility tests, including blood work, ultrasounds, a hysterosalpingogram, and a sperm test), but knowing that it was a go in the past is helpful.
While we don’t want you to get back on the bike until you are ready to ride (having more children just to prevent secondary infertility is certainly not wise), don’t wait too long. Although in many cases it will be like riding a bike, there are a good number of us who will run into some major roadblocks. Don’t be fooled by how simple stuff was the first time around—this ride may be totally different. Think of this advice as your helmet. While it may be in your head instead of on top of it, our recommendation may help save you from a pretty bad fall. And if you are going to hop back on that bike, safety is key, because in reality, it’s not always that easy.