Secondary versus Primary Fertility: Is It The Same?

Published by Sarah Hughes on

Guest post written by Elaine Robertson North

Imagine if you will, two friends talking about their shared sorrows at not being able to conceive. One has been trying for so long and is so desperate, she has an appointment booked to discuss IVF. The other is equally bereft, having had two miscarriages and then nothing, and is struggling to find the strength to believe there is still hope.


I’m in no doubt that anyone with an ounce of compassion would feel a sense of sorrow if they could hear the conversation, but what if I told you that second woman already has a child? A beautiful two year old son, who is bright and engaging and full of joy. Would knowing that her yearning is for a second child, and not for her first, make you feel differently towards her?


Well that mum was me. And if you were suddenly unsure how to feel about my situation, I can assure you I felt similarly conflicted, feeling blessed and hopeless in equal measure. And in the company of my friend who was battling to have her first child, I immediately felt I had less right to feel all the emotions I knew she was feeling. How could I possibly consider my position to be the same when I already had a happy healthy toddler? My bewilderment and disappointment were just as real, only mine came with a coating of guilt that I should dare to talk like ours was a shared experience, while my son played happily beside us.


Like lots of things we encounter as women, I was experiencing something I didn’t even know existed. Secondary infertility is a diagnosis reserved for women who conceive easily the first time, and then encounter problems trying to get pregnant a second time. It occurs at around the same rate as primary infertility and is especially common in women in their late 30s and early 40s. Having had my first child at 41, I’d always feared that conceiving a second time would be a challenge. With a little research, that fear was duly confirmed, with a name for the condition added to really seal the deal.


The good news is that with the help of a nutritionist who got me fighting fit on the inside, I did conceive again and went on to have another beautiful boy. My friend was also successful, not once but twice, with both of her children conceived naturally. 


But I still think this idea that there’s a hierarchy of longing when it comes to primary and secondary infertility is a fascinating one. This notion that the despair you might feel trying to conceive your first child, trumps whatever emotion is felt by someone experiencing the same sense of dismay trying to conceive their second. And what if someone is struggling to conceive their third child? Do they have any right to feel disappointed at all? A thought that leaves me unsure how to conclude. 


My instinct is to say that if someone has dreamt of a family of four, five or even six, then they are of course entitled to feel sadness and disappointment if, for whatever reason, they are unable to fulfil their dream. But primary fertility must surely come with a level of despair all of its own. So maybe there is a hierarchy. And maybe that’s okay.


About Elaine Robertson North

Elaine is the author of two novels, I Can’t Tell You Why and Bring Me To Life which are available here: She lives in North London with her husband and their two sons and when she’s not writing, she can be found looking harassed on the school run, on the side lines of her sons’ football matches, or singing her heart out with her local branch of Popchoir. You can follow what she’s up to on Instagram:, Facebook: and on Twitter: @RobbieNorth.


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