More and more women are speaking out about their infertility struggles. Celebs such as Chrissy Teigen and Giuliana Rancic have been very up-front about their battles to conceive — and have thus opened up an important conversation that has helped alleviate the stigma surrounding infertility. But less has been said about secondary infertility — the phenomenon of struggling to conceive after having gotten pregnant easily in the past. But one celebrity is using her platform to bring awareness to the issue. On Wednesday, Today host Dylan Dreyer announced she was pregnant after one miscarriage and a “long, emotional journey.”
“You know, I opened up about my infertility and my secondary infertility and just surgeries I’ve had to have,” Dreyer told co-host Savannah Guthrie, “and the day I was going to start my IVF — I had all my medicines, I brought it to the Kentucky Derby with me — the doctor calls and says, ‘Don’t take anything, you’re pregnant.'”
Dreyer was lucky, as secondary infertility remains, for many women, a problem that totally takes them by surprise — and it’s more common than you might imagine. SheKnows reached out to Dr. Erika Munch (a fertility specialist at Texas Fertility Center) and Dr. Rinku Mehta (of the Frisco Institute for Reproductive Medicine in Texas) to find out everything you need to know about trying for baby No. 2 (or 3!) and when to seek treatment if things aren’t happening on their own.
1. Secondary infertility is not uncommon.
“Secondary infertility is at least as common as primary infertility,” say Munch. It affects approximately one in every eight couples who are trying to have a baby.
2. Whether or not you have secondary infertility depends on your age — and how long you’ve been trying to conceive.
Technically, secondary infertility is when a couple who has become pregnant and given birth in the past without difficulty is unable to conceive and deliver thereafter. But how long before a secondary infertility diagnosis is considered depends on your age. If you’re under 35, “secondary infertility” means you’ve tried getting pregnant for 12 months without success. If you’re 35 or older, it’s 6 months.
And when it comes to infertility, history may repeat itself. “If you had trouble conceiving your first child or needed infertility treatment to achieve a pregnancy in the past, it’s possible that you’ll need treatment again,” says Munch.
3. When you should see a doctor depends on your age and medical history.
If you have a known fertility issue, then doctors recommend heading in as soon as you’re ready to start trying for another pregnancy. If you’re under 35, it’s recommended that you consult with your doctor after a full year of unprotected sex with no pregnancy. If you’re over 35, you only have to try for six months before making the call for an appointment.
4. There are things you and your partner can do to try to prevent secondary infertility issues.
Biological issues like irregular ovulation or problems with sperm function or development may always have an impact on your fertility. But if you and your partner have no known problems that could prevent you from conceiving, Mehta suggests looking at your lifestyle. “Maintaining a normal body weight, regular exercise and healthy well balanced diet are all recommended for couples trying to conceive. And poor lifestyle factors such as obesity, smoking, excessive alcohol or drug use can contribute to infertility.”
She also points out that when it comes to avoiding secondary infertility, the clock is ticking. “Age of the woman is the single most predictive factor regarding fertility. I would advise women to not wait too long between trying to have children if they were already over age 35 when they conceived the first time.”
5. There are lots of treatment options for secondary infertility.
If you find yourself unable to get pregnant on your own, don’t panic. Just like when a couple has trouble getting pregnant the first time around, there are a ton of treatment options. In fact, the ways primary and secondary infertility are treated are very similar, and your doctor can help tailor a plan that’s best for your exact issues. Options include medications to help regulate ovulation, inseminations to help in situations in which poor or low sperm quality is the issue and even in vitro fertilization. Don’t worry if it sounds overwhelming. “The vast majority of couples with secondary infertility are successful in achieving another pregnancy; it’s just a matter of how much extra help is needed to get them there,” says Munch
6. Treating secondary infertility isn’t just physical.
Having trouble getting pregnant can be extremely stressful for a couple, especially if conception is something that happened easily for you in the past. It’s important to be kind to yourself while coping with secondary infertility, and whether it’s talking to a close friend or doing yoga, trying to find healthy ways to relieve your stress. Mehta recommends that couples coping with secondary infertility have honest discussions about their family goals as well. “I always recommend that couples keep open communication between them and be on the same page as far their desires to pursue fertility goes.”
A version of this story was originally published in November 2016.