This post mentions miscarriage and may be triggering for some readers.

In a series of stories examining fertility, Mamamia talks to women, couples and experts about what it means to struggle to conceive.

If you already have one child, you might assume you will easily be able to have a second – just as I did after a trouble-free pregnancy with my now nine-year-old son Toby.

Yet my husband Jules and I tried to fall pregnant for over six years, suffering three miscarriages before finally having his brother Leo in February 2017.

It was bewildering and frustrating when people asked me when I was going to give ‘poor’ Toby a sibling. I had no real answer to give, and it was hard to watch my friends complete their families while we tried to remain hopeful.

To understand more about secondary infertility, I spoke to two women about their experiences - and got the lowdown from Dr Andrew Hedges at Hunter IVF about what to do if you find yourself struggling, too.

Kylie, mum of one 10-year-old boy

Kylie had her son Kale in 2009 after trying just once to get pregnant with her ex-husband.

“That marriage ended and I met my husband Paul seven years ago. I already had my son and he had a grown-up daughter from a previous relationship, so we just assumed we would easily be able to have a child together.

“Yet after 18 months of trying, we still hadn’t fallen pregnant - but we couldn’t seem to find a doctor who wanted to investigate our issues.”

Watch the trailer for Mamamia's new fertility podcast, Get Me Pregnant. Post continues below.

During this initial period of trying for a baby, Kylie’s brother died and her dad was diagnosed with dementia. Kylie wondered if the stress was a contributing factor, so the couple tried to get on with their lives as ‘normal’.

After more time passed with no pregnancy, a friend recommended Kylie see an obstetrician and gynaecologist to look into her painful periods.

“After some investigation, a polyp was discovered on my uterus as well as endometriosis. I had a number of procedures and operations to sort out the issues and I tried one round of the ovulation stimulation drug, Clomid, to see if that would help.

“Unfortunately, it didn’t, so we decided to take another break as I was sick of being poked and prodded to no avail.”

After consultations with another doctor, more investigations and minor operations, Kylie has yet to fall pregnant in over seven years of trying.

“We have discussed fostering and adoption but it is a huge mountain to climb that we are just not sure about.

“I am 37 and otherwise healthy and I feel blessed to have my one son, but it has been so frustrating to not be able to have a second child. At times I have put off career development and felt judged by society for not being able to have more children.

“I’ve joined multiple secondary infertility Facebook groups for support, but now we are choosing to focus on our marriage and our mental health.

“Just because I have been lucky enough to have one child, it doesn’t take away the pain of not being able to have more.”

Phoebe, mum of three daughters aged 11, and 9-month-old twins

Phoebe and her husband Toby conceived their first daughter Beatrix easily when Phoebe was 30 years old. They began trying for a second baby two years later.

“We tried for about five years on and off. As we hadn't had any issues the first time, and we were busy with our careers and raising our daughter, we weren't really stressed about it until the end of that period when we realised there might be an issue.”

The thought of not being able to have a much-wanted second child caused Phoebe a lot of stress, while husband Toby remained hopeful.

“I felt like there was something wrong with me but Toby was very philosophical about it because we already had our beautiful little girl. I just couldn't make peace with not having a second. Everyone else I knew had two kids or more, but it wasn't working for us and we couldn't understand why. It was a very tough time.”

The couple embarked on three rounds of IVF, spread across two years to keep the financial burden to a minimum.

“We had a gap of two years in between our first and second rounds of IVF. I was running my own business and we were financially stressed, so we had to put the baby dreams on hold.

“The constant dialogue of wanting a second child was always in the back of my mind and I would often get upset about it.

“We tried naturally in between the IVF treatments which added to the stress, because every month I was getting a negative pregnancy test result.”

When the third round of IVF finished with no embryos to transfer, Phoebe had already started to research other options.

“I had found a clinic in South Africa via Facebook with an egg donor agency attached that we decided to try. From that point on, it took us four months to organise our trip to Cape Town.

“The IVF clinic and egg donor agency were really geared up to support people coming from other countries. We selected an egg donor by her childhood images, her bio and medical history. They have code names so we don't know who they are, and that was fine by me. Our family essentially had a lovely two-week holiday in Cape Town with a bit of IVF on the side!

“The night we flew back in from South Africa I did a pregnancy test to get the negative out of the way. I'd had so many years of negative pregnancy tests that it felt impossible we would have success, but I got a positive result immediately and had floods of incredibly happy tears. I felt like the luckiest person on the planet!”

The clinic had put two embryos in, but Phoebe had not considered the possibility of having twins.

Listen to Mamamia's fertility podcast, Get Me Pregnant. On this episode, hear from fertility specialist Manuela Toledo. Post continues below.

“At our first ultrasound, the sonographer said 'Oh! There's two' and I cried again. My husband and I were so shocked and excited, it was the best feeling in the world.”

The pregnancy was surprisingly plain sailing for Phoebe, who gave birth to her twin girls Indigo and Willow in May 2019.

“It was just as easy as my first time around and although I was anxious about how big I was going to get and how my body would cope 10 years later, it was a dream. To be honest, I just wish I had done it sooner.

“My twins are my little angels and I'm so grateful for them. I did feel anxious that I would constantly have in my mind that they weren't mine biologically, but once they were born all of those fears disappeared.”

So, what is unexplained secondary infertility and what help is available? Dr Andrew Hedges of Hunter IVF explains:

“Secondary infertility describes when a couple are having trouble conceiving the second time around, after an uncomplicated experience with their first pregnancy and birth.

“It is very common, more common than people think, and it can be distressing and frustrating for couples as it's unexpected.

“The processes for dealing with secondary infertility are the same for a couple experiencing primary or general fertility issues. We will check for medical conditions, disease and low sperm count, before deciding on a course of action.

“Even if all the results were okay with the first pregnancy, things can change or develop for many reasons as time goes by.

“Couples or women experiencing secondary infertility should see their GP for a referral to a fertility specialist.”

Read more from our fertility series here:

• "It's not your fault, but I hated you": When it feels like everyone's pregnant, except you.
• Everything you want to know about the process of IVF, answered by a fertility specialist.

Feature image: Getty.