Families: Lonely...With An Only

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After an easy first pregnancy with Sabrina, now 4, April and Richard Simanoff of Huntington, N.Y., were mystified and heartbroken when their attempts to have a second child brought nothing but grief. Since 1999, April, 34, a homemaker, has had five miscarriages. Countless medical tests have found no definitive cause. This unexplained secondary infertility--as the inability to conceive or bear a second child is known--has propelled the Simanoffs onto an emotional roller coaster. They say they feel guilt over not being able to give Sabrina a sibling, anger when people ask when they're going to have their next child and, most of all, a sense of not belonging.

"I'm a stay-home mom, but I can't relate to that world, since [those moms] all have more than one child," says Simanoff, who will try some new treatments this fall to help her maintain a pregnancy. "You're just so isolated in dealing with secondary infertility that you have to create an environment that makes you feel better in any way you can."

While infertility is an emotionally and financially draining disease that afflicts about 10 million men and women, those people hit with secondary infertility face a unique anguish. Couples are often in shock or denial when they can't conceive or carry a second child, especially if their first pregnancy went smoothly. They also feel caught between the world of the fertile and the infertile, with no place to turn for support or empathy. "Friends and family dismiss secondary infertility as a loss, figuring you should be grateful if you already have one child," says Diane Clapp, psychiatric nurse and medical-information director for Resolve, a national infertility-education and -advocacy organization based in Somerville, Mass.

Although no hard statistics are available, infertility experts and reproductive endocrinologists say the number of people suffering from secondary infertility grows every year. Clapp estimates that there are 3 million people coping with secondary infertility, up from about 1.8 million in 1995. Physicians and therapists who specialize in counseling infertile couples have seen as much as one-third of their practice become devoted to those with secondary infertility, up from as little as 10% just five years ago, according to a study at Cornell University.

Dr. Stephen Corson, director of the Women's Institute for Fertility, Endocrinology and Menopause in Philadelphia, suggests two reasons for the rise: people are waiting longer to have babies, and more couples in their second marriage are trying to have children. In fact, 52% of men with secondary infertility were married before, according to a survey of 578 infertility patients that Corson conducted last year for the American Society for Reproductive Medicine.