Anna* delighted in motherhood and was eager to add a second child to her family. She expected conception and pregnancy to again be quick and easy but, after a year of negative pregnancy tests, Anna’s doctor used a term she had not heard before: secondary infertility.

For Anna, the anguish associated with secondary infertility – the inability to conceive or carry to term a second or subsequent child – was pervading all aspects of her life. Anna believed her family to be incomplete without a second child and was devastated at the thought of her child growing up without a sibling.

She came to dread kids’ birthday parties and other social interactions, fearful of inevitable questions about a sibling for her toddler. She became fixated on the idea of pregnancy, seeing pregnant women and families with multiple young children “everywhere”. While this could be explained by the psychological concept of attentional bias (paying attention to selective factors leads us to believe there is an increase in a specific event or occurrence), the distress and sorrow caused by these sightings was genuine.

Anna spoke of feeling like a failure, that her body had let her down and, worst of all, that she was a disappointment to her partner and child. She blamed herself for taking........

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