Kim Kardashian West has never been afraid to share every aspect of her life, from body-baring photoshoots to a (literal) book of selfies. Oh, and let’s not forget the 10-season reality TV juggernaut that is Keeping Up With The Kardashians. This week, Kardashian sat down with Matt Lauer on The Today Show and candidly discussed her trouble conceiving a sibling for daughter North West.
“They say if you’ve been trying [to have a baby] for a year, then you usually need a little bit of help,” she explained. “They have recommended to me to get a surrogate, and I would like to hold out a little bit longer, and still try. I still have hope.” (And trying they are: Kardashian has previously said that she and husband Kanye West are “having sex 500 times a day” to get pregnant.)
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Say what you want about Kardashian’s vanity or her career, but “secondary infertility,” or having trouble getting pregnant the second time, is a problem millions of people can relate to. A 2012 study of people around the globe found that an estimated 10.5% of women who wanted to have a child were unable to conceive for a second time in 2010, which translates to more than 48 million couples worldwide with primary or secondary infertility.
It’s also a problem that’s tough to talk about. As one writer for the New York Times explains, “Couples often feel guilty seeking treatment when they already have a child, or they are told that their previous fertility proves that nothing is wrong.”
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Unfortunately, secondary infertility happens for many of the same reasons as those responsible for primary infertility, according to Alan B. Copperman, MD, director of the Division of Reproductive Endocrinology and Infertility at Mount Sinai Hospital in New York City.
“Secondary infertility is extremely common, and often includes issues with eggs, sperm, Fallopian tubes, or timing,” Dr. Copperman says.
Kardashian is 34 years old, below the typical age range for fertility issues, which tend to start at 35. “A woman is born with all of the eggs she will ever have in her lifetime, and by the time a woman is in her 30’s and early 40’s, the majority of eggs may no longer be healthy,” Dr. Copperman explains. (Note: Dr. Copperman is not treating Kardashian and does not know the specifics of her case.)
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Many women do get pregnant and have healthy babies in their mid-30s and beyond. Dr. Copperman emphasizes that it’s important to do a thorough evaluation of a woman’s anatomy and hormones—along with checking their partner’s sperm—before concluding that age is the culprit.
Kardashian hinted that giving birth to North may have contributed to her fertility issues. “I had a tough delivery, so I understand what my challenges are,” she said.
But Dr. Copperman says previous delivery issues aren’t typically a factor in secondary fertility, unless the mother had an emergency Caesarian section that led to a post-op infection. Difficulty removing the placenta can also cause problems down the road if it led to bleeding and scarring of the uterus. (According to reports, Kardashian actually planned on having a C-section, but she ultimately went into labor early and had North naturally. It’s unclear whether she had any type of infection.)
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No matter the cause, Dr. Copperman says there is help available for couples experiencing secondary fertility. “While the majority of patients will need mild, if any, intervention, there are many who could benefit from fertility treatments ranging from pills to insemination, to even in vitro fertilization.”
Kardashian would prefer to conceive naturally, but she’s not against other options, like surrogacy or even adoption. “Never say never,” she told Lauer, adding that at the end of the day, she’s just happy to have North.
“I’m so blessed that I have one, and I don’t want to take my focus off of her,” Kardashian said.
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