For many families across Australia, IVF offers hope where there was once uncertainty. Around one in 16 Australian babies are now born through assisted reproductive technology, making IVF an increasingly familiar part of the country’s reproductive story.
Behind those statistics, however, are journeys that rarely fit neatly into success rates and medical charts. For those experiencing secondary infertility, the struggle to conceive after already having a child, the emotional landscape can be especially complex.
Nisha Gull-E-Nishat understands that reality all too well.
The Pakistan-born migrant is the mother of a daughter conceived through IVF. Since 2023, she has undergone more than 20 IVF cycles and experienced two miscarriages while trying to give her daughter a sibling.
For Nisha, fertility has never been solely a medical issue. It is deeply intertwined with culture, family expectations and identity.
Within many South Asian communities, the traditional idea of the “village” offers care and support, but it can also bring unintentional pressure. Questions such as, “When are you having another?” or “Why don’t you give your child a sibling?” are often asked with good intentions, yet can be painful for someone undergoing treatment.
“We can love our culture and still challenge some parts of it that place intense, silent pressure on women,” she says.
“When you are actively undergoing treatment, those casual questions become incredibly heavy to carry.”
People often see a family with one child and assume it is a lifestyle choice, unaware of the medical and emotional journey taking place behind closed doors. Nisha believes more open conversations are needed to reduce stigma around IVF and to challenge misconceptions that assisted conception is somehow less natural than other paths to parenthood.
The biological realities remain sobering.
According to the Australia and New Zealand Assisted Reproduction Database (ANZARD), the chance of a live birth following a single embryo transfer declines steadily with age. Women under 35 typically have a 45 to 50 per cent success rate per transfer. That falls to 35 to 40 per cent for women aged 35 to 37, around 20 to 25 per cent for those aged 38 to 40, and below 10 to 15 per cent for women over 40.
Research also suggests women from minority ethnic backgrounds often experience lower live birth rates, influenced by barriers to care, delayed treatment and cultural stigma surrounding infertility.
For many parents experiencing secondary infertility, another challenge is the way grief is sometimes dismissed.
The phrase, “At least you already have one child,” is one Nisha has heard often.
She rejects the idea that gratitude for one child should erase the grief of wanting another.
“My daughter is special and wanted. Our family is not incomplete because we haven’t had another child, and my desire for another baby takes absolutely nothing away from her,” she says.
“But holding one truth does not erase the other. Grief is not a competition. You don’t have to be completely empty-handed to feel a profound absence.”
The demands of IVF extend well beyond the emotional toll.
A single treatment cycle can involve 50 to 70 injections, repeated blood tests, strict medication schedules and the anxious wait for laboratory results, all while balancing work, family life and parenting.
Drawing on her own experience, Nisha encourages women to advocate for themselves throughout the process by keeping detailed records, seeking second opinions when needed and asking questions about every test, medication and treatment recommendation.
For Nisha, the goal is simple: to create a space where women’s culture, careers, emotions and bodies are acknowledged together rather than treated as separate parts of their lives
Years of treatment and loss have also reshaped how she understands resilience.
“I used to think resilience meant pushing through no matter what and keeping a brave face,” she says.
“Now I know resilience is knowing when to stop, when to cry, and when to ask for help. Hope is no longer blindly optimistic. It is quieter now. It means remaining gently open to the possibility that it could happen, while completely accepting the truth that it might not.”
That journey ultimately led her to establish the Healing Node Collective, an organisation supporting women aged 35 and over navigating fertility challenges, IVF and hormonal changes.
Rather than focusing only on clinical treatment, the collective aims to provide culturally informed, long-term support through peer networks and workplace advisory services, recognising that fertility affects far more than physical health alone.
For Nisha, the goal is simple: to create a space where women’s culture, careers, emotions and bodies are acknowledged together rather than treated as separate parts of their lives.
For anyone facing a similar journey, she hopes sharing her story reminds them they are not alone, even when the path feels isolating.
Support and information for people experiencing infertility and pregnancy loss is available through healthcare providers and specialist support organisations across Australia.
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