Debunking Secondary Infertility: A holistic approach to addressing 5 root causes

This post is quite vulnerable, and I hesitated to write it without getting pregnant again first, but I wish I had. My imposter syndrome of not speaking up without a solution is part of the problem. Secondary infertility is either quite rare or, like so many women's health issues, not talked about or studied nearly enough. In the hormone healing and bio-energetic nutrition space, it feels almost taboo. The silent expectation is that once women embark on their hormone-healing journies and get pregnant once, they should be on the right path for subsequent pregnancies. Maybe it's because the health and wellness space is very much a business, and no one wants to buy into a lifestyle without guarantees. What I can say is that it's truly disheartening to face this issue seemingly alone in a sea of fertile women, especially when you feel like you've tried 'all the things.'

This post isn't a how-to guide or tool for self-diagnosis but a starting resource if you feel like you're nourishing, supplementing, exercising, etc., and getting worried about how long it's taking to get pregnant again. I hope to shed some light on fundamental factors you may want to consider addressing and give you a jumping-off point for research, working with a practitioner, and supporting your body through your healing journey. 

As a note, I will not go into male infertility in this post. I focused on my cycles and personal well-being, while my husband focused on his health. Having your husband on board is fantastic, and Andrew Huberman does a great job debunking male infertility in this podcast episode if you're interested. 

As a transplant, my in-person community is comprised of the new moms that I met through a local mother's group after the birth of my daughter. This community was such a blessing in new motherhood. Given the similarities in ages, it felt like almost everyone was newly pregnant with their second child by the time we started trying. After a few months of relatively worry-free disappointment, I did start to get discouraged and frankly resentful of the women who didn't appear to take their wellness quite so seriously and still got pregnant quickly or on their first try. It made me a worse friend and caused me to step back and isolate myself. I looked toward my online community of women, mostly dispersed through pro-metabolic and "crunchy" nutrition groups on Facebook. I didn't find answers there, and as is the complicated nature of any infertility, I was just left feeling lucky to have one healthy child that I was able to conceive easily. 

Without repeating my whole fertility and hormone healing journey, the all too common reader's digest version is that I was diagnosed with PCOS at 11 years old, put on hormonal birth control, and remained on various forms of birth control for 15 years. I dealt with chronic digestion, mood, and physical ailments. After huge transitions in 2020, including a cross-country move, getting married, being laid off, and moving back in with my parents, I felt like a shell of who I knew I could be. I decided to get off hormonal birth control and reverse my PCOS through nutrition (see my post on PCOS here.) I got my IUD removed on my birthday in November, and by March of the following year, I was pregnant. After a pretty rough first trimester, complete with relentless nausea and what I kept feeling was prenatal depression, I had a healthy and joyful rest of my pregnancy and birthed a big, beautiful baby girl at home. 

What is secondary infertility? 

Secondary infertility is defined as the inability to conceive or carry a baby to term after previously giving birth following natural conception. Most commonly, the diagnosis applies after 12 months of trying to conceive. Like primary infertility, the diagnosis does not reflect a root cause. 

Because of the vague definition, I don't feel entirely comfortable carrying this label. Still, "secondary infertility" is what I researched when I was struggling to conceive, and the term you're probably googling now if you found your way to this post. I have PCOS, and while when we started trying to conceive, I was having regular monthly periods, my periods became irregular as I started working again and dealing with a series of personal emotional upheavals. I was also still nursing my toddler. In the pro-metabolic space, many women continue to nurse their older babies through their pregnancies and tandem nurse their children for years. I truly believed that nursing shouldn't impede conceiving and maintaining a healthy pregnancy with proper nourishment and strong ovulation. Now, I don't know if that is true for all women. Maybe I wasn't as deeply nourished as I thought, maybe stress was catching up with my body, or maybe I was menstruating and not ovulating (yes, that's a thing, especially with PCOS). I won't know for sure because I didn't get to the point of clinical testing, but after about a year and a half of trying, I was able to conceive. It may have been weaning my toddler that helped regulate my cycles, the extra acupuncture sessions and Chinese Traditional Medicine (TCM) herbal blends I was taking, or finally being consistent in my nourishment after months of stress and poor eating habits, but I finally had a strong ovulation, and the pregnancy took. 

How to address the underlying causes? 

I'm a researcher by nature and a recovering maximalist in my approach to health. I try not to throw random solutions at my health concerns, but as I got more concerned and eager to conceive, I did try various approaches. What I learned is that it is critical to address the most apparent underlying causes of secondary infertility first: nourishment and stress. One of the most encouraging fertility books I've read is Awakening Fertility: The Essential Art of Preparing for Pregnancy by Heng Ou. Even though it's technically in the cookbook category, a good 70% of the book is devoted to what the author's TCM practitioner aunt calls "preparing the baby room." It's about the critical preparations you can make to support your body through pregnancy, labor, postpartum, and even your eventual menopause. Even though the book doesn't go into detail on secondary infertility, it is a great reminder to go back to the basics when preparing to conceive. 

Getting enough calories. 

So many women don't get adequate calories or protein habitually. Proper nutrition is also about creating a sense of safety in your body and getting out of a sympathetic state on a regular and prolonged basis. I consume beautiful, nutrient-dense meals multiple times per week, but from one day to the next, I'm guilty of being wildly inconsistent in my calorie intake, protein consumption, and meal timing. It took a real protracted effort to get back into a good meal-prep routine and eat regularly rather than running on stress hormones for hours on tough days. It sounds simple, but it takes work to eat consistently. I experimented with a prepared meal service for a few months, and while my husband and I grew extremely bored of the variations of chicken or beef that all tasted mysteriously identical, it did get us eating enough protein and back into the habit of eating lunch every day. Now I'm back in a meal prep routine and while I've still got a long way to go with consistency in all areas of my life, most days I am nourished. This safety is apparent. You don't realize that you're running on stress hormones and adrenaline until you suddenly have stable moods and energy levels throughout the day and aren't crashing by mid-week. 

Replenish your minerals. 

Minerals are having a moment right now, but taking mineral supplements or blends without testing is like shooting in the dark. Taking beef liver, oyster, and magnesium supplements, all of which are excellent tools in moderation, can distort your mineral balance easily if you don't know your baseline. I've seen many women, especially new moms, become mineral-obsessed and force minerals into everything they put in their bodies. For many women seeking quick solutions, prioritizing minerals can quickly become a food fixation or restriction. It's important to start slow, test your minerals if you can afford to, and listen to your body's response at each step. 

The best way to start restoring your minerals after your first pregnancy without testing is not through supplementation; it is through natural mineral-rich beverages like bone broth, adrenal cocktails, herbal tea, and raw milk or foods like organ meats and seafood. These foods are naturally balanced and contain fat and protein to aid absorption.

(I grew up eating organ meats and love seafood to the point of obsession. In fact, it's a significant factor in our upcoming move to Maine. I know that many women in the pro-metabolic space struggle to incorporate these foods, opting for supplements or hiding them in other dishes, and that makes me sad. So much of how we absorb nutrients comes from our perception of the foods we eat. I'm working on a few recipe posts that I believe can help those of you who cringe at the thought of liver or canned seafood learn not just to tolerate these powerhouse ingredients but genuinely enjoy them. Stay tuned!)

Protect your energy. 

Whether it is people or tasks in your life that are unaligned, sap your energy, or bring unwelcome emotions, it's essential to critically assess whatever and whoever isn't serving you. I've had a tough year and had to make tough decisions to leave a job I was misaligned with, end what I thought were life-long friendships with people who didn't share my core values, set more explicit boundaries with family members, and get off social media. These changes were not easy. It didn't feel good, and I doubted my intuition at times, but I know that I removed so much internal tension and anxiety within myself. The emptiness I created is the fertile soil I needed to help me grow as a person and grow my family.

Slow down. 

Slow living is a term thrown around quite often these days, and in most people's minds, it conjures up beautifully edited YouTube vlogs of sourdough bread-baking, meals from scratch, and sunny afternoons outside with your kids. I'm a sucker for this image, and I honestly find it encouraging to see, but when I try to emulate this lifestyle exactly, I get burnt out. 

Over the last few years, I learned to bake sourdough, cook from scratch, ferment, can, make cheese, and pickle. These are slow living skills that I genuinely enjoy, and I am so proud to know how to do, but at this moment, I'm a working parent in the suburbs, with no safe outdoor space and a toddler home full time. Slow living should reduce stress, help you find beauty in your surroundings, embrace slow transitions, and get out of your head, not add to your to-do list. I have been working hard to remove stressful tasks and experimenting with how little I can keep on my must-do list every day. It may feel like nothing can be crossed off, but if you're realistic in your expectations of yourself and your time, you might be surprised. It's essential to reassess your capacity and remove as many things from your plate as possible when trying to replenish your body and make room for a new baby.

Address your trauma. 

There is no better or more urgent time to unpack your trauma than when preparing to bring a baby into the world. When I found out I was having a girl with my first child, I totally broke down. I was faced with a lifetime of unresolved tension and resentment for my relationship with the mother figures in my life, my perception of my femininity, my self, and the world. I had so much to unpack, and it was a complex process. I also knew on a deep level that I needed to go through it before my daughter's imminent arrival. 

With secondary infertility, entirely new emotions came to the surface. I questioned my birth experience with my daughter, my recovery, my worth as a mother, a homemaker, a wife, a family member, and my purpose. Infertility causes you to question your value and wonder if there is some higher reason you're not able to conceive, and it's painful. I realized that with all the progress I had made in preparation for and after becoming a mother in the first place, I slid back into my maiden energy and victimhood, back into what the author of Maiden to Mother terms 'letting life run through you rather than come from you.' I needed to let my maiden go and transition to mother once again. Whatever trauma you may be holding onto, this is the time to unpack and release it. Work with a practitioner if that's available to you, buckle down on your spiritual practices, or just set aside time regularly to journal, reflect, and process because trauma affects your physical body, too.

If you resonate with my story, maybe the maiden-to-mother lens will also be helpful to you. I recommend the book Maiden to Mother: Unlocking Our Archetypal Journey into the Mature Feminine by Sarah Durham Wilson. The exercises and reflections helped me shift some things internally and get me closer to understanding who I'm trying to grow into. I also thoroughly enjoy Jessica Ash's podcast Fully Nourished, especially the episodes on femininity and female archetypes. Her perspective has been a paradigm shift for me and helped me reconceptualize how I view my femininity, how I can empower my feminine energy, and even how I view my husband's masculinity within our marriage. 

I wrote this post to share my story and do my part to demystify what secondary infertility looks and feels like. Every woman's body is different, but the doubt, overwhelm, and grief staring at just that one line every month is very much shared. This isn't a how-to guide and not the place to list the supplements I took, but I hope that reading this post helps you pause and evaluate what's going on in your body on a fundamental level. I encourage you to dive into your nourishment and release as much stress and trauma as you can in this season. Prepare your internal baby room, and have faith that it will be filled.