Secondary infertility is when you’re unable to conceive after previously giving birth for longer than 1 year. It affects about 11% of couples in the United States and is something I see a lot in my practice. It’s often very frustrating and confusing for women since they have already conceived and they don’t understand where things are going wrong. There can be a number of different root causes for men and women. I’ll go through some of those and then share my thoughts and what I often see.
It’s important to note that we can have these present the first time we get pregnant but they may not be bad enough to impair our ability to conceive. Then you pair them with nutrient deficiencies and the stress of postpartum and that can make it difficult to conceive in the future.
While the focus is often on women when we have a hard time conceiving or maintaining a pregnancy, especially after already having a child, our husband’s health also matters and can lead to secondary infertility.
Just like with women, men could have had some of these things going on previously, but they weren’t bad enough to prevent conception. Men also go through stress during the postpartum period, which can lead to changes in their daily habits, sleep, nutrition and greatly impact their health.
I’ve seen many couples struggle with secondary infertility and I think a lot of it has to do with changes that occur postpartum in their lifestyle and daily habits that then worsen issues they had previously but weren’t bad enough to prevent them from conceiving the first or second time around. Here are the major areas I see shift negatively postpartum that could then make it difficult to conceive again:
Things can get weird after you have a baby. Your schedule often ends up being weird in the beginning, especially if you’re breastfeeding and it is easy to fall out of supportive habits like getting light in the morning and taking light breaks throughout the day. This is a shame because that morning light exposure supports a healthy stress response and will help you remain resilient to stress when things get challenging. It also supports thyroid health, which can take a hit postpartum as well (more on that below). I also see a lot of moms using their phones at night when nursing and getting exposed to a lot of blue light during a time when their bodies should be experiencing darkness. This can lead to poor sleep (yes worse than it already is) and blood sugar balancing issues. Learn more about the importance of light in this podcast episode.
There’s both positive and not so positive stress in the postpartum season, especially in those early months. Typically we are getting less sleep and/or broken sleep, which makes us less sensitive to insulin. This decrease in insulin sensitivity can make it difficult to balance blood sugar. Blood sugar highs and lows will add to our stress and increase the burden on the adrenals. If a mom doesn’t have support, this is going to fill her stress bucket as well, especially if she has other children. Difficulties breastfeeding will also lead to more stress during this time. There just a lot of new things, a lot of decisions to be made, and for many moms, not enough support. Not to mention, some women have just had major surgery if they had a C section or could have experienced a traumatic birth. There are varying degrees of postpartum stress but I believe this plays a significant role in difficulty conceiving in the future. It uses up more nutrients, which can lead to deficiencies and can lead to insulin resistance, making it difficult to have healthy hormone levels. This chronic stress will also lead to thyroid issues (more on that below).
There are often changes in an important hormone called leptin, which is essential for fertility. Leptin is a hormone that plays a crucial role in regulating energy balance and appetite in the body. It is produced by fat cells and released into the bloodstream. The primary function of leptin is to communicate with the brain, particularly the hypothalamus, to signal the amount of fat stored in the body. This, in turn, influences energy expenditure, food intake, and metabolism. When fat cells increase in size, they release more leptin, signaling to the brain that the body has sufficient energy stores. This signals the brain to reduce appetite and increase energy expenditure, helping to maintain a stable body weight. Conversely, when fat stores decrease, leptin levels drop, signaling the brain to increase appetite and decrease energy expenditure, promoting food intake and fat storage.
What disrupts leptin?
These are all areas that often get out of balance during the postpartum season. Prolactin, the hormone that supports breast milk production, can also increase leptin. Leptin resistance is a major cause of difficulty conceiving or maintaining a pregnancy.
Pregnancy requires a lot of nutrients but so does postpartum. The energy demand is even higher, especially if you are breastfeeding. While I do believe we can improve are nutrient status during this time if we are mindful, it’s incredibly easy to become deficient in imporant nutrients. This often happens because we aren’t eating enough or prioritizing nourishing foods. I see many women under eat during this time in general, but especially protein rich foods. I don’t think we need to be perfect when it comes to our food. Prioritizing a few specifics at most meals can make a huge difference. Here are some things that can help avoid nutrient deficiencies postpartum:
All of the above will lead to struggles with thyroid health. We need a healthy thyroid in order to have healthy hormone levels and not only get pregnant but maintain a pregnancy. Poor light exposure, stress, and nutrient deficiencies will all negatively impact our thyroid’s ability to do its job. If you want to learn more about thyroid health, I have an in depth free training you can access here.
If you want support on your fertility journey, you can sign up for our Nurture Your Fertility program. We would be honored to support you!
