In this episode, I sit down with Tina, a Functional Diagnostic Practitioner, a previous team member, to talk about a topic that’s often overlooked - secondary infertility. If you’ve had one child and are now struggling to conceive again, you’re not alone. We unpack why secondary infertility happens, what testing to consider, and how to shift your mindset through this emotional journey. Each pregnancy is a gift and not a guarantee. Our goal is to help you build the family of your dreams by uncovering the root cause of what’s getting in the way. Tune in to learn more.

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Takeaways

Secondary infertility can be confusing for couples who have previously conceived easily.

Long-term breastfeeding can deplete a mother's nutrient stores, impacting fertility.

Nutritional deficiencies can lead to prolonged nausea during pregnancy.

The immune system changes with each pregnancy, affecting fertility.

Understanding the timeline between pregnancies is crucial for recovery.

Testing for nutrient levels and gut health is essential in addressing infertility.

Personalized protocols based on testing results can improve fertility outcomes.

Emotional well-being is closely tied to physical health during pregnancy.

Every pregnancy is unique, and past experiences can inform current fertility issues.

Reframing expectations around family planning can alleviate stress.

Chapters

00:00 Understanding Secondary Infertility

06:13 The Impact of Nutritional Depletion

12:30 The Role of Immune System Memory

18:38 Testing and Assessing Fertility

24:08 Personalized Protocols for Fertility

26:10 Navigating the Journey of Trying Again

Connect with Dr. Jane Levesque

Website - https://www.drjanelevesque.com/

Instagram - https://www.instagram.com/drjanelevesque/

Facebook - https://www.facebook.com/DrJaneLevesque/

Hi, we are back today with Tina and we are gonna talk about secondary infertility. Tina, I love connecting every month, I think we have a call right now and every time I'm like, we are up leveling our knowledge every time we chat, it's super exciting. So tell me why you wanna talk about secondary infertility, why is this a thing that's coming up?

Yep.

Yeah, I'm seeing a lot in practice. I would say I'm working with about four couples right now that are dealing with secondary infertility. And so, you know, a big part of what we do is dive into the research a lot when we're seeing things. So this is something that's been on my radar quite a bit right now.

Yeah, so let's break it down. I think it's not like we expect any infertility troubles, but I do think that the secondary infertility is like it just gets us a little bit more because you're like, I was able to do it the first time or the second time. Like why now? So it's a little bit less unexpected. You know, tell me what are you seeing in terms of why is this actually happening and what do we need to start looking at to address it?

Yeah, yeah, I think, you know, I have very different.

reasons across couples. One of the biggest things that I'm seeing, you know, with one couple in particular is long standing breastfeeding, right? So nursing, I think we're going on two years now and her first pregnancy was very easy. Her first pregnancy, her birth story was beautiful. It was an at home birth and everything just flowed. And so she's so confused, right? And she says, you know, maybe it's the nursing. And so

After two years, mean, pregnancy depletes your body, nursing depletes your body, and at this point, her body has not had a chance to fully restore to levels.

without nursing. And so to try and now go and have a baby, there's just no stores left there. And I'll give an example, actually. When I was pregnant, my baby dropped from 10th percentile to second percentile in growth in the final week. And I did not want to be induced. And my doula said, he may not have the stores of energy to come Earth side if we don't do that. And so it's the same thing if a mom is so depleted.

how is your body going to have the energy to create another baby, which is so taxing. And so that's a big thing that I'm seeing right now.

The breastfeeding, can I just jump in? Because I learned something and it was just from Dr. Lea Hichman, of course. And because there was a lecture on breasts and we were talking about, she's talking about breastfeeding and how it's actually not beneficial to breastfeed for either party. So the mom or the baby after 13 to 16 months. And 13 is more girls, 16 months is more boys. And I was just like, what?

I thought longer is better to an extent but what happens when you're breastfeeding post that well first of all the baby doesn't really need the nourishment anymore because they should be eating solid food and they should be eating high quality food so if they're not you know I've had moms who are like we were on a trip and they weren't eating so well so I felt really good because I could give them breast milk and it's like you know going on two years three years of breastfeeding

What happens with the breast milk is that you're actually stimulating a lot of detox and you're dumping a lot of deeply stored, because it's so much depletion. And the more depletion happens, the more you're opening up those detox pathways. So I just thought that was really, really eye opening for me because I breast-myfed my second to like 22nd months, whereas the first one stopped at 13. And I like, I didn't push it and I was like, thank God I'm done.

Whereas my second, I kind of just let her hang on and with the idea that like, they'll let you know or they'll... So it was just eye-opening from that perspective where sometimes we're holding on to something that's actually maybe not good for us and we just didn't know that.

Yeah, yeah, I think it's very much a comfort thing at that point when it's gone on that long. It's that connection to baby. That's right, yeah. I mean, we have to respect that.

And for both, sometimes it's for mom and for the baby, right?

100%.

And also you need to decide on your timeline when it comes to having that second child. So that's a big one I'm seeing. And so important to know, you know, in that first pregnancy, which I'm dealing with with a client, we want to make sure those nutrient stores are built up so that we can recover after the pregnancy. We can recover much better after nursing and move into further babies if we're trying to not deplete everything.

we have. And so that's where I think our pregnancy care is very important. It tied to nausea. There's a lot of correlation between nutrient depletion and nausea in that first trimester. So important things to know there. I think it's very

If nausea is lasting more than past that first trimester, then usually it is just nutrient depletion, whether that's B6 or iron or any other nutrient. I think I remember I was nauseous until I was week 16, week 20 almost in my first pregnancy. And I was like, why, you know, why am I still nauseous? And I remember going to the doctor and she was like,

We have people who are nauseous the entire pregnancy. And so it almost just gets put into your brain that like, oh, that's totally normal. You're just gonna be nauseous. But it is, if you're past that week 13 and 14 when the placenta should be taking over the hormone production, maybe 16 at the very,

normal.

top end if the placenta you know took a little bit longer to develop. It is sign of big nutrient deficiencies which are then usually are going to show up for the babe or for the mom or both later down the road. So absolutely really important to look into.

Yeah.

Yeah, I think another really important thing that people may not be aware of is just the uterine immunological memory, right? So after that pregnancy, your immune system changes with every pregnancy. The uterus remembers the immune cells from past pregnancies. There's changes in immune cell populations, how they communicate and function with other cells. And so when we look at immune function, we need a flexible immune system, but your immune system

has changed after that first pregnancy, right? And now there's also been time since that first pregnancy for new toxins, new pathogens, more oxidative stress, you're further aged, right? So what's happening there. And so it's important to remember that there is that immunological memory in the uterus and taking that into account. And that's where I think we need to know what's going on with the immune system. We need to know if there are toxins that exist there that the immune system maybe didn't manage to

fight off after that first pregnancy.

Yeah, I mean, I think my biggest takeaway with secondary infertility when I first started seeing it and even when I missed

like miscarried the second time because my first pregnancy happened so quickly. I've realized that like, okay, every pregnancy is a gift. Like nothing is a given just because it happened the first time. And part of my grief and my miscarriage was that like, my God, I didn't appreciate that first pregnancy at all. Cause I just assumed that it was a given because it came to me so quickly. And obviously I had my complications and my issues during the pregnancy, but I just very much look at every pregnancy is a new start.

Mm-hmm.

and we have to, it gives us a lot of history when we understand.

how the first pregnancy happened, what happened during the first pregnancy, what was labor like, what was breastfeeding. That's part of the history that can tell me what could be going on now. But essentially we still have to get to the root cause. You know, what is going on with your nutrient levels? What is going on with your digestion? What's going on with the vaginal microbiome? How are you, have you recovered fully post the last physically, mentally, emotionally, spiritually, and then starting it from fresh knowing that

Every pregnancy is its own unique case. And for those women who have been pregnant, right, like yourself, each pregnancy, I'm sure you were like, this is completely two different pregnancies.

Yeah, yeah, absolutely. I mean...

I definitely had, I would say my pregnancies were quite easy, but they were very different. And my bounce back after was very different because there had been two years in between. And so I had changed quite a bit. And our experiences between pregnancies as well is very important. You know, I look at one of my other couples and there's been about five years from the first pregnancy to now this secondary infertility that they're dealing with. But the traumas that they have,

experienced in those five years have been great. There have been many. And so is it secondary infertility or is it that they have experienced so much and their nervous systems are out of whack and you know because of these traumas there's been a lot of pain medications and things like that and so we need to get those bodies to a place of calm again.

because I can't say it's secondary infertility. I can just say that they have been stressed to a point that is far worse than where they were before their first pregnancy.

Yeah, and I think for women, like, pregnancy is a stressful thing.

Right? Like it's so depleting and we can see it. If we talk about the timeline for a second in terms of what is the optimal timeline to actually have between children. And again, there's no judgment on, you get pregnant when you get pregnant and we just plan our families and things happen the way that they do. In which case we just support you the best that we can. But when we look at it from a biological standpoint, physiological standpoint, like what is the best timeline? Well,

you're going to take three to four months to get pregnant. That's normal. So if it happens on month one, fantastic. But like three to four months is normal. You're going to be pregnant for 10 months. It's like a whole year basically. And then you're going to breastfeed for that 13 to 16 months. And then you're going to need minimum six months recovery. And if you've had any complications. So I have a patient who had help syndrome right at the end, had to go and do an emergency delivery. So after she stopped breastfeeding and she breastfeed for about 18 months,

we need to give her a minimum of a year before she's ready just because of the toll that her body took during help and how stressful that was. And we don't really think about it, right? Because she's like, well, I've recovered from it. It's like you recovered, but not all the depletion and the nutrients because you could still see it on the blood work. So that right there is like three years. know, idea it's so maybe you're getting pregnant if it's a year of...

Mm-hmm.

Being pregnant, six months of breastfeeding, so it's like two years in between, and then you give yourself three to four months. That's kind of like the most minimal timeline that I would recommend. Otherwise, when women come to me and they say they have unexplained infertility, and she's six months postpartum, I don't say you have unexplained infertility. It's like, well, unless you want to stop breastfeeding your baby, and then you want to start repleting your nutrients.

store.

And then we'll swim, and they're like, well, I don't want to stop breastfeeding my baby. I just want another baby. And it's like, well, then you're not going to have the nutrients that you need. It's like pouring from an empty cup. We kind of like to pin our patients a little bit into a hole. Like, what do you want? You have to decide. Do you want a baby that's depleted? Do you want to be depleted? Do you want to? Because we can't have it both ways, you know?

Yeah. Yeah.

Yeah, and I don't even see it as putting them into a hole. It's just, we're not going to impose our timeline on you, but we are going to ask you to make your own. And I think by reiterating back to you what you're telling us, I think it's that, yeah, you know, and I've had to do that in other areas of my client's lives. But for sure, you know, I understand the attachment to nursing and wanting to have multiple babies, but it's which one is it right now for you?

Totally.

Yeah, and I don't...

I and when I say this too, cause I have a couple that I'm thinking of right now in there. She was, she's like, maybe it is the breastfeeding that's causing the depletion. And then we get in front of a call and she goes, okay, you're not the first person that have told, has told me this. So she's just hearing this confirmation. Cause then the truth is she has this little voice inside of her that's going, maybe this is this, maybe it's the breastfeeding, maybe it's the stress, maybe it's the trauma, maybe it's this house or maybe this is relationship, whatever it is. The truth is we have that little voice inside and I

always say like, we just give you permission to actually admit what you have been thinking about and then validate that because when you start doing it for a long time, you can just kind of see it. You know, you're like, yep, that totally is a thing when somebody is depleted.

And when I test, I still went ahead and I tested her. We're still working, getting her ready and optimized to start trying soon, because she is older. She's like 45. So it's like, we have to get going. And her nutrients were so low. Like everything was so depleted. And then it's just, when you see that, it's really easy for her to go, maybe my breast milk is not as good as I think it is. Right? Because it's like, well, you're so depleted. How could you be making...

Yeah.

Mm-hmm.

really good nourishing breast milk when your bones are breaking down.

Yep, Yeah, and I want to point out here, because I said, you know, my pregnancies were fairly easy, but there was a huge difference in my second pregnancy. And I think we often forget about it. I had extreme anxiety through my second pregnancy.

in that anytime my husband left the house, I felt like there was going to be like vivid imagery. I thought he was going to get into an accident. And then after my baby was born, I could not go to a playground and watch my kids go down a slide to that extent. And I had trouble nursing both of them. So when we talk about nutrient depletion, I had no idea at that time, but mood.

pieces are very much tied to nutrient depletion because we create amino acids and neurotransmitters from our nutrients. And so that was a big thing for me that I wish I was working on nutrients because that is just as hard as throwing up throughout your entire pregnancy. And so I want women to remember that.

It's not worse sometimes, Like it's hard to be anxious when you're pregnant, the whole time, you know, and then let alone progesterone, right? Like you're talking about what's progesterone and what's that doing for neurological development and all that kind of stuff. Like it's, it's a lot.

Yeah. Yes.

Yeah, yeah, and you know, I think women just attribute this to like, it's in my head. I think we forget, right? It's, there is very conventional system. I've said it to everybody. We're not floating heads and headless bodies roaming the earth. Like it's very connected, you know? And so if you are feeling that anxiousness, know that

Because who told us it's in our head? You know what I mean? I'm like, we're so good, that they're so good at tricking us. Yes.

It's not just in your head. And whatever you're depleted in, it impacts baby, right? So if you can't put yourself first, think about how it's impacting baby, you know?

Mm-hmm.

Yep.

Well, funny enough, like the baby will take everything because baby puts himself first or herself first. Yeah. And it's, yeah, I just, we've, we've been talking about this for a while from the conventional and I don't mean to like turn against the conventional system because I genuinely think that there's fantastic doctors out there and we absolutely need the medicine. But the system as a whole has done such a good job into making us believe that symptoms are normal and that there's nothing

Yep, 100%. 100%.

we can do about it, which the underlying belief is that while my body is broken and there's nothing I can do about it, I'm hopeless, I'm powerless, I'm, you know, and it's literally the opposite energy when it comes to creating, knowing that like, I can do this, my body's fully capable, I trusted, I know exactly how it works, I can feel my ovulation, I know how to take care of myself. And then you can have the soul come in and take over your body and you can be totally fine with that because you are so solid.

in knowing and understanding who you are and what's you versus what the baby is. And that foundation is just really missing. So when you've been anxious all your life and then all of sudden you're anxious when you're pregnant, it's like, that's normal. It's like, no, it's not. No, it's not.

Mm-hmm. Mm-hmm. Mm-hmm. Yeah. Yeah. And when all you're being told with secondary infertility is it's because you're older, well, yes, thank you. That's a very obvious thing to say. But there's a lot more underneath that that's not being acknowledged by the conventional system. And I think we've touched on quite a bit of that today in terms of nutrients, what's happened in the experience between pregnancies, immune system memory. Those are all things to consider.

answer.

Yep. And I know we talk about this a lot, but let's talk about the testing that we do to assess and understand what is going on for each individual and then how do we overcome this secondary infertility.

Yeah, for sure. So we're going to want to see that nutrient status for sure. Like we've talked about extensively here. So a nutrient panel, really comprehensive blood work. It's not something that's being run by your fertility clinic or conventional doctor. There's markers on there that are going to get a lot deeper. We're going to want to look at the gut microbiome because immune system is very tied to the gut microbiome and we need to know what's happening there. And in pregnancy, things shift in the gut microbiome. And so we have

Which?

to see what is happening within there to make sure that you're absorbing those nutrients. Those would be for sure three that speaking generally and we don't speak in generalities but if we're looking at secondary infertility those are three top tests that we would be looking at to start getting the body back into a place of I can get pregnant, I can carry, I can do this.

Yeah, in.

If you're like, well, my doctor ran some blood work or can my doctor run these? Again, the conventional system is going to come from an angle. Is there a medication that I can give you for whatever the finding I'm going to have? That's literally why they run their lab work. If they cannot give you a medication, they will not run that test. So thyroid is a really good example. They won't test the antibodies because they cannot give you anything for antibodies. They will test TSH because they can give you Synthroid, liver thyroxine, and they can see how that's impacting. But again, it's very much looking at the body.

as this fragmentation as opposed to at the whole picture. Tina, I would agree with you. I would add the methylation panel. I don't know if you said methylation panel. I think that to me is just like blood work, methylation, nutrients, gut. And I know that it's, okay, if I had to talk top three or then maybe top two, it's really hard to pick because there's not a single test that's gonna give you all the information. Some testing is better than no testing. And for those of our listeners who are in the fertility 101 group

Mm-hmm. Mm-mm.

have read about, you can run one test at a time and we're still going to give you information. It's still going to be so valuable, but it will still leave pieces of information out. And that's where more comprehensive testing. just say, you're going to spend more money in a short period of time, but less money in a long period of time because you're just compressing. Like you're getting to know everything. So then you can just address it all at once versus just addressing one component, giving it three, four, six months, addressing the next component.

Mm-hmm.

and giving it three, four, six months, so on and so forth. So in the fertility space, it's like, we just don't have that time. Most people don't, especially if you're over the age of So that's why we test all the things so we don't have to extend it.

Yep.

Yeah, I had a client. It's the male partner. I actually wanted him to come teach all of our clients how to ask questions, because he asked brilliant questions. And he said, if we don't go with the full package of labs, will that slow us down mid-work with you? And I said, yep.

Yes.

It will, good question. And so they decided to go with all of it because long-term resources, you you could end up spending more time, more financially because then we have to pause. And as we've seen with one of my recent clients, nutrients take some time to build up in the body. And so now we have to add more months to restore nutrients.

Yeah, they said no initially because they didn't really understand. You didn't really push and that's totally fine, right? Like we're not pushing people. We're just going to present the information and then let our clients decide. And then, you know, but I do try to make sure I paint that timeline because now.

Hey, we worked six months together. Everything has improved, but we're still missing a couple of pieces. Time to do another test. It's going to take another month to get it timed with your cycle, to get the results back. And then whatever we find is going to take three to four months to fix. If we tested that at the beginning, you have essentially saved yourself that time because some of those nutrients we would have added in earlier on into the protocol. So it just gets you to start thinking about tests in a different way versus just this one thing I'm going to test. And then that's it.

Mm-hmm.

Yeah.

Mm-hmm, yeah, yeah. Especially with that secondary infertility people because they're like, I got pregnant once, like this should happen. And that's where we say every pregnancy is a blessing and every pregnancy is different.

Yep.

100%. I will say that the vaginal microbiome has been so eye-opening for myself and my clients lately. especially since we switched to the US biotech, I really love the way that they're presenting the testing. if you have any symptoms or if you had a really like, so whether you had you tested positive for group strep B during pregnancy or you had any fever that came up on labor or

or any signs of infections or needed any antibiotics post, I would also add the vaginal microbiome in there because it will be amazing. Like the uterus has memory and if there is something that reset it and essentially it has not reset back and it doesn't know how and there's still some signs of inflammation and that could be, I just get some brown spotting before and after and the brown spotting is lasting a little bit longer than it should or there's just a little bit of a smell or the discharge is just

a bit. I've had people who didn't have a lot of vaginal symptoms, but when we tested the vaginal microbiome, there was just enough. I'm like, we need to look at this. And you test the vaginal microbiome and you go, there it is. And whether it's an infection or that microbial imbalance, BV, you name it, Candida, you can really see it.

Mm-hmm.

Mm-hmm.

Yeah, yeah, for sure. I'm excited to run that as well. I'll be doing that soon.

Is it good to be near him in a minute? Okay. Cool. So then once we have the testing, really the approach is what do we do once we have the testing?

you

So from there, that's where we get really personalized, right? And we can, we've already before the testing, we've kind of gotten a window into the world of our clients. So we've been able to personalize the protocol when it comes to nutrients and air quality and what's happening in the home, environmental exposure to things. But then we get those answers. And when I do calls with people, I'm like, you're going to hear me say answers a lot. And that's because we will not make any decisions.

Mm-hmm.

without answers. And so we get the answers from those labs. And this is where we can get very specific with nutrients. For example, if we're talking about people who are carrying excess weight, we don't want them to be super malnourished or depleted going on a diet trying to lose weight. But we can avoid that by knowing these are the nutrients you're missing. We're going to focus your diet on these nutrients.

and bring down weight, but we're not going to deplete you further in these nutrients. So we can get really specific based on the answers we get from labs to improve balance, to improve resilience in the body, to bring up energy stores. And that's what we're doing at that point. So very specific protocols for each person.

Yep, I do, I love.

Even you said this at the beginning of the podcast, like, I have four, whatever, four couples right now that I'm working with with secondary infertility. And all of them have different reasons as to why they're not getting pregnant the second time. And I think that's the exact point is that everybody, whether it is secondary infertility, whether it's endometriosis or PCOS or POI, whatever the condition is, there is still your own unique expression of it, of whatever is causing the

fertility. So if we look at the lens of pregnancy as a natural process, if it's not happening, something is missing. We are then just taking a look at what is the body trying to tell us and how is this expressing itself. everybody, even if it's in secondary infertility and everybody has it, each person, each couple, I should say, will have it for very different reasons.

Absolutely. Yep. And that's very clear in my caseload right now.

Yep. Tell me, just as we wrap up, how long do you tell people that, how long does it take to replenish the nutrients and see a general timeline? And then how long do you give patients to try again before we say we're missing something?

Mm-hmm.

Yeah, yeah, I want you doing some good work. And by work, mean, you know, with your protocols with replenishing the body for at least six months. At that point, we should be retesting to see where the body's at. And if it's a green light, then I'm saying we're trying for no more than three, four months. OK. And if it's not happening, we're back to the drawing board. I'm not telling you to be trying for another year and then come back to me because that's absolutely ridiculous.

Mm-hmm.

We need to go back to the drawing board within three, four months and see what's going on and course correct and shift things, right? And that's where I think there's a lot of confidence and trust in our relationship with our clients in that because we are working to do our best and the body is very complex and we will go back to the drawing board if it's not happening in that timeframe and you have to just trust that we'll do that with you.

Yeah, 100%. And you know what I'll wrap up with, for some of you listening, that might be like, my God, six months, nine months, but I want to keep trying. Or, you know, what if I'm missing? And I would ask like where that anxiety is coming from, because I remember when I had my miscarriage, my first thought was...

And A, I'm not going to be able, what if I can't get pregnant again? And I completely missed out on this first pregnancy and this amazing thing that my body did the first time. And then B, daughter, my siblings will be too far apart. My kids will be too far apart and they're not going to get along. And there's this weird pressure that we put on ourselves because we have this image of our perfect family. And that image starts to get, it sometimes it just feels like you're getting further and further away from it with each coming month. And they

There was a really big like, I'm not having my kid for, like I'm not having a second child for my daughter that's already here. I want this child for myself. And I think the sibling is a beautiful thing. And it was just such a shift for me that released this pressure of like, what if they're five years apart? What if they're three and a half or four? Like then that's what they'll be. You know, it's not, I will figure this out. Cause this is just something that I want to do again. And I think it's beautiful to have siblings and it's beautiful to have, you know, big family.

and I'd love for everybody to have big families and do it well, but we have to like realize what is our intention and why are we doing this in the first place. That really helped me, so I hope, you know, for some of you who are like feeling the pressure of having siblings, certain ages, you can also reframe that for yourself and that stress just goes, okay, I just need to figure this out versus this is, you know, figuring it out for my child.

Mm-hmm. Yeah, I think a sibling is a blessing at any point.

Yeah, yeah, yeah, exactly. Thank you, Tina. It's always a pleasure. We'll see you soon. Yeah, bye.

Thank you. So good. See you soon. Bye.