Second Trimester Loss & Low AMH: Causes, Testing, and Functional Fertility Insights

Jul 28, 2025

Ask episode

Chapters

Transcript

Episode notes

We’re diving into the top functional and conventional tests to consider after the second trimester or late pregnancy loss, especially if you’ve been diagnosed with low AMH, high FSH, diminished ovarian reserve (DOR), or premature ovarian insufficiency (POI).

If you’ve had a second trimester loss or late pregnancy loss after 20 weeks and been told “everything looks normal,”this episode is for you. We dive into what’s often overlooked in conventional care and how a functional fertility approach can help uncover underlying imbalances that impact conception, hormone health, and pregnancy outcomes.

In this episode we cover 7 categories of testing to consider after late loss especially if you have low AMH, diminished ovarian reserve, autoimmune issues, recurrent miscarriage, or unexplained infertility.

You’ll learn:

The top clotting and thrombophilia markers to test (including Factor V Leiden and antiphospholipid antibodies)

Which inflammatory and immune markers (hs-CRP, ANA, cytokines, NK cells) are often missed and why they matter

How the vaginal microbiome and hidden infections like ureaplasma can cause second-trimester loss

The role of chronic stress, adrenal hormones and the HPA axis in pregnancy outcomes

Why a comprehensive blood chemistry panel can reveal nutrient deficiencies and hormone imbalances that are missed by conventional labs

Key methylation and genetic SNPs (like MTHFR) that impact detoxification, clotting and hormone metabolism

The impact of gut health and stool testing on immune tolerance, estrogen balance and inflammation

We’ll also explain how this whole body functional lens can guide your next steps in preconception planning, whether you’re trying again naturally or preparing for IVF.

This episode is for you if:

You’ve experienced a loss after 14 weeks of pregnancy and are seeking deeper understanding and support.

You want to explore both conventional and functional medicine approaches to uncover underlying causes.

You’re looking for practical lifestyle, testing, and healing strategies to improve future pregnancy outcomes.

---

TIMESTAMPS

[00:00:00] Introduction: Late term pregnancy loss overview, compassion, and what to expect in this episode [00:02:30] Functional fertility testing for late term loss thrombophilia panel, immune markers, inflammation, and infections [00:06:00] Stress hormones, nervous system support, and comprehensive blood chemistry for improving pregnancy outcomes

[00:09:00] Blood sugar, insulin, and comprehensive thyroid testing in pregnancy loss [00:12:00] Genetic testing, including MTHFR mutations and the importance of body healing before conception [00:14:30] Role of gut health, infections, and estrogen metabolism in pregnancy loss

---

RESOURCES

📩 Get your free 10-day elimination diet plan! Email hello@fabfertile.ca with the subject line 10 DAY to receive your guide and take the first step toward reconnecting with your fertility.

Causes of Miscarriage Before 12 Weeks: What Most Doctors Miss: https://fabfertile.com/blogs/podcasts/causes-of-miscarriage-before-12-weeks-what-most-doctors-miss

The Clotting Connection: Hidden Causes of Implantation Failure and Miscarriage: https://fabfertile.com/blogs/podcasts/the-clotting-connection-hidden-causes-of-implantation-failure-and-miscarriage

Autoimmune Roadblocks to IVF: How ANA Affects Fertility: https://fabfertile.com/blogs/podcasts/autoimmune-roadblocks-to-ivf-how-ana-affects-fertility?_pos=1&_sid=4203e92e4&_ss=r

How To Prevent and Reverse Autoimmune Disease and Get Pregnant: https://fabfertile.com/blogs/podcasts/how-to-prevent-and-reverse-autoimmune-disease-and-get-pregnant?_pos=5&_sid=a4eef3155&_ss=r

Before Your IVF Transfer, Test This First: https://fabfertile.com/blogs/podcasts/before-your-ivf-transfer-test-this-first?_pos=4&_sid=5114b4bda&_ss=r

Low AMH? Why 'Normal' Vitamin D Levels May Still Be Hurting Your Egg Quality: https://fabfertile.com/blogs/podcasts/low-amh-why-normal-vitamin-d-levels-may-still-be-hurting-your-egg-quality?_pos=4&_sid=eac9ba23d&_ss=r

Why Addressing Homocysteine Levels Can Boost Egg and Sperm Health: https://fabfertile.com/blogs/podcasts/why-addressing-homocysteine-levels-can-boost-egg-and-sperm-health?_pos=1&_sid=2e1b473ff&_ss=r

How MTHFR and methylation affect fertility with high FSH and low AMH: https://fabfertile.com/blogs/education/mthfr-methylation-high-fsh-low-amh-fertility?_pos=2&_sid=d553bdf89&_ss=r

How Iron Deficiency Impacts Fertility, Egg Quality & Low AMH: https://fabfertile.com/blogs/podcasts/ferritin-iron-deficiency-fertility-low-amh-high-fsh?_pos=3&_sid=022381a8b&_ss=r

1. Factor V Leiden & Prothrombin Mutation in Late Fetal Loss

Martinelli I et al. (2000, New England Journal of Medicine) This study found that women who carry Factor V Leiden or the prothrombin G20210A mutation have a 3.2× greater risk of late fetal loss, likely due to impaired placental blood flow. https://www.nejm.org/doi/full/10.1056/NEJM200010053431405

2. Antiphospholipid Antibodies & Late Fetal Demise

Branch DW et al. (1992, Obstetrics & Gynecology) This foundational paper established the connection between antiphospholipid antibodies—such as lupus anticoagulant and anticardiolipin—and late pregnancy loss. https://pubmed.ncbi.nlm.nih.gov/8602296/

3. Elevated NK Cell & Cytokine Activity in Recurrent Miscarriage

Kwak-Kim JYH et al. (2003, American Journal of Reproductive Immunology) Researchers found that women with recurrent pregnancy loss often show elevated natural killer (NK) cell activity and inflammatory cytokines like IL-6 and TNF-alpha, suggesting immune dysregulation as a key contributor.

https://pubmed.ncbi.nlm.nih.gov/32992208/#:~:text=Different%20authors%20have%20described%20an,Reproductive%20immunology;%20Uterine%20NK%20cells.

4. Vaginal Dysbiosis & Risk of Preterm Birth

Aagaard K et al. (2014, Science Translational Medicine) This study highlighted how reduced Lactobacillus dominance in the vaginal microbiome increases risk of preterm birth and pregnancy complications, including second-trimester loss. https://pmc.ncbi.nlm.nih.gov/articles/PMC5782380/

5. MTHFR Mutation & Homocysteine in Recurrent Miscarriage

Nelen WL et al. (2000, Fertility and Sterility) This meta-analysis showed that MTHFR mutations can lead to elevated homocysteine levels, which are associated with increased risk of recurrent early and late miscarriage due to vascular and clotting issues. https://www.sciencedirect.com/science/article/pii/S0015028206030706#:~:text=An%20elevated%20plasma%20homocysteine%20concentration,using%20a%20comprehensive%20literature%20search.

Our favorite fertility tracker Inito (use code FABFERTILE15 to save 15)

Fab Fertile Method https://www.fabfertile.com/what-we-do/

Ultimate Guide to Getting Pregnant This Year If You Have Low AMH/High FSH Not sure where to start? Book a 15-minute call here and we’ll give you options to help.

---

💛 Join my free Facebook group: Get Pregnant Naturally With Low AMH and/or High FSH: https://www.facebook.com/groups/451444518397946

---

Please note we only promote products that Sarah Clark or her Fab Fertile team has tried and believes are beneficial for someone who is TTC. We may receive a small commission