Unexplained infertility. Can anyone...explain it to me?

(23 Posts)
Tinkleybison Tue 01-Jul-14 21:35:51

Although I've googled this I still can't get my head round it!

Tests have shown that I am ovulating every month, my tubes aren't blocked, scan looks fine, DH's sperm is okay, we have one DC and I've had one other pregnancy - but in the last couple of years of trying - nothing! We're both mid-thirties. So what the heck is going on in there??

Does unexplained fertility actually mean that science isn't advanced enough to locate a possible cause? - or does it mean that it really should be happening but just randomly isn't?

Can anyone who has had this diagnosis tell me how they moved forward from it? What was recommended? Are there any tests I might have missed?

While I'm grateful not to have anything 'wrong' I'm struggling with the 'nothingness' of it.

eurochick Tue 01-Jul-14 21:42:12

I have the same "diagnosis". It basically means all the standard stuff is ok (eggs, sperm, tubes) but something else is going on. It could be 101 things - chromosomal issues, womb lining, an autoimmune response, blood clotting, sperm DNA fragmentation, vaginal PH and so on. The standard tests don't cover these. You can have some of them tested for privately, but ultimately, there is a lot we still don't know about human fertility. I think most drs don't bother to test for all these things because there are so many possibilities and many of the tests are expensive. And the answer to many of the results is IVF anyway, so if there is no obvious cause, trying an IVF round is the "logical" next step.

We had the standard tests and a few extra ones, and none of them threw up a clear cause. However, I got pregnant twice (one mc) from 4 rounds of IVF, so clearly putting a fertilised embryo in the right place overcame whatever undiagnosed issue we had.

I found being unexplained very difficult. I found putting myself through medical procedures when no one could tell me WHY they might help difficult. But ultimately, it did help us.

Tinkleybison Tue 01-Jul-14 21:46:04

Thank you eurochick. The sonographer used that phrase too 'there are 101 reasons why you might not be getting pregnant'. I had wondered if IVF was the next logical step. I take it there is no point in taking clomid if you are shown to be ovulating?

Trooperslane Tue 01-Jul-14 21:52:15

Us too op.

It's fucking frustrating.

I had several miscarriages, we tried from I was 32 and finally had dd after 8 years and 4 ivf.

She was worth the wait but it is the worst thing ever.

Look after yourself and make sure it doesn't totally take over your life, like it did mine.

X

Tinkleybison Tue 01-Jul-14 22:17:09

Thank you too Troopers any advice on how to stop it taking over also gratefully received!!

RawCoconutMacaroon Tue 01-Jul-14 22:31:45

Two suggestions you can try for free, will cause you no harm at all and MAY do some good...

Don't take ibuprofen or similar painkillers around the time of ovulation. I realise that's difficult if you have painful ovulation signs as the follicles develop (I know from experience!), but ibuprofen taken at that point in the cycle can stop the follicle from rupturing (and therefore the egg can't be fertilised).

Secondly, consider a gluten free diet (and don't replace the gluten containing junk with gluten free junk such as gluten free bread and cake, eat real food instead!). That might sound woo but it's not - the older we get, the more autoimmune issues we tend to develop and the more we tend to react to inflammatory foods like gluten. Anything that's affecting your immune system, the absorption of vitamins and minerals through your gut and the level of inflammation in your body is likely to affect your fertility. Yes, some of these immune factors can be tested for (although you may have to pay), but others can't partly because it's poorly understood at this point in time (maybe in a few years...).

Nobody needs to eat gluten containing grains, or any grains for that matter so it won't harm you, and who knows maybe it will work for you and your DH (or not, but worth a try for a few months maybe).
Marks daily apple blog is a good free resource (all recipes are gluten free/grain free) and there is a searchable archive on health topics including fertility, autoimmunity etc.

Clearly these low tech ideas are not going to help everyone but no harm will come from them either smile.

SilverStars Tue 01-Jul-14 22:37:24

There are A whole range of tests that you can pay privately for that may explain why you have secondary infertility. It was not until we paid for lots of tests for primary infertility that we discovered my dh's sperm was not as good as NHS SA test showed and that I had issues maintaining a pregnancy - shown through level 1 and level 2 immune tests. Other tests such as "hiddenC" ( treatment is specific antibiotics) may shed further light.

If still in NHS system the tests are great but limited. And as they do not fund assisted fertility if have one child it is limited there as well. Where I live clomid is not prescribed on NHS if have a child or if have no medical diagnosis that needs it. Areas vary - no NHS testing here for secondary infertility either.

If you have gone private for testing then perhaps look at other tests? But many private clinics will promote assisted fertility as a solution.

Inshock73 Wed 02-Jul-14 12:45:24

I'm so glad I spotted this thread I was about to ask the same question!

I'm in the same position and it's driving me mad! All my tests have come back normal including the day 21 progesterone test which confirmed OV had occured and a really healthy level of 52. My cycles are like clockwork, OV is like clockwork and partners sperm test was really good.

I saw a private consulant last October and he discouraged me from starting IVF as he was confident I would conceive again. Mc at 9 weeks in March 2013. I've now been ttc for a year and nothing!

Reading all your posts with interest!

Tinkleybison Wed 02-Jul-14 16:33:10

Thanks everyone. I'm fortunate not to have ovulation pain, so not really an ibuprofen user, but interesting to hear what you say about gluten Raw - thank you for that.

Silver with the more advanced tests, if they do find a cause is there anything that can be done or is the recommended course of action still generally IVF?

SilverStars Wed 02-Jul-14 19:10:50

It depends what they find. I had issues on both level 1 and level 2 tests. Therefore I needed a range of medication for doing ivf but also will need it of get pregnant naturally as my problems are implantation and early miscarriage as well as difficulty conceiving. Much depends on who you see. If it is a fertility clinic they advocate assisted fertility. But other consultants focus on diagnosis and then depending on what is found as to what is recommended.

My dh has issues with male infertility and we were told by NHS there was nothing we could do. So they recommend ICSI. But I had a mc last year from a natural pregnancy so know it is not impossible. My dh as seen a top private urologist who specialises in make infertility who has prescribed drugs to improve sperm count!! We have a retest soon to see if it is working.

Shellster52 Wed 02-Jul-14 19:47:11

MY CAUSE OF 'UNEXPLAINED' INFERTILITY

I was going back and forth to appointments for a year having blood tests, scans, etc and DH had 2 sperm tests in that time... both fine. I then saw another Dr who told me we need to go to a specialist lab for semen test and it showed hubby has 98% abnormal sperm. This test was just 2 weeks after DH produced a sample for the 'normal' lab which came back as normal. So it wasnt that his sperm changed from normal to bad in those short 2 weeks - the first lab just didn't have the technology. Now, when I hear 'unexplained', I always want to tell people about this. And SilverStars seems to have the same experience.

The other thing is that now I have been through IVF a few times, I realise that IVF can tell things that other fertility tests cannot. For example, some mens sperm tests fine, but once they put the egg and sperm together in the petri dish, the sperm just swim around the egg randomly and aren't attracted to it as they should be. I have seen women have 0 of their 13 eggs fertilised because of this and next time, they might use ICSI or calcium along with the sperm to fertilise the egg.

Also, as was my case, even if hubbys sperm was normal, I realised my first IVF that my eggs didn't have the energy to grow to implantation stage and were disinterated at day 2. I have since changed my diet and added supplements to correct this. But again, my egg isn't something they could have tested in this way prior to IVF.

Thirdly, there just unfortunately are the statistics that a womans number of eggs with chromosmal abnormalities increases at around 35, and then goes sky high around age 40, which is another thing that can't be tested through the pre IVF tests, but the studies from others womens eggs show this.

Sorry for the long post. I just know how frustrating this is and want to share my experience in case it is any help.

Tinkleybison Wed 02-Jul-14 20:40:34

Thankyou Silver and Shellster. It's far more complicated than I realised! Could I ask what level two tests are and also what supplements you have added to your diet?

SilverStars Wed 02-Jul-14 22:45:32

I had Immune level 1 and level 2 tests. Cannot get level 2 done by gp and some tests are sent to Chicago. They are listed here:
Immune tests

Tinkleybison Thu 03-Jul-14 07:46:24

Brilliant - thank you!

everythingisonmurtaghlist Thu 03-Jul-14 08:44:52

We were unexplained too. Had 3 goes of IUI - unsuccessful then went on to IVF. Out of 9 eggs only 1 fertilised - the embryologist advised it looked like a bonding issue between the eggs and dh's sperm as the unfertilised ones either had no or only 1 or 2 'burrowed' into the egg. To establish if it was the egg or the sperms 'fault' would have required more testing. Luckily our little egg is now a gorgeous 2.9 year old.

Milestone Tue 07-Oct-14 16:57:21

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Eric1976 Fri 17-Oct-14 09:50:16

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allchatnicknamesgone Fri 17-Oct-14 12:53:22

It's a minefield.
All my tests were fine. Hubby had very first dodgy sperm count that basically fast tracked us to ivf and icsi (we're obv not nhs funded though).
Since that bad sperm all others have been fine which has lead us to think the first one was not right. It was a test you do at home and take to hospital. Probably sitting around in lab too long!
Anyhow, the advice we got was quite simple. At the time I was quite grateful for some straight talking. Essentially, they said it would probably happen naturally at some point but it could be years and in that time your chances of ivf success is constantly reducing according to stats. I just thought f**k it, been waiting round long enough let try for another 3 months then give ivf a shot.
I'm in 2 week wait. Every egg fertilised and every embryo made it. We had 11 at blastocyst stage. Whilst that was great news, it has puzzled us because his sperm obviously likes my eggs. We'll see what next week brings. There is a slow rise panic in me that the issue could lie with implantation now....I'm even worried I could have undiagnosed endo just because I say another post on MN and it sparked a few things.

Good luck with what you decide next OP x

allchatnicknamesgone Fri 17-Oct-14 12:54:33

Oh forgot to mention. Whist at egg collection, the embryologist even asked us if we really wanted icsi because his swimmers were fine and it didn't really warrant it.

EricaJ Mon 20-Oct-14 18:20:13

My 'unexplained infertility' (2.5 years of TTC, one mmc and one cp ) turned out to be asymptomatic endometriosis, that could only be diagnosed with a laparoscopy...

I got pregnant 2 weeks after the lap. Unfortunately I went onto miscarrying at 7 weeks so we are sort of back to square one and wondering if we should be worrying about recurrent mc (got tested for that too, all came back clear) instead of infertility. But that's a different story.

Two gynos told me to 'just relax and it would happen'. Only the third one decided a lap was worth it. It made me think that maybe 'unexplained' is much more rare than we think, more a case of 'cause not found', which is not quite the same thing.

Nicolae82 Tue 21-Oct-14 19:40:09

Hi, I feel your frustration but want to tell you that there is light at the end of the tunnel. I started trying for a baby in August 2011. I had come off the pill months before to help prepare my body. But after 6 months even, I got a suspicion that things weren't right. I never had a positive on ovulation tests. I gave it a year and went to the specialist and after various tests, said it was unexplained infertility. I was ovulating according to my day 21 progesterone. I was getting completely beside myself, like I had no control of my body and felt like I'd never get pregnant. The dr told me to try for 2 years and then come back. I walked out there sobbing my heart out as he couldn't do anything. In June 2013 I started acupuncture for infertility as a desperate measure, and I was very sceptical. In august, after 3 treatments, I got my Positive pregnancy test. I am convinced it was because of that. My friend started accupuncture at the same time as she had been trying for 18 months and she fell pregnant as well after 4 treatments. Coincidence? We will never know, but I would advise anyone to give it a shot.

I had a healthy pregnancy and gave birth to my beautiful daughter in May.

I just wanted to say that I was feeling like it was never going to happen, reading discussion boards in desperation. But it will happen to you.

Best of luck.

tigerdog Wed 22-Oct-14 06:44:34

I am also unexplained and feeling a bit fed up. I think not having an identified reason, for me at least, means I feel like I have to try everything that is in my power even if there is no science to it whatsoever. No idea what is behind our unexplained diagnosis though as Day 3/21 tests all very good, OH sperm excellent, no blockages, normal uterus, no endometriosis (had a lap to check) and now just waiting for IVF after 21 months and no joy. I am having acupuncture, do regular yoga, have gone gluten free, given up caffiene, have started therapy to try and address any anxiety/stress issues that may be causing an emotional blockage. Next thing to try for me will be a juice detox and completely give up refined sugar (chocolate is my vice). I still also have the odd glass of wine too but thinking I'd better drop that guilty pleasure too.

Daft thing is, I feel as though I can get pg but it just isn't happening. The only worry for me is that with Coeliacs in the family, that I have an undiagnosed autoimmune disorder.

Anyway, that was quite a theraputic rant! Good luck to those of you waiting and lovely to hear the success stories.

Jenniehudson Thu 22-Sep-16 16:13:47

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