Unexplained infertility - after 3 years of trying.

[seaviewasia]

Hi there, just wondered if anyone is in a similar situation to me. I have unexplained fertility, in perfect health, all my tests including FSH levels, Lap and dye tests have all been perfect. I am 34 years old and we have been TTC for 3 years. Doctors tell me I am a picture of health. I have regular 28 day cycles - almost always to the day. I have never had a missed period, been pregnant or been on the pill. My husband's tests all came back normal too. He is 39.

I was slightly underweight and in order to qualify for IVF on the NHS I have had to put on 3kg. I am half a kg away from normal weight.
I was always extremely relaxed about getting pregnant but I am beginning to feel the pressure after trying naturally for 3 years. I will be 35 in January.
I have now been referred via the NHS to have IUI/IVF but after 3 months I am still waiting for an appointment. I also have an appointment with a private clinic this week as I feel I need to move things along now.

Just wondered if anyone here has been in a similar situation. Would you have IUI first before IVF if you were in my situation?

Unexplained subfertility is actually no diagnosis at all. It basically means that they have failed to find out what is wrong. Sometimes it is a "diagnosis" given to couples when not enough investigative tests or thorough enough investigations have been done.

The fact that you've now been referred for IUI and IVF could well indicate male factor problems or equally they still don't know why the subfertility is happening.

How many tests have been carried out on both of you within the last six months, any test result older than this should be discounted.

Some private treatment is poor as well as expensive; I would be asking them lots of questions as to your actual suitability as a couple to undergo either IUI or IVF. Both of you without question should attend this appointment. It is vitally important that you can all work as a team whether you are private or NHS.

The most common tests that tend to be omitted are:-

Adequate x-rays of the uterus which may show abnormalities not otherwise seen at laparoscopy.

Hysteroscopy - telescope inspection of the inside of the uterus which may occasionally show abnormalities not seen otherwise

Repeated sperm counts over several weeks and months to make sure there is no subtle abnormality

Testing the sperm in special media such as swim up tests and velocity testing. However, when they are done, they often uncover a hidden cause for the suppposed unexplained problem.

Thorough hormone tests to detect abnormalities of male hormone or early falls in progesterone.

Scanning of the ovaries to see if follicles really are developing and there are no sign of polycystic ovaries.

Hi there,

Attila - thanks for the tips.

I have had all the tests you mentioned. Everything came back fine. PCOS has been ruled out.

My husband has only had 2 sperm tests though but everything was fine. I have never heard of the hormone test to detect abnormalities of male hormone or early falls in progesterone.

Thanks for the tip. I will mention it when I go to the clinic.

Would love to hear from anyone who has a similar profile and also going through IUI or IVF.

I have a friend who was in same boat; infertility never explained. She fell pg first NHS IVF attempt (aged 38) and now has a beautiful daughter and will try for another DC. Try free IVF first? Good luck. X

Hi Seavie - I've done several rounds of IUI (unsuccessful) but I am on the ttc 10+months thread and one person on there has just had success with iui after 2 yrs of trying, so we know it can work for the right candidate. They say you should give IUI 3 or 4 goes and if that doesn't work then it probably won't work. I guess in terms of whether you do this depends on how you feel about waiting. I'm planning to go for IVF at the end of the year (been trying for 2.5yrs now - tried iui and all sorts of things) and I'm now wanting to rush things after receiving my AMH result which has fallen off a cliff since I last got it tested. However, I am basically unexplained as this wasn't an issue last year.
I did IUI because it felt like the next natural choice although I probably wasn't a good candidate as my husband's sperm is pretty good and I had got pregnant pretty quickly to begin with (although m/c'd) so i don't think i have have hostile mucus.

Anyway, I'm not sure whether this is helpful. You may not want to jump straight in to ivf so perhaps iui is worth a shot. Anyway If you want to join the ttc 10+months, you are more than welcome do so. We are a friendly bunch and most of have been trying for over 2 yrs and many are unexplained and between us we think we know more than the doctors!!

Best of luck

Hi Seavie I'm In a similar position to you except I'm 5 years older. I'm currently going through IVF for the first time. We're unexplained too and have been trying for as long as you too, neither of us has any issues with our results. I did a lot of reading up on the iui vs IVF, from what I can remember iui has a much less success rate than IVF, if I recall it's something like 20% compared to about 50-60% for someone under 35, so that's a big difference. I guess it's something you can get clarified if you do have your private consultation soon. I also remember reading that the length of time becoming pregnant is statistically better with IVF vs iui. We weren't given an option and I guess that must have been because of age, we've been given a 30% chance of success.

Would be worth chasing up your appointment on the NHS 3 months sounds like a long time, perhaps you could then compare the advice, also some clinics will have better success rates than others so that's something to consider too.

Good luck with it all x

Hi seaview
snap snap snap
there are a whole host of us on the Mid 30s, TTC#1... thread
x

Thanks everyone for the responses. Wow! I am new on here and quite overwhelmed by how many people replied.
I am keen to do IUI first because I feel it's the more natural approach despite the low success rate. I don't know if it's true but a very good friend of mine who is a fertility acupuncturist tells me IVF babies are not the same. I will eventually go down the IVF route if IUI is not successful but her advice really concerned me.

I will definitely chase up the NHS route.
Thanks for all your suggestions and insight. I will move over to one of the other threads.
Hope to see you all there.