Unexplained infertility options - advice needed please

[Goldendoodlelover]

Hello - wondering if anyone can help me with a few qs about unexplained infertility… I’m 30, have been TTC baby number 1 for about 11 months now with no luck/bfps.

I decided to have a fertility MOT just to check everything is OK: husband’s sperm analysis came back fine, all my bloods/AMH were normal, the ultrasound did show I have polycystic ovaries but apparently I don’t qualify for PCOS because I am having regular-ish periods (28-34 days) and I have normal testosterone levels (although I do still really struggle with hormonal acne in the luteal phase)

I had my day 21 progesterone taken this month and it was 25.3. I thought over 30 was indicative of ‘strong’ ovulation but doc is insisting 25 is fine (my BBT and OPKs also suggest I’m ovulating) and I actually think I ovulated late this month (day 18 or 19) so I guess 25.3 is good given the test was technically early?

Anyway the doc has said that the only other test they can offer me is a HSG/Hycosy to check my tubes, and if all clear then it’s just a waiting game until we feel ready to try IVF.

No mention of giving Clomid/Letrozole a go (I assume because I am technically ovulating?) or IUI… it just feels like an enormous step to go from no treatment at all to IVF (and I swear there are other tests on offer like sperm DNA fragmentation?)

I’m wondering if I should ask for a second opinion? I always spot 4-7 days before my period (sometimes continuously, sometimes for one day and then I stop for about 5 days before my period, which always gets my hopes up that it’s implantation bleeding, sigh) and I mentioned this to my doc and she was also quite dismissive about this and said spotting is ‘normal’, but I’m not convinced?

I’m wondering if there’s something I’m missing here - not sure if I am looking for an answer just so there is something to ‘fix’ (rather than the endless emotional rollercoaster of trying each month) I know 11 months isn’t that long in the grand scheme of things but 2 of my best friends / bridesmaids at my wedding last year got pregnant within the first month of trying, and my sister in law just announced her pregnancy, so am struggling a bit.

Any advice or similar stories would be much appreciated!

Hey there,
best of luck getting pregnant. I am taking some courses in nutrition and have come across the idea that a keto diet can help with unexplained infertility.
Take a look here, and see if you find it worth a try.

Sorry to hear you're having a tough time. I'm no expert but I'd definitely recommend you do the hycosy - even if no problem is found I've heard lots of stories like yours where women get their bfps immediately following one as it seems to clear out the tubes a bit (unfortunately not in my case, but worth a go).

I'd also recommend getting a second opinion about the spotting. It might be normal in the sense that it's not unheard of, but I find it hard to believe that it doesn't indicate your progesterone may be too low to sustain a pregnancy, you may just need cyclogest or similar to support your luteal phase.

I'd also be questioning the direct move to IVF. Just because you ovulate doesn't always mean the egg is mature enough to fertilise or implant, leteozole is I'd say worth trying (given the relatively lower cost and stress compared with IVF) - I know of other women who have been prescribed it even though they were already ovulating themselves and it worked for them.

Excuse any gaps in my memory because my clomid child was born 21 years ago.

Your husband’s tests came back fine? Which one? When we were going through unexplained infertility DH had to provide a sperm sample and all the test measured was number of sperm.

Jump forward quite a few chapters we had to do the deed at about 5.00am. Me not shower and report to hospital very early. There the some sperm was drawn off from my vagina to be looked at under a microscope. They encouraged us to look at all the little swimmers too 🤮 . Test shows DH sperm was swimming just fine in my juices.

Bizarrely that was the shag that resulted in DD2.

Not exactly a romantic beginning

@LavenderSweetPea I think you’re right, I have also heard a Hycosy can boost your fertility for a couple of months as it flushes/‘clears’ out your tubes! I have heard that it is not a particularly pleasant procedure but I think I just need to pop a couple of painkillers and give it a go. I think Letrozole is worth a try as apparently it can give you ‘stronger’ ovulation / regulate it (at the moment I currently ovulate anytime between day 13 and day 21) or try a mediated IUI - IVF just seems like such an expensive last resort and I’m just psychologically not there yet but also not loving the rollercoaster of the two week wait!

@fortifiedwithtea he had his sperm volume, motility and morphology all analysed and they all came back within normal parameters - perhaps on the low side of normal but apparently no cause for concern! The sperm test you had sounds… interesting?! A good story to hopefully tell any future grandkids though…!

Hi @Goldendoodlelover i know this is an old thread but just wondering how you got on? What interventions have you tried if any?

@Pep1952 heya so after 15 months ttc I actually fell pregnant in February! I had a Hycosy in December and then my original doctor basically diagnosed me with ‘unexplained’ infertility and told me to come back when I was ready to try ivf and said there was no point in me trying letrozole as I was already ovulating. Anyway I wasn’t super happy with this so I found a different doctor who did a monitored cycle and said she thought my progesterone was a bit low and so she gave me progesterone from 1dpo and boom fell pregnant! Am now 27 weeks and my advice is basically never to be afraid to ask for a second opinion!

So happy for you @Goldendoodlelover ! Good job on getting that second opinion. Really pleased it ended up being a relatively simple fix with your progesterone :) that doctor who said to go straight to IVF should really go through a bit of training 🙄

@Goldendoodlelover congratulations!! I’m soo happy for you xxx