Is this unexplained infertility?

[shortgreengiraffe]

I'm 33. Been TTC for 18 months. Very irregular cycles. Dr did some tests and I've just been back for the results - they are all normal and blood test showed I ovulated. OH's sperm analysis all normal too.

Dr has referred me to gynecologist as said there's nothing else she can do at this stage, with a view to starting the ball rolling for IVF. I don't know whether to feel positive that there doesn't appear to be anything wrong or upset that whatever is wrong isn't easily treatable.

I cried in the surgery which I am very embarrassed about. I haven't told anyone in real life so she is the only person I have ever spoken to about it which is I think what made me so upset.

Does anyone know what happens from here? I feel so out of control of the whole thing.

I'm in a vaguely similar boat: ttc 17 months without any clear answers yet.

My advice would be to become your own advocate. Learn about the blood tests they're doing. You said irregular cycles, that means irregular ovulation. What day did they check for ov? What did your day 2-5 tests say and what specifically did they test for? At this point, all of your results might be normal but in combination with more tests, they might identify a slight issue (and it only takes a slight issue to delay conception). Have you had an ultrasound? This may reveal something...

It might only take something like clomid to help with ovulation?

Some people find relief from starting tests as they feel everything is then out of their hands - control is given away. This can be liberating. Or if nothing is found, it can be utterly crushing. I found that when my thyroid came back as fine... there are no answers. Hugs. Be kind to yourself.

Thanks @physicskate for replying.

I think I need to take OH with me next time I have an appointment. I thought it would be better on my own but I just end up getting upset and then can't really think straight on anything.

I've had an ultrasound (clear) but not the thyroid test. There are thyroid issues in my family which I did mention but they haven't tested specifically. Maybe I should ask?

Hi there, I was in your position before. I think they technically class it as "unexplained infertility" when you've been trying to conceive for 12months with no positive result. I don't think it's an accurate description though because it doesn't mean you're infertile, just that it's taking longer or you might need some help to get pregnant. The word infertile just seems so final and absolute!

It is so hard not to get emotional about it. Maybe write a list of questions you have next time you visit the gp. Ask for the thyroid test and ask for repeat day 3 and day 21 bloods. These results can vary month to month anyway so it's good to have them done more than once.
Find out what tests the specialist will do and the timeline for being seen- that should give you something to work towards. Best of luck

Thank you Whereland that's a good idea about writing things down too. I'm very fortunate and until now I've hardly ever been to the GP so I don't always know what to expect.

Hi shortgreengiraffe thanks for sharing! Im in the same boat I'm 37, been trying for over 2yrs & eventually went to the docs. OH sperm tested (all ok), I've had blood & urine tested (ovulating and egg count higher than average), had a HSG (showed a little spillage) then had an ultrasound (all ok) but have no idea what the outcome is?? Fed up and frustrated as all my friends (and a family member who wasn't even trying) have recently had babies. Sending you luck for answers and your dream outcome in the future xox

I am in same position unfortunately! 36 and been ttc for maybe 3 years, 2 of which we've been on the NHS trying to find reasons for why we haven't conceived. Initially they believed it was lack of ovulation but I think I'm just a late ovulated and the day 21 blood test was mistimed for me. Since then I've had every test related to inferitluy and there is nothing "wrong" with me or my partner. I am provisionally scheduled for first round of IVF in September.
As other ppl have said, you have to speak up and be your own advocate, GPs aren't specialist so you need to be referred for further investigations other than the standard blood tests, usually this is an assisted conception unit attached to a hospital. Make the appointment with yr GP, take yr partner and ask to be referred. It could be a simple fix such as regulating your ovulation through diet or even drugs like clomid. If you can afford to go private then do it, I wish I would have a year ago, that said, my clinic are very good. Best of luck, it's a long, winding road but you will get there!

Thank you for replying. It's nice to chat to others in the same position but of course I wish none of us were here.

The doctor I've seen is lovely but I don't really know what tests have been done. I had two swabs (one chlymidia, one unknown - both clear) two bloods (day 2-5 and another which showed I had ovulated) and a scan which showed I don't have PCOS.

Please can I ask what some of the other tests mean? I won't be seeing the doctor again but I have been referred to the hospital so would like to be prepared with my questions.

How do you know what your egg count is? I don't think I've had that test. What's HSG and spillage? Sorry to sound naive but this wasn't an area of expertise I ever planned to gain.

I've considered asking my parents for the money to go private. I know they have it and would give it to us without question but that would involve me telling them which I haven't. They so want to be grandparents and I feel like such a failure for not being able to give them that.

Day 3 bloods can't possibly show you ovulated in the previous cycle. Also, if you have irregular cycles, then it's blinding obvious that there definitely is a problem. PCOS is pretty complex and not all the same for everyone. I would ask the surgery for a copy of all the tests that you had. Also, a scan would have identified numbers of follicles, their sizes and any problems. Do get a copy of your husband's semen tests too and don't take 'fine' for an answer. I've heard 'fine' from doctors before and some off the time it was a complete and utter bull when I looked at the actual results.

Just how irregular are your periods? When your GP said you didn't have PCOS, did he test for insulin resistance, LH to FSH ratio, testosterone levels etc? Do you have any physical symptoms?

I had a HSG on my second appointment with the fertility nurse. It was like a smear, but they check your tubes are open by inserting a dye which shows up on X-ray. Was a little painful (just like period cramps) one tube was open but one tube on the X-ray showed the dye had spilled slightly and was told that had to be confirmed by the consultant. When I was at that appt I asked the results of my blood test & urine test from first fertility Hosp appt .She had all that on file and went thru my results to date which showed my egg count as I was worried about my age! About the HSG I heard nothing from consultant then got a letter 2 weeks later for ultrasound which I was told was fine? But haven't heard anything else so I'm waiting to see gynaecologist next month. The urine test was for immunity to rubella. If I could give you any advice then speak up and ask as much questions. I find NHS choices website useful. Even write things down in advance? So far the staff have been helpful and empathise but I still have a lot to ask but don't want to bother my GP. The waiting game is frustrating!

P.S your not a failure! Having this forum has gave us all insight it's not easy but glad we have somewhere to chat on this taboo subject, really hope everyone gets there dreams soon! Love to you all xox

Sorry I wasn't clear - I had day 2-5 bloods and another test for ovulation which showed I had ovulated. I have had a previous test for rubella (showed I am immune) so no need to do that again. I think the scan only tested for PCOS which came back clear. Definitely no test with the dye or any other hormone tests. Perhaps they'll happen when I am referred to the hospital?

Periods are irregularly irregular! Sometimes have a few cycles of a pattern then can have a 70-day cycle. Its always been like that so can't blame the stress of TTC.

Good point about sperm test, will ask for more info.

I know there are far worse things that can happen and I consider myself lucky in life, but this is hard and I really hope all of us here get what we are aiming for.

Sounds like your ovulation is very much a mixed bag. You're likely to ovulate on the normal-ish length cycles but a period after 70 days is likely to be a bleed that hormones eventually cause without you having ovulated ( from what I read somewhere just because a friend is going through a similar struggle).

And do let yourself feel shitty about the whole thing. It's a real challenge with these things and some people get seriously depressed over it. Personally, DH and I have been doing regular counselling to cope.

You are not unexplained; there is a cause for your very irregular cycles which they have not found yet. Thyroid problems and a condition called polycystic ovaries or its related syndrome can cause irregular cycles. Blood tests done on the wrong days can give meaningless results; what hormone levels did this person originally test?. On the day 3 test (if you have irregular cycles these tests can be done according to calendar days) they should have compared your LH (luteinising hormone) against your FSH (follicle stimulation hormone) levels. If that was not done its meaningless; these levels can be ok if not compared. Blood work re the thyroid gland should also be properly done too.

Taking your man along to future appointments can help no end; these, particularly the initial appointment which is a chat, can make people bags of nerves and he can also ask questions and give moral support.
Your doctor has done the best thing here by referring you on; you need a diagnosis first and foremost. You will also need to be persistent in order to get answers.