Unexplained Infertility

[nova29]

Previously posted in the wrong topic so here I go again...

I was wondering if anyone has any advice or been in a similar situation as me.

I've been recently referred to the assisted conception unit by my gp, I have done all the usual tests so has my partner and all have come back normal and not shown any issues. I have regular periods and ovulate every month. The words that tend to keep being mentioned is "unexplained infertility". At my last appointment I was told I would be given Clomid for 6 cycles. I wasn't expecting to be given this and thought I would be doing IVF.

Is this normal procedure before they recommend IVF??

I'm nearly 33 and feel like I am running out of time, I've never been pregnant and have been trying for years...my partner and I have been together for 15 years and have never managed to conceive so we feel like Clomid is just a waste of time and would rather do IVF straight away instead of wasting another 6 months.

Hi, we have the 'unexplained infertility' label too - I'm sorry you find yourself here, it sucks.

We were referred straight for IVF after investigations. Tbh, if you're ovulating regularly I'm not sure what Clomid would add for you. Maybe ask the assisted conception unit to explain their rationale for it, and explain that you're keen to progress to IVF instead?

@Scirocco

Hi, we have the 'unexplained infertility' label too - I'm sorry you find yourself here, it sucks.

We were referred straight for IVF after investigations. Tbh, if you're ovulating regularly I'm not sure what Clomid would add for you. Maybe ask the assisted conception unit to explain their rationale for it, and explain that you're keen to progress to IVF instead?

Thank you for replying.

I feel the same too, I'm not convinced with the Clomid. The only explanation we got was that IVF was very intrusive which I do understand. I did try to explain that we were keen to go on to IVF as we have been together for so long and want to start this next chapter in our life but it kind of went unnoticed.

Thanks again for replying!

Hi there,

Unexplained here too. We went straight to IVF. Luckily our doctor was very straightforward and told us timed intercourse or IUI's are useless in our case since I am ovulating every month. I have some issues with lining and egg quality and we haven't had any success yet, but at least I got some answers.
IVF is instrusive yes, but I think they should have listened to you, especially since you have been ttc for such a long time!
🍀

@Yuliaaa

Hi there,

Unexplained here too. We went straight to IVF. Luckily our doctor was very straightforward and told us timed intercourse or IUI's are useless in our case since I am ovulating every month. I have some issues with lining and egg quality and we haven't had any success yet, but at least I got some answers.
IVF is instrusive yes, but I think they should have listened to you, especially since you have been ttc for such a long time!
🍀

Hello, thank you for your reply this has been really helpful!

Unexplained subfertility is infact no diagnosis at all; all this means is that they have failed to find out what is wrong. It is sometimes a diagnosis given to couples when they as a couple have not been adequately investigated despite them thinking otherwise.

You need a diagnosis first and foremost.

What tests have been performed on both of you during the last six months?. Anything older than this should be discounted. Both of you need up to date test results as well as being more thoroughly investigated by a subfertility unit rather than say a GP.

Clomid is often prescribed when ovulation problems are seen. Did they at all explain their reasons for clomid?. It can have the opposite effect if you are indeed ovulating regularly (it should be proven by both blood tests and ultrasound scans).

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 testsvelocity 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

We were told "unexplained infertility" too and have been referred straight for IVF. It's frustrating for me because I do not have regular cycles (35-70 days) and although I did ovulate the month I had a blood test, I'm sure I don't ovulate every cycle.
When we had our consultation with the IVF clinic, our consultant said he is absolutely sure from my blood results that I have PCOS.
The problem we have now is IVF due to start in Feb 2022, so if I push back and ask for clomid instead, we could waste months and then end up back at IVF anyway 😞

@AttilaTheMeerkat

Unexplained subfertility is infact no diagnosis at all; all this means is that they have failed to find out what is wrong. It is sometimes a diagnosis given to couples when they as a couple have not been adequately investigated despite them thinking otherwise.

You need a diagnosis first and foremost.

What tests have been performed on both of you during the last six months?. Anything older than this should be discounted. Both of you need up to date test results as well as being more thoroughly investigated by a subfertility unit rather than say a GP.

Clomid is often prescribed when ovulation problems are seen. Did they at all explain their reasons for clomid?. It can have the opposite effect if you are indeed ovulating regularly (it should be proven by both blood tests and ultrasound scans).

Hi thank you for your message.

So within the last 3 months I have had all blood tests required which all came back fine. I've had a ultrasound to scan my ovaries and was told they looked great as well as the number of follicles. My partner has also done a semen analysis in the last 6 months, again everything is normal.

I'm currently waiting to do my second HSG test as the first time round they had difficulty inserting the catheter inside my cervix.

They did not offer much an explanation, only that IVF is very intense and before they offer it that they would put me on Clomid. I was taken by surprise and only later realised that Clomid is usually offered when there are ovulation problems so I didn't get the chance to question this.

Really considering going private at this point...

Thank you so much again for your reply this has been really helpful!

I was also in the "unexplained" category after numerous tests and went straight to IVF clomid was never even discussed.
I had one round of IVF and was very fortunate to conceive DD and then DS was a spontaneous conception when she was 18 months, so second the above that there's no such thing as unexplained just we haven't worked out whats wrong with you yet (and likely never will).
Good luck x

Also unexplained here. My cycles are like clockwork and I ovulate every month so I was referred straight for IVF. If you're the same then clomid is a waste of time and money for you and the NHS. Can you go back and tell them you're certain you ovulate so clomid is unlikely to help, and that you'd like IVF? Seems worth a try before paying for private.

Whatever my problem, it was overcome with IVF on the first attempt. Frustrating though it is, there are reasons to be hopeful when infertility is unexplained.

I was in a very similar situation of unexplained fertility and had very regular cycles. I was given clomid for 3 months before eventually starting IVF. I did a lot of reading around the subject (note I am a pharmacist so couldn't stop myself) and there is plenty of evidence to suggest that clomid does increase the chances of conceiving in women who ovulate regularly. The theory is that it will help to stimulate the release of 2-3 eggs rather than 1 therefore increasing the chances of 1 fertilising. I believe that a lot of NHS fertility services are trying clomid first as an alternative to IVF initially as it is significantly less invasive and also because of the COVID backlog.

My "unexplained infertility" turned out to be endometriosis after I insisted on a proactive investigation (lap). I was already scheduled for IVF just after the op but that sadly failed. I did however get pregnant naturally 4 months later. This was after having tried with zero success for over 4 years. Worth checking for endo if there seems to be no other obvious cause.

Hi Following!!! We have the same issue. We are trying to get baby No.2. It took us 2 years to get number 1. I'm 34 and again feel I'm running out of time @nova29 it's stressful. We're due our "basic" tests but I have been asking the same question! What's to they do and how is it assessed if there are no identifiable problems. It's disheartening and exhausting!! I feel your pain.

I understand as it's baby No.2 for us we will have to go private for our fertility treatment if needed.

Hi @nova29 my situation may be slightly similar to yours, I've never had a positive pregnancy test. My day 3 and day 21 blood were normal, my ultrasound showed a really good antral follicle count. My husband sperm sample had amazing numbers. We went private after a year of tracking and timing intercourse perfectly, my cycles are regular, I ovulate every cycle, we always caught the most fertile time and yet I never implanted.

Nobody offered clomid to me and even if they did I think I would've seen this as being a waste of time, to some extent IVF can be diagnostic...

During my fresh cycle it became clear that me and my husband create the embryos of 20-year-olds, in the cycle we had nine blastocytes, all high-quality, but when an embryo was transferred it didn't implant. In the next frozen cycle there was also no implantation. And then I had all my tensing embryos tested and 83%, I was 35 years old during the collection so this was an amazing result. This all indicated that the issue isn't the embryo for us, there's a problem with implantation.

I had a lot of investigations and so far the only explanation seems to be my microflora. There are tests for this. I'm unfortunately on my 3rd test since my microflora was as bad as it could get on the first two.

If I were you I would be pushing to move forward to IVF, hopefully it will become clear if this is an embryo quality problem or an implantation problem.

@ChristmasJumpers

We were told "unexplained infertility" too and have been referred straight for IVF. It's frustrating for me because I do not have regular cycles (35-70 days) and although I did ovulate the month I had a blood test, I'm sure I don't ovulate every cycle. When we had our consultation with the IVF clinic, our consultant said he is absolutely sure from my blood results that I have PCOS. The problem we have now is IVF due to start in Feb 2022, so if I push back and ask for clomid instead, we could waste months and then end up back at IVF anyway 😞

Hey thanks for your reply.

It's really not easy trying to decide which route to go down, I feel the same should I waste another 6 months or decide to go private and not do Clomid.

Good luck on whatever you decide!

Oops at the typos in my comment, it was supposed to say, we had the remaining embryos tested and 83% were euploid.

@ArtfulScreamer Thank you for your reply! Hoping to have a success story like yours x

@Holskey I'm the same too, regular cycles between 28-31 days and ovulate every month. So at my last appointment they made it clear I would only be able to do IVF after trying the Clomid first. My next appointment is coming up soon so I will try to push for IVF and see what they say. Thank you so much for your reply!

@CEH1305 Thank you so much for your reply that is very helpful!

@Confused521 thanks for your reply. Will give that a mention at my next appointment.

Yet another unexplained infertility person -as others have said it’s not even a real diagnosis, just doctors don’t like to say they don’t know what the issue is. Cynically but l think Clomid a lot of the time it used to make people shut up and go away for a bit. All it did for us was give me ovarian cysts

@Pinkmini21

Hi Following!!! We have the same issue. We are trying to get baby No.2. It took us 2 years to get number 1. I'm 34 and again feel I'm running out of time *@nova29* it's stressful. We're due our "basic" tests but I have been asking the same question! What's to they do and how is it assessed if there are no identifiable problems. It's disheartening and exhausting!! I feel your pain.

I understand as it's baby No.2 for us we will have to go private for our fertility treatment if needed.

Thanks for the reply and good luck on baby no.2!

@Gardenlady543

Hi *@nova29* my situation may be slightly similar to yours, I've never had a positive pregnancy test. My day 3 and day 21 blood were normal, my ultrasound showed a really good antral follicle count. My husband sperm sample had amazing numbers. We went private after a year of tracking and timing intercourse perfectly, my cycles are regular, I ovulate every cycle, we always caught the most fertile time and yet I never implanted.

Nobody offered clomid to me and even if they did I think I would've seen this as being a waste of time, to some extent IVF can be diagnostic...

During my fresh cycle it became clear that me and my husband create the embryos of 20-year-olds, in the cycle we had nine blastocytes, all high-quality, but when an embryo was transferred it didn't implant. In the next frozen cycle there was also no implantation. And then I had all my tensing embryos tested and 83%, I was 35 years old during the collection so this was an amazing result. This all indicated that the issue isn't the embryo for us, there's a problem with implantation.

I had a lot of investigations and so far the only explanation seems to be my microflora. There are tests for this. I'm unfortunately on my 3rd test since my microflora was as bad as it could get on the first two.

If I were you I would be pushing to move forward to IVF, hopefully it will become clear if this is an embryo quality problem or an implantation problem.

Hello, thank you for your reply. The more I read the more I'm getting the sense the Clomid is maybe to buy them time before doing IVF but for me seems like a waste of time.

Me and my partner have been together for 15 years and only used protection in the first year and none after that, I have never been on the pill. We have never had any pregnancies or miscarriages. Considering all this it still doesn't make sense why Clomid.

I will try to push for IVF at my next appointment and if not successful will go private.

Thanks again for sharing!

@nova29 I think pushing for Ivf is sensible, when we first saw the fertility clinic the specialist told us we should just keep trying and I said no that I knew something was wrong and I wanted Ivf, she said that since we are private patients that fine. That was September 2020, since then I've been through 1 unsuccessful fresh cycle transfer, 3 unsuccessful frozen transfer cycles and tried naturally inbetween and yet I'm no closer to a child now than when I first saw her, at least I have an idea of what the issue is though, so going away and trying as she advised us to wouldn't have achieved anything but delay us further.

@NorthSouthcatlady

Yet another unexplained infertility person -as others have said it’s not even a real diagnosis, just doctors don’t like to say they don’t know what the issue is. Cynically but l think Clomid a lot of the time it used to make people shut up and go away for a bit. All it did for us was give me ovarian cysts

I agree with you I think it is to make people to go away for a bit and end up choosing to go private to speed up the process Sorry for hear about your experience on Clomid x

@nova29 yeah that too! I’m sure they love it when people go private, let’s be honest and realistic the NHS doesn’t want to do IVF. In your shoes l would crack on with IVF

Hey there! @nova29 may I ask for an update please?

I'm 35 and would love to hear about what your experience

@gianaInfertilitySucks Hi!! So I done my 1st round of IVF in February, collected 7 eggs that all fertilised. 3 made it to day 5 blastocysts. I had a fresh transfer which failed. I'm currently on my tww for my frozen transfer, will find out this week if it's worked or failed again.