I am beyond grateful to be pregnant with my first child - a daughter due in May. I do however still hold a lot of anger and resentment and sadness about how our supposedly unexplained infertility was handled both by the NHS and our fertility clinic. I want to share our story in the hope it may help another couple as I know we will not be the only ones.
Not long after we started trying my amazing husband went to his GP about a varicocele he knew he had (look it up but this is an issue with the veins in the testicle that affects blood flow and can cause overheating). He requested a semen analysis which came back normal or low-normal on all counts. The varicocele was dismissed as unlikely to be affecting his sperm quality. However - the key big however - these basic sperm analyses do not test for dna fragmentation which varicocele is known to cause. I of course also went for initial tests which all came back fine.
Two years of trying later we went to a fertility clinic and they tested me a lot (surely it must be a woman problem!) but did not run any further tests on him despite knowing about the varicocele. Like many clinics they are all gynaes. Not one urologist in the team. DNA fragmentation testing was not even available there. Given the supposedly unexplained nature of our infertility and not wanting to delay things further (I was 35 then) we ended up starting ivf. This was thankfully successful for us with our third embryo (first fresh transfer failed and second embryo failed to survive the thaw then the third one stuck after a natural modified cycle using my own hormones).
Throughout ivf I still wanted to know why we could not get pregnant naturally given we hope to have another child in the future. So a few days before our successful embryo transfer we went to see Dr Jonathan Ramsay who is one of the best people - let alone doctors - who I have ever met. He is so empathetic and knowledgeable and he made us feel listened to and validated for the first time. I so wish I had found him earlier but better late than never. I actually give him some credit for this embryo sticking because he made such a huge impact on my mental health which really helped to relax me. He confirmed that the varicocele was large and therefore definitely significant (his words) and ran a dna fragmentation test which showed high fragmentation. My husband has now had his varicocele embolised which we hope will improve his sperm quality. Our plan is to run another dna fragmentation test before we start trying for another child.
In short: had my husband been tested to the same extent I was from the start we may never have needed ivf. We are very lucky to have one more (low quality) embryo in the freezer which we may decide to try and use (especially if the next dna fragmentation test is still borderline) but if not then we are hoping to naturally conceive next time. Dr Ramsay believes this to be the unexplained explained.
Best of luck to everyone on this path as we both found it really really tough. The sense of loneliness and shame and feeing like the entire world was pregnant except me is not something either of us will forget. Oh and by the way - the little embryo that could was a 3BB.