Unexplained infertility and wanting to explore alternatives before IVF

[FeelinHopeful1]

We have been told we have unexplained infertility and doctor advises to proceed straight to IVF.

I feel like this is quite invasive and my last option on the route. Surely if there is nothing wrong from bloods / internal scans / semen analysis there has to be another way or another thing to try get to the bottom of it before IVF. Has anyone looked into restorative reproductive medicine and other tests I.e. nutrition, different bloods, sperm fragmentation etc. I want to try as much as possible alternatives first. Even IUI. My doc felt it would be a waste of time/ money.

On a separate note I feel like potentially it could be stress causing it and honestly feel like I wish I could try giving up my job for something less stressful and see if that was what worked.

TTC 18 months, have never had a positive pregnancy test, 32. Looking for someone in same boat.

I am in a similar boat (except a couple of years older). My hormone levels are all fine, uterus appears totally normal on scans, partners sperm test all good. My periods are totally normal and regular.

I had a hycosy to check tubes are clear and partner has been checked by a urologist (as he had some slight pain).

I felt the same way as you, but after a lot of research and discussion with my fertility consultant we've decided to proceed with NHS IVF before doing further testing. We decided this because:

• IVF for unexplained infertility has good success rates (higher than where a "problem" has been identified) so there's a good chance it will just work
• a lot of the additional testing you can do isn't routinely recommended by NICE because theres no evidence its effective. That doesn't mean it isn't in some cases, but we had nothing guiding us to do any particular test over anything else, so we could easily end up spending thousands on testing things essentially at random
• often the treatment when a problem is identified is IVF anyway
• our NHS fertility consultant basically said they wouldn't modify the IVF protocol based on the results of any additional testing we did, so we thought we may as well use our "free" try and then pursue more tests after if it doesn't work
• IVF can be diagnostic in a way, in that the process can narrow down where the issue is occurring (do you not produce enough eggs, does fertilisation fail, do embryos not develop, does implantation fail, etc)

My understanding is that IUI is only really effective in cases of poor sperm motility or if there are physical difficulties actually having sex. Otherwise the success rates aren't any higher than trying naturally.

Of course, it's definitely worth making sure all the basics are covered in terms of eating well, minimising stress as much as possible, making sure your weight is in a healthy range, etc. Limit drinking etc. You could check your husband doesn't have a varicocele (these can be surgically fixed which can improve sperm if it is causing DNA fragmentation - if DNA is fragmented without a varicocele then I think ICSI is the solution)

The other thing, my feelings about IVF changed a lot between the 18m and 2y mark. At 18m I was desperate to find the answer and fix the problem. Now I'm closer to 2y I've come to terms with it being unanswered a bit more and just want to get started with IVF because ultimately I want a baby more than I want to find the answer. Obviously that's a very personal decision but I would consider getting things rolling with being referred for IVF if you plan to do it on the NHS, because it can take a while and you can explore other stuff in the mean time privately if you like.

Thanks for the reply! It's kind of comforting in a way to hear from someone in the same boat. Never heard of the varicocele so will look into this... we had kind of said we would give it another few months of trying naturally before explore IVF but I think summer could be a good time to try because its a quieter time for me at work. I'm in Ireland so we don't have the NHS so have to pay privately unfortunately! I dont qualify for our free round in the fertility hub as weight is too high :( I am very active and eat healthy but BMI is putting me at 3 stone overweight. Trying to bring it down but takes time.

Lots of good points there and things to consider, thank you 😊

Maybe have a chat with Plan Your Baby and see what other options are. I spoke to them with my NHS blood test results and really felt that he (Dr Sami) took a lot of time to go through everything properly and brought up a few things that the NHS consultant hadn't mentioned. It gave me another couple of things to try before going down the IVF route.

They are online mainly so you can do a video call. I did a free nurse consultation first then a call with Dr Sami.

Funny, like @leaflake said, I was in a much better head space to consider IVF at 2 yrs vs 18 months.

We had unexplained infertility (although later on people did start to say male factor might be a problem but it was borderline). It took us 4 egg collections and four transfers (and 2 miscarriages) to have our much longed for baby despite everything looking okay on paper and I was relatively young (32 when we started IVF, 30 when we started ttc, 35 when I had my son). If you can get free rounds on the NHS I honestly wouldn't delay (assuming you're not opposed on moral/religious grounds to IVF) - you really cannot know how long it will take to work, even if there are no known issues. And as a PP said, it can be diagnostic in a way and start to narrow down what might be going wrong/where (e.g. is it that the eggs aren't being fertilised or developing right, is that the embryos aren't implanting etc).

Also echo a PP that if private diagnostic testing highlights a particular protocol or drug is needed, NHS often won't be able to include it (and you can't usually combine private and funded and just pay for the add ons yourself). That being said, if you're able and happy to go private and potentially lose your NHS funding in doing so then I can see some merit in undertaking some further testing/investigations to inform private IVF.

What about getting a second medical opinion? A friend of mine had success on her second attempt after switching to another clinic. It turned out that the first clinic had misdiagnosed her.

Hello!

I felt the exact same way about being pushed into IVF, a HYCOSY showed that I had a polyp and my left fallopian tube waa blocked. First surgeon we were referred to didn't want to check the tube but I pushed and ultimately he agreed. However, I didn't feel I could trust him, from the amount it took for me to persuade him so sought a second opinion.

Long story long, I had a laparoscopy and hysteroscopy 6 weeks ago and they found that I have a unicornuate uterus- a rare uterine abnormality which means one side of my uterus didn't develop when I was a fetus. I say this not to scare you but to encourage you to push and seek answers.

We are going do the RRM route, look up NaPro technology and Ireland have a good one from my research https://neofertility.eu/

Good luck!