The Puzzle of Unexplained Infertility: Navigating the Unknown

If you’re dreaming of starting a family, the emotional rollercoaster of trying to conceive can be overwhelming, especially if you’ve been trying for a while. When all medical tests come back normal, and the cause of fertility struggles remains elusive, it can be even more frustrating and disheartening. 

Unexplained infertility accounts for 1 in 4 cases of infertility. Dealing with infertility can take an enormous toll on one’s emotional well-being, and unexplained infertility adds an extra layer of complexity. While the term “unexplained” implies a lack of known causes, there are several factors that may contribute to unexplained fertility. It is important to remember that if you’ve been given this diagnosis, there is always a reason, yours just hasn’t been found yet.

These reasons could include:

Vaginal Health: The vaginal microbiome refers to the community of microorganisms, living in the vagina, these fluctuate throughout your cycle. Research has shown that the dominance of Lactobacillus in the vaginal microbiome plays a vital role in fertility outcomes. Women with a dominant Lactobacillus vaginal microbiota (≥ 90%) have a higher success rate in both term pregnancy and live birth rate.

Women that are low in lactobacillus have more chance of picking up a vaginal infection, as there is not enough of the good bacteria to fend off the bad. If there is an overload of pathogenic bacteria in the vagina we can only assume it must exist in the uterus, this can have a negative impact on fertility. Often there can be no signs or symptoms that this pathogenic bacteria is present. A vaginal microbiome test can be carried out to assess the different levels of bacteria present. 

Undiagnosed Conditions: Endometriosis is a condition where cells that make up the endometrial lining are found outside of the uterus, these bleed during a period just like the endometrial lining, this can cause severe pain. In the bodies attempt to get rid of these cells the immune system is called in releasing cytokines which are the bodies way of reacting to a perceived threat, this can be harmful for fertility. Endometriosis can cause wide spread inflammation harmful to our developing eggs. It is thought that undiagnosed endometriosis is responsible for up to 25% of unexplained infertility cases. Ways to diagnose endometriosis are through a laparoscopy or an MRI scan. 

Undiagnosed Thyroid Conditions: The thyroid play a large role in our fertility hormones and left untreated can cause fertility issues and raise the risk of miscarriage. Having a full thyroid test means not just testing your TSh levesl but also your T3, T4 and antibodies. 

Immunological Factors: it is possible that the immune system, specifically the immune response to sperm or embryos, may play a role in unexplained infertility. 

Hidden Male Factor Infertility: While the male partner’s semen analysis might appear normal, there could be undetected issues with sperm function, such as reduced sperm DNA integrity or impaired ability to fertilise an egg. It is important to fully investigate male fertility by having a DNA fragmentation test and a semen culture to rule out an infection that could be impacting fertility. 

If you’ve been diagnosed with unexplained infertility then keep pushing for answers. Often couples are told IVF is the only option, but without understanding and getting to the bottom of what is causing their fertility struggles, IVF is often unsuccessful. 

Other methods such as fertility acupuncture, herbal medicine, nutritional supplements and mind-body techniques (meditation, yoga or mindfulness) can be really helpful for individuals or couples going through this process, and supporting you to find the answers you need. 

If you would like to find out more about fertility acupuncture and the services I can offer, then please book into a complimentary 15-minute consultation here.

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