This can be a devastating and incomprehensible diagnosis to receive.
These couples are often told, “everything looks fine”; “you’re both perfectly healthy and should be able to conceive”; “just relax and it will happen”!
Many couples who seek my expertise after being given this news, say that they feel terribly upset and at the same time frustrated that they don’t have any tangible reason for this diagnosis.
They believe that because they don’t know what’s causing this problem, it is out of their control and this gives them a sense of hopelessness.
It’s important to know that the diagnosis of unexplained infertility can only be made, ‘after a couple has been trying to conceive for at least one year and has had comprehensive investigations done.’
This means that all the tests the couple have had indicate that she is ovulating, her fallopian tubes are not blocked and his sperm has ‘reasonable parameters (number, motility and morphology)’… and so it appears, there are no identifiable reasons for their inability to conceive.
In my opinion, the term ‘unexplained infertility’ is not accurate. It suggests there is no chance that the couple will conceive.
I prefer the term unexplained ‘sub-fertility’. This more accurately explains the fact that there is still hope the couple will conceive because they may have a few milder issues that need to be uncovered and addressed, rather than one major obvious factor. I usually tell my patients that in actual fact, there may be identifiable reasons that can be explored.
Unfortunately the diagnostic testing we have available to date, can only identify some of the major reasons a couple may have difficulty conceiving, but they aren’t able to identify all the reasons.
In my experience, there are often subtle factors (affecting both partners’ health) that could impact conception.
I always take a thorough history of each and every patient.
I intensely analyse their pathology results (blood, urine, sperm) according their medical reference ranges which apply to the general population as a whole.
In my experience, these ranges are too large and not specific enough for me to be able to identify and hone in on irregularities or imbalances from a fertility perspective.
After many years treating couples who have been diagnosed with ‘unexplained’ infertility, I have formulated my own reference range which is specific to the needs of my fertility patients. I call it my ‘Optimal Pathology Reference Range for Fertility’.
My suggested ideal reference window is much narrower than the general reference range.
During the consultation, I will address each and every result that doesn’t satisfy my requirements and discuss it with the couple in front of me.
And if necessary I might suggest other tests to be done – such as Functional Medicine, Genomic, Gastroenterology, additional Thyroid tests or possibly Microbiome testing.
Once I’ve collated everything, I will be able to work out a treatment regime that should address all the inadequacies, deficiencies or imbalances I have detected. These may include nutrient deficiencies, metabolic, hormonal imbalances, degree of stress, generalised inflammation and environmental toxin exposure.
I will then give the couple appropriate individualised lifestyle and dietary advice as well as a prescription for whatever I feel is necessary to help improve their overall heath and fertility.
I always make sure the couple understand that the whole process is a team effort. They will need to work with me to make appropriate changes to improve their health and hence their chance of a successful outcome.