Explanations for unexplained infertility
Are you frustrated by a diagnosis of unexplained infertility?
It certainly frustrates me when my beautiful clients are told by their doctor that all their tests are ‘fine’, and they should consider jumping right into IVF.
And while IVF may indeed be the best solution in some cases, this advice really overlooks the obvious fact that there are factors reducing a couple’s chance of conceiving. Just because these don’t come up on ROUTINE testing, it doesn’t mean the issue/ issues don’t exist.
I love this quote from the medical journal Best Practice & Research Clinical Obstetrics & Gynaecology
“There is a need for better understanding of unexplained infertility. Maybe all that unexplained infertility is not unexplained if better understood and assessed”
HELL YES! I couldn’t agree more.
That’s where I come in. Taking my magnifying glass and looking through the finer details of your diet, lifestyle, stress levels and blood tests to see what the REAL DEAL is.
And every time we find multiple things that we can improve to boost your chances of conceiving (either spontaneously or via IUI & IVF).
What exactly is unexplained infertility?
Unexplained infertility is defined as not having conceived after 12 months of trying, not explained by ovulation issues, poor sperm quality, issues with the fallopian tubes (like blockages or damage), infections or other clear fertility barriers.
Approximately 15% of couples struggling to conceive are diagnosed with unexplained infertility.
FLOW’s Naturopathic approach
If a couple present with unexplained infertility, it’s time for me to do my best detective work and figure out what’s going on. The main area’s I assess include:
Nutrient levels (via blood test assessment and dietary analysis)
I don’t just want your nutrient levels to be ‘normal’, I want them to be amazing. Maturing healthy egg and sperm in a nourishing environment requires optimal nutrient levels. The ideal levels of these nutrients are often well above what most labs consider ‘normal’.
For example, many labs consider a vitamin D value above 50nmol/L as normal, but studies suggest a value over 75 and even higher is ideal for fertility & a healthy pregnancy.
Diet
We know dietary patterns associated with abundant vegetable and fruit intake, vegetarian protein, fish, nuts, seeds and wholegrains supports fertility. The standard western diet is high in damaging oil and fats which impact fertility, and high refined sugars which directly compromise egg and sperm quality and may disrupt ovulation.
Auto-immunity
Auto-immunity is when the immune system makes a mistake and attacks the body's own tissues or organs.
Thyroid auto-immunity is commonly associated with fertility issues, and is not always picked up on routine blood tests.
Some other auto-immune conditions or markers associated with infertility include Coeliac disease, anti-cardiolipin antibodies, anti-sperm antibodies, and anti-nuclear (ANA) antibodies.
Metabolic health
Metabolic health is an overall term to describe the state of our blood sugar control, body weight and cardiovascular system.
It is well documented that blood sugar imbalances and diabetes, both high and low body weight, and issues with the cardiovascular system like high cholesterol and impaired blood flow can impact male and female fertility.
Stress levels
Studies show that both emotional (family stress, work and study stress etc) and physical stress (injury, illness) increase stress signals in the body which interrupt our hormone health and potentially damage our eggs and sperm.
Sleep patterns
Melatonin – our sleep hormone – is a potent anti-oxidant (protective agent) for our eggs. An disrupted circadian rhythm (think excess device exposure, irregular sleep patterns, shift work) can reduce melatonin and thereby decrease our eggs protective capacity.
Drivers of oxidative stress
The health of our eggs and sperm is closely related to the activity of anti-oxidants. I like to think of these as fire fighters who extinguish any reactive oxygen species, which are like ‘flames’ that can cause damage in the body when created in excess.
Factors that increase these damaging flames include smoking, pollution, endocrine disrupting chemicals, high blood sugar, western style diet, stress, being overweight.
Hormone health
A full hormone assessment may highlight subtle imbalances that can have not-so-subtle impacts on egg and sperm health, and for the egg-contributing partner, endometrial receptivity (ability of an embryo to make itself comfy in the womb).
Hormones must be measured at the correct time of the cycle (typically on the second day of your period and then again 7 days post ovulation) to get the most meaningful information.
Methylation
Methylation is a set of complex processes that utilise B-vitamins like vitamin B12 and folate to complete processes essential for hormone health, liver detoxification and cell division in a developing foetus. If this process is impaired, it can have significant reproductive outcomes.
I know this was a bit of a long one, and this isn’t even an exhaustive list, but I just really wanted to highlight that if you find yourself in this boat, there is a myriad of extra support you can receive to get to the bottom of what’s happening. And if you need guidance, I am here to hold your hand every step of the way.
References:
A S V, Dhama K, Chakraborty S, Samad HA, Latheef SK, Sharun K, Khurana SK, K A, Tiwari R, Bhatt P, K V, Chaicumpa W. Role of Antisperm Antibodies in Infertility, Pregnancy, and Potential forContraceptive and Antifertility Vaccine Designs: Research Progress and Pioneering Vision. Vaccines (Basel). 2019 Sep 16;7(3):116. doi: 10.3390/vaccines7030116. PMID: 31527552; PMCID: PMC6789593.
Deroux A, Dumestre-Perard C, Dunand-Faure C, Bouillet L, Hoffmann P. Female Infertility and Serum Auto-antibodies: a Systematic Review. Clin Rev Allergy Immunol. 2017 Aug;53(1):78-86. doi: 10.1007/s12016-016-8586-z. PMID: 27628237.
Noventa M, Quaranta M, Vitagliano A, Cinthya V, Valentini R, Campagnaro T, Marci R, Paola RD, Alviggi C, Gangemi M, Saccardi C, Nardelli GB, Gizzo S. May Underdiagnosed Nutrition Imbalances Be Responsible for a Portion of So-Called Unexplained Infertility? From Diagnosis to Potential Treatment Options. Reprod Sci. 2016 Jun;23(6):812-22. doi: 10.1177/1933719115620496. Epub 2015 Dec 20. PMID: 26692540.
Mol BW, Tjon-Kon-Fat R, Kamphuis E, van Wely M. Unexplained infertility: Is it over-diagnosed and over-treated? Best Pract Res Clin Obstet Gynaecol. 2018 Nov;53:20-29. doi: 10.1016/j.bpobgyn.2018.09.006. Epub 2018 Oct 6. PMID: 30518485.
Várbíró S, Takács I, Tűű L, Nas K, Sziva RE, Hetthéssy JR, Török M. Effects of Vitamin D on Fertility, Pregnancy and Polycystic Ovary Syndrome-A Review. Nutrients. 2022 Apr 15;14(8):1649. doi: 10.3390/nu14081649. PMID: 35458211; PMCID: PMC9029121.