Updated: Mar 6
Unexplained infertility. That weird space in the fertility world where there seems to be no problem, but you’re still not getting pregnant. Hellish, right? Let’s break it down so you can see what you might be able to do to break out of the unexplained infertility space!
What is Unexplained Infertility?
Unexplained infertility (or idiopathic infertility) is exactly what it sounds like: infertility that has no known cause. It's a diagnosis you get after a standard battery of fertility tests have all come back with normal results.
Both men and women can be diagnosed with unexplained infertility and, in total, between 10 and 15% of all couples struggling to get pregnant end up with the diagnosis. It’s important to note that unexplained primary and secondary infertility occur at basically the same rate.
And as with everything else in the fertility world, the odds of being diagnosed with unexplained infertility go up as you get older.
What Causes Unexplained Infertility?
That’s a tough question because if we knew what caused it, it wouldn’t be unexplained! However, I’ve put together a list of 12 possible culprits. Some of them might surprise you, so read on!
Medical Issues Beyond Current Scientific Knowledge—Our modern understanding of fertility, coupled with sophisticated medical testing and imaging, is really good. But there are so very many steps in the process of creating a baby, and doctors don’t have a perfect understanding of all of them. So even when things look great, it’s possible that there is still an undetected issue of some sort that is causing a fertility problem.
Hormone Levels—Your doctor has no doubt ordered all kinds of blood work to assess your hormone levels, vitamin and mineral levels, and much more. There is an established “normal” range for all these tests. But each woman is unique, and it’s possible that what’s “normal” for most women is either too high or too low for you.
Not Having Enough Sex—I hear the giant “DUH!” that you’re thinking right now. But while it seems obvious, it is worth mentioning because it turns out sometimes we don’t have enough.
Back in the spring of 2020 when the pandemic first began and countries around the world went into lockdown, women everywhere had their fertility treatments suspended.
One Italian fertility clinic decided to take advantage of the situation and investigate the link between unexplained infertility and frequency of sex. (You can read their full paper here.)
This fertility clinic had 50 couples seeking treatment who had been diagnosed with unexplained infertility. In the weeks and months following the start of lockdown, 7 of those couples conceived naturally. When the fertility clinic followed up with the couples to get more information, they learned that the amount of sex the couples were having had gone up. Way up: from an average of twice per month to 2 or 3 times per week!
Sleep Quality and Quantity—Sleep is another area we often overlook. Our society as a whole is chronically sleep deprived, but we’ve mostly come to regard our feelings of sleepiness as normal. Just have some more coffee and you’re good to go!
Alas, sleep actually plays a tremendously important role in hormone regulation so if you’re having trouble getting pregnant, more and better sleep is the kind of low-hanging fruit you should be going for.
There are no hard and fast guidelines when it comes to sleep—every body is different and functions best with different amounts. So even if you’re pretty sure you get enough sleep, it’s worth playing around with it. You might just be surprised what a little extra shut-eye can do for you.
Movement and Exercise—Too much and too little can both be problematic. Most of us are familiar with the fact that too much intense exercise can lead to amenorrhea, the cessation of ovulation and menstruation. But you might not know that too little movement is also a problem.
Movement and exercise, just like sleep, play an important role in regulating your hormones. If you’re not moving your body enough, it’s likely that your hormones are somewhat out of whack.
(Note that I say “movement and exercise.” You by no means need to be a gym rat. Finding consistent ways to move your body throughout the day is a great improvement over sitting at a desk or on the couch.)
Stress Levels—Here’s yet another thing that can mess with your hormones! Long-term, chronic stress (like the kind created by fertility problems) produces its own set of hormones that completely interfere with your reproductive hormones.
Food—You’ll find all kinds of fertility diets and lists of things you should and shouldn’t eat when you’re trying to conceive, but I don’t really like to point too many fingers at food.
For starters, I’m not completely convinced that radically shifting the way you eat actually makes a big difference. On top of that, I think that radically shifting the way you eat can be radically stressful, and in my book, additional stress is to be avoided at all costs.
When it comes to food there’s one simple rule I teach my clients: if there is a kind of food or foods that you know don’t sit well with you, avoid it/them. Inflammation in your body can be a fertility blocker, so it’s best to avoid the foods that potentially cause you inflammation.
Relationship Issues—Relationships can be complicated and messy. And sometimes they get in the way of your fertility. They can cause stress, mess with your mindset, and diminish your confidence. Additionally, a friend’s or loved one’s problems can even become intertwined with yours in ways that can be tough to untangle.
Fear—Fear of being a bad mother, fear of labor and delivery, fear of changes to your body, fear that your relationship with your partner will change…the list goes on and on.
As “woo-woo” as it might sound, the subtle messages fear sends to your body can keep you from getting pregnant. You see, your body is hardwired to keep you safe, so when your mind feels fear, your body does whatever it can to protect you. In the case of any pregnancy/motherhood related fears, the solution is simply to keep you from getting pregnant in the first place.
Impatience—When you want to get pregnant, you want to get pregnant. Right. Now. I totally get it. But did you know that a perfectly fertile woman in her 20s only has a 20% chance of getting pregnant each month? And that number falls as we get older. As cruel and unfair as it sounds, sometimes what you might perceive as a fertility problem is simply not having the patience to wait it out until the winning cycle comes along.
(And I’ll just go one step further and point out that impatience breeds stress and stress heightens fertility problems. It’s a nifty vicious circle, ain’t it?!)
Chemicals—Our modern world is amazing, convenient, and also pretty toxic. There are chemicals everywhere: food, furniture, clothes, electronics. Literally everywhere. And some of these chemicals, the endocrine disruptors, can have a bad effect on your fertility. There is no way to live completely “clean,” but in this article I lay out several simple steps you can take to limit your exposure and boost your fertility.
Negative Mindset—Have you been experiencing a lack of confidence and negative self-talk? When you’ve been trying unsuccessfully to get pregnant it’s understandable that you might feel and think this way. But just like fear, a negative mindset sends a signal to your body and your body responds.
A quote from Ralph Waldo Trine that I love is, “Never repeat or affirm anything about your health you don’t wish to be true.” It speaks directly to the issue of mindset and the difference that it makes.
What to do next?
This list gives you a lot of starting places to make small changes that could greatly improve your chances of overcoming unexplained infertility, either naturally or using an assisted reproductive technique.