According to the Centers for Disease Control and Prevention, about 20 percent of women are diagnosed as infertile without a specific reason why. Doctors call cases "idiopathic" when the fertility issues arise from "no known cause."
Most of the women I see in my clinic have been told their fertility problems are idiopathic. But the fact that a doctor can't explain their problems doesn't mean that the problems are unexplainable or unfixable. Here's what I tell my patients about what may be causing their unexplained fertility struggles and what they can do about it:
1. There are subtle signs your body sends that indicate whether your hormones are off.
Most of my patients have normal labs but also have very clear signs of a less than ideal hormonal balance. They may have irregular periods, short or long luteal phases, spotting, acne, bloating, severe PMS, or night sweats—all indications of a hormonal imbalance. And because these symptoms of imbalance aren't picked up by labs, doctors often fail to diagnose the imbalance itself.
Pay attention to these symptoms as well as how your cycle compares to the optimal cycle. Ideally, your cycle should be regular, about 28 days from the beginning of one period to the next, bleeding should last four to five days and should occur without PMS symptoms like breast tenderness, bloating, or cramping. Differences between your cycle and the optimal one could be the result of hormonal imbalances.
2. One of the biggest obstacles to fertility is often egg quality, and factors that affect egg quality may not show up in labs.
Egg quality is the potential of an egg to become a viable pregnancy after fertilization. Fertility doctors often run lab tests (like FSH and AMH) that can indicate ovarian reserve (the size of your remaining egg supply), but these tests fail to detect other things that affect the quality of those eggs, such as inflammation or poor mitochondrial health.
If your fertility challenges are "idiopathic," then egg quality is a likely culprit, and boosting the quality of your eggs could be the key to a successful pregnancy.
3. Symptoms doctors chalk up to age can be fixed as long as you're within your reproductive window (mid-40s).
While fertility is shown to decline with age, being a little older doesn't decrease fertility in and of itself. In fact, studies show that our age is not the biggest determining factor in our fertility. It's not the steady march of time that damages our eggs most but rather the qualities of the environment in which our eggs live.
Factors like inflammation, oxidative stress, toxins, hormonal imbalance, and poor blood flow can all disrupt intraovarian homoeostasis, adversely affecting our egg quality and overall fertility. In other words, it's not age that hurts our fertility, it's the quality of our health. By improving these factors, we can enhance our fertility even as we get older.
4. Finally, here are the things you can do to improve "unexplained" fertility challenges.
The three months prior to the ovulation process is when each egg is most susceptible to environmental factors within your body, making the three months before you conceive a crucial time for influencing your fertility.
Our immature eggs, called oocytes, are effectively suspended and asleep until about three to four months before they are ovulated. During the several months leading up to ovulation, they go through a phase of huge growth and maturation. And the environment in which this growth and maturation occurs has a tremendous impact on the viability of the egg and, therefore, your chances of having a successful pregnancy.
1. Eat a Mediterranean-style diet, which focuses on fish and lean protein, fruits, vegetables, and good fats and has been shown to decrease inflammation and boost fertility.
2. Avoid processed foods, fried foods, and sugar.
3. Avoid alcohol and smoking. Quit smoking now, and limit alcohol intake to two glasses a week.
4. Avoid plastics with bisphenol A (BPA), which is a known endocrine disruptor and has been correlated with miscarriage. Sources of BPA are mainly plastic containers, canned food linings, and credit card receipts.
5. Supplement with a high-quality prenatal vitamin that contains the bioavailable form of folate—methylfolate.
6. Supplement with omega-3 FAs to reduce inflammation.
7. Supplement with vitamin D, which increases follicular development and ovulation.
8. Supplement with CoQ10, which research shows can decrease chromosomal abnormalities and boost egg quality.
9. Get moderate exercise. Thirty minutes four to five times a week is a good goal.
10. Get acupuncture to boost blood flow to the uterus and ovaries.
11. Develop a stress management routine—pick up meditation, take baths, do yoga, get acupuncture—anything to get you out of the fight-or-flight response and signal to your body that you are safe and ready to carry and care for a baby.