You’ve been to the doctor for all the blood work and all the tests. Yet, it’s all come back “normal.” Your partner’s sperm has been tested and came back “normal.” At this point, your conventional doctor might have diagnosed this unexplained fertility but, there is likely a reason for your conception struggles. You just have to know where to look.
Beyond the reproductive organs
Most of the time OB-GYNs or specialists like reproductive endocrinologists only look at your reproductive organs and hormones for answers to your fertility struggles. Our bodies are more complex than that. Every system in our bodies is interconnected so when one system is off, it can cause knock the other systems out of whack as well. Something that is almost always going to be affected is fertility. This happens because the body’s first priority is to keep us alive and reproduction isn’t necessary for survival.
So, when you visit an OB-GYN or specialist to find answers to your fertility issues, not only are they potentially overlooking factors outside of the reproductive system as possible causes of fertility struggles, but they also might be relying on normal lab ranges as a benchmark for your hormone ranges.
Functional medicine
Functional Medicine is a systems biology–based approach to health that focuses on identifying and addressing the root cause of disease. One key thing we’ve learned from functional medicine is that what’s considered a normal lab range for some could just be the bare minimum required to function for others. Instead, functional medicine uses optimal ranges, the levels necessary to function optimally. Vitamin D is a great example of this. Normal lab ranges typically reference anything between 20-40 ng/ml as normal while the optimal ranges are 60-100 ng/ml. There’s a large discrepancy between the two that could hold some “unexplained” answers. The same can be said for sperm. Sperm count, motility, and morphology thresholds can actually be the bare minimum for conception.
Another area that often gets overlooked in conventional medicine is the timing of sample collection. Most doctors collect hormone samples once or twice throughout your cycle. This makes it easy to miss if you’re experiencing abnormal hormones during other times in your cycle.
Finding answers
If you’ve addressed all the reproductive factors and still don’t have any answers, it’s time to look elsewhere.
Thyroid: One common test performed outside of the reproductive system is for the thyroid. However, most doctors only check the Thyroid Stimulating Hormone (TSH) and only consider normal lab ranges. You’ll want to ask your doctor for a FULL thyroid panel which should include TSH, T4, T3, rT3, and thyroid antibodies. These tests will give you a much more complete picture as to whether your thyroid is working optimally or if there is a hiccup somewhere in the system.
Gut: Even if you don’t think you have tummy troubles, it’s worth looking into. 80% of our immune system is located in the gut and gut health affects everything from hormonal balance to inflammation. When something is off in the gut, it’s definitely going to affect your fertility. To determine if your gut is affecting your fertility the best tests to look into are celiac testing, a GI Map, and an MRT food sensitivity test.
HPA- axis testing: Your Hypothalamic-Pituitary-Adrenal-axis (HPA) is your body’s stress system. Looking into how this system functions can be an indicator that stress is at the root of your fertility struggles. Consider a multi-point saliva cortisol test where you check your cortisol at 4 different points throughout the day to see how well your circadian rhythm and stress response is functioning.
Immune system testing: The immune system is responsible for inflammation which can affect fertility. Some things you will want to look into are c reactive proteins (a measurement of inflammation) and autoimmune markers.
Liver: The liver is so important to our overall health. It’s key in helping to maintain proper hormonal balance and remove toxins from the body. If your liver isn’t functioning optimally, it’s going to result in impaired fertility. Tests that can be helpful in determining liver function are the DUTCH test (which can tell you if your liver is properly removing excess estrogen) and a homocysteine levels test (an important indicator of your ability to anti-inflame and remove toxins).
If you have unexplained infertility, it’s likely there’s another system in your body that isn’t functioning properly and causing your body to down-regulate fertility. However, if you’ve explored all of the options listed above and still don’t have an answer, consider environmental factors like mold or chemical exposure in your area. You can also consider testing your partner’s sperm DNA if none the above provide answers. Testing egg quality, on the other hand is more challenging unless you’re paying for testing with IVF. However, there are things that you can do to support egg quality and give you your best chance at conception.
No matter what your results are, the best and easiest things you can do for your fertility are to eat a quality diet, get in daily movement, and take a good prenatal vitamin.