Unexplained infertility is just a root cause you haven't identified yet...
When Sarah came to see us for the first time, she told us a familiar story:
After struggling to conceive naturally with her partner, Ashley, and running some of the standard tests, there were no obvious answers as to why it wasn’t happening for them.
After some further standard investigations, their doctor reviewed their case, shrugged their shoulders, proclaimed they had ‘unexplained infertility’, and suggested they think about IVF.
Assuming that the tests were the best available, and that the doctor really knew their stuff when it came to fertility, they left the appointment with a pamphlet about IVF and a referral to a clinic.
A diagnosis of ‘unexplained infertility’ is received after several standard tests and examinations are performed, and the results do not flag a reason for infertility.
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Medical science baffled! The vague label of 'unexplained infertility'
It seems crazy to us that in a world where medical technology advances at an unprecedented pace, the mystery of ‘unexplained infertility’ continues to baffle healthcare practitioners.
And so, after some basic tests, invasive procedures, and emotional rollercoasters, you find yourself facing a diagnosis that offers no clear answers – just a vague label of ‘unexplained infertility’.
You’re not alone; millions experience this frustrating journey, leaving them questioning their bodies and their dreams.
What lies beneath this inexplicable phenomenon?
Is it all simply a matter of chance?
Or something more insidious lurking in the background waiting to be identified?
Just as all symptoms in the body are a sign of an underlying imbalance – so is unexplained fertility.
When you’re labelled as having ‘unexplained infertility’, it’s not final – it’s just that you haven’t figured out your personal underlying imbalance yet.
And if conventional medicine has its way, you never will – you’ll be shoved off down the IVF route, and the root cause of your unexplained infertility will never be explored.
Then years later, you may find you’re diagnosed with a seemingly unconnected chronic health problem – say thyroid, or an autoimmune condition.
Connecting the dots...
Still nobody will connect the dots back to your unexplained infertility, but with the right assessment and interpretation at the time (which might be now for you if you’re reading this), the early signs of these chronic health issues would have provided critical information.
And knowledge is power – if you’ve been able to identify your personal root causes of infertility, you can do something about it.
Helping you to identify the root causes of your personal fertility challenge, and empowering you to do something about it, so you can have your baby, is what we do at Coho Fertility.
And the truth is that there are advanced tools, tests and strategies that turn the mysterious ‘unexplained infertility’ diagnosis into an actionable, root-cause medicine approach, meaning you go from fertility frustration to fertility clarity and finally get the answers you need.
The whole system we’ve designed for you over the past decade and more, is called the you=2 Fertility Success Path.
This because what is absolutely necessary in ‘unexplained infertility’ is a deeper dive to uncover underlying imbalances and potential root causes in both men and women.
The Coho you=2 Fertility Matrix
A big part of why the you=2 Fertility Success Path works time after time, is the you=2 Fertility Matrix.
The you=2 Fertility Matrix represents the deeply interconnected nature of both known and hidden factors, many of which might seem completely unconnected to your fertility challenges.
So what could some of these yet to be discovered root causes of infertility be?
Today we’ll take a closer look at a few examples that we commonly come across in our fertility clinics:
- Environmental toxins
- Genetic factors
- Thyroid & stress hormone imbalances
- Endometrial lining issues
- Autoimmune conditions
- High sperm DNA fragmentation
- Hidden infections
you=2 Fertility Matrix: Environmental toxins
It’s no secret that our environment is filled with hidden chemicals, but did you know that these environmental toxins could be deeply impacting your reproductive health?
From pesticides in our food, to heavy metals lingering in the air we breathe, and microplastics just about everywhere, toxic substances are not just a threat to public health but can also play a sneaky, hidden role in infertility.
There are numerous studies now that clearly make the link between environmental chemicals, hormonal disruption and fertility problems.
Environmental toxins can cause infertility in 4 main ways:
- Endocrine disruption – causing hormonal imbalances in both men and women
- Damage to the female reproductive system
- Damage to the male reproductive system
- Disrupting foetal development
A high environmental toxin load in the body can reduce your potential for natural fertility success, but also makes IVF less likely to succeed.
And there are hundreds of environmental toxins.
Some of the most disruptive to fertility include:
- Organochlorine compounds (chlorinated pesticides, polychlorinated biphenyls, and dioxins)
- Bisphenol A (BPA)
- Organophosphate pesticides and herbicides
Instead of solely focusing on genetic and biological factors in infertility, experts and scientists are now acknowledging that our modern lifestyle – shaped by pollution and processed foods – plays an undeniable part too.
This shift encourages us to be proactive about detoxifying our internal and external environments, and supporting our natural detoxification pathways.
Advanced testing solutions can now accurately detect levels of environmental chemicals in the body, and this is something we employ in our clinics where we believe that toxins are playing a role.
you=2 Fertility Matrix: Genetic factors
Genetics play a crucial role in fertility, and whilst we can’t change our genes, we can control the environment around our genes.
This environment controls genetic expression, which in turn controls a range of outcomes, including fertility (it’s an area of research known as epigenetics).
Every human also has a huge number of what’s called single nucleotide morphisms (SNPs) that result in a variant of a gene presenting itself.
Genetic SNPs often result in an enzyme, pathway or function working faster or slower than what is considered normal.
If we can identify this (and we can) then these affected pathways can be supported by the correct nutritional, lifestyle, and supplemental support needed for optimal function.
And there are a number of gene variants that one can have, that negatively affect fertility.
Genetic testing isn’t some far-fetched concept, it’s very real and very easily accessible.
With our Coho one to one clients, we recommend genetic testing for 100% of our fertility clients and it gives us life changing information that we can take action on.
Gene SNPs can affect:
- Stress
- Thyroid hormones
- Sex hormones
- Detoxification
- Progesterone metabolism
- Insulin sensitivity
- Inflammation
- Nutrient requirements
- Egg quality
- Sperm quality
- Pregnancy duration and early pregnancy loss
- Birth outcomes such as gestational weight and developmental delays
For instance, certain variations in genes related to ovarian function might not provoke any symptoms, but could quietly reduce the chances of conception.
The MTHFR gene is one that has been extensively researched and affects folate levels in the body.
Variants in this gene (particularly the C677T variant) can impact both male and female fertility, can affect the number and quality of embryos in IVF cycles, and miscarriage rate.
Tailoring treatments based on genetic insights can be game-changing for those struggling with infertility.
you=2 Fertility Matrix: Thyroid & stress hormones imbalances
Stress is a hugely important contributing factor in fertility.
You’ve probably heard a story like this already – a couple struggling to conceive for years, decide to have a break and re-evaluate and then voilà – they get pregnant.
Stress hormones impact just about every function in reproductive health and can result in all kinds of fertility challenges.
Stress comes from many different sources:
- Emotional
- Mental
- Physical
- Physiological
And all of these stressors impact our stress hormones, notably cortisol and DHEA.
In men and women, stress can suppress Luteinising Hormone (LH).
In men, low LH can impact testosterone and sperm cell production.
In women, low LH can prevent ovulation, cause low progesterone levels, and increase pregnancy loss risk.
Stress hormone fluctuations can explain why during some cycles women are ovulating and in others there is a lack of ovulation.
When stress is high, the body is in danger mode – the ‘fight or flight’ state which is not supportive of reproduction.
But due to the poor testing of stress hormones in conventional medicine, stress hormone imbalances go unidentified.
Here’s where functional testing can shed light on the true status of stress hormones.
Thyroid health is also critically important for fertility and in pregnancy, and is rarely properly assessed.
Studies have shown that a high TSH (thyroid stimulating hormone) level can negatively impact fertility, and even a level that isn’t considered too high in conventional medicine can be a problem.
Although research is a little conflicting in this area, we aim for our all of our women to have a TSH of 2.5 of less for optimal fertility (this is still regarded as normal, in conventional medicine).
you=2 Fertility Matrix: Endometrial lining issues
The immune cells in the uterus play a critical role in the implantation and development of a fertilised embryo.
Natural killer cells (NK cells) have been a hot topic in recent years in fertility, and a high level of NK cells in the endometrium impacts implantation of a recently fertilised egg.
Other issues can also go unnoticed.
Inflammation from pretty much any source in the reproductive system can impact the level of inflammatory molecules (cytokines) in the endometrial lining.
This inflammation can be from:
- Endometriosis
- PCOS
- Adenomyosis
- Fibroids
- Scarring from surgical procedures
- Bacterial infections
- Yeast infections
- And even inflammation in the bowel (resulting from IBS, an imbalanced gut microbiome, constipation or Inflammatory Bowel Disease)
It’s also frequently believed that when endometriosis has been treated through laparoscopy, then the problem has been fixed.
This is very often not the case, because only what can be seen has been removed.
What isn’t visible during a scan is the underlying immune dysregulation and inflammation in the endometrial lining, and this can be a root cause factor in unexplained infertility.
Then there’s endometritis – chronic inflammation in the endometrium which is usually triggered by a bacterial infection.
Chronic endometritis impacts implantation and embryonic development.
you=2 Fertility Matrix: Autoimmunity
Autoimmune disease affects hundreds of millions of people worldwide, and rates are increasing.
And about 25% of those with one autoimmune condition will develop more than one autoimmune condition.
In all autoimmune conditions, there is a dysregulated immune response and associated inflammation.
These two factors can hinder fertility.
Then there are specific reproductive system associated autoimmune processes that are rarely identified in conventional medicine.
These include ovarian autoantibodies (antibodies the immune system can make, that ‘attack’ the ovarian cells), and anti-sperm antibodies that can be produced by men and women.
Known autoimmune conditions such as:
- Systemic lupus erythematosus
- Rheumatoid arthritis
- Hashimoto’s
- Crohn’s disease
- Ulcerative colitis
- Coeliac disease
All impact fertility in different ways.
However, what we find in many of our clients, is undiagnosed autoimmunity that is likely the root cause of their ‘unexplained’ infertility.
you=2 Fertility Matrix: High sperm DNA fragmentation
Foundational factors such as sperm morphology, motility, count, and concentration are usually checked and if they’re all are normal, than there is an assumption that there’s nothing wrong with male fertility.
This often incorrect conclusion then leads to a diagnosis of unexplained infertility, because no other cause is found.
But this is a very poor level of evaluation.
The missing piece of the puzzle could be that the integrity of the DNA inside the sperm cells is not good enough.
Without testing, you would never know that high sperm DNA fragmentation is holding you back from having your baby.
Sperm DNA fragmentation testing takes a dive into the integrity of the DNA inside the cells, and it can be an essential part of discovering unexplained fertility issues.
you=2 Fertility Matrix: Hidden infections
There are many hidden, low grade infections that you’d never know you have, that can disrupt fertility at all stages – egg quality, sperm quality, fertilisation, implantation and embryo development.
And again, it’s almost impossible to know what hidden infections are at play, without advanced, accurate, testing.
Examples of background infections that could be the root cause of infertility include:
- Long COVID
- High chronic viral load, for example:
- Epstein-Barr virus (EBV)
- Cytomegalovirus (CMV)
- Herpes simplex 1+2 (HSV 1+2)
- Human herpes virus 6 (HHV-6)
- Hidden vaginal and semen infections (even without any symptoms and when a standard test shows no infections), such as:
- Candida / other yeast infections
- Mycoplasma
- Ureaplasma
- Gardnerella
- Atopobium
- Prevotella
- Enterococcus
- and many more!
- Chronic Lyme disease (borrelia burgdorferi)
The wrap...
If you’ve been told you have unexplained infertility, the only thing you need to take away from reading this article is that that’s only because it hasn’t been explained yet.
And that’s because standard testing and interpretation isn’t up to the task.
The good news is that at Coho, our entire you=2 Fertility Success Path is powered by specialist testing that we’ve spent thousands of hours researching, and more importantly, using in the field helping people to have their baby.
So not only do we use the right testing, we’re experts at interpreting the results and knowing what to do with them in your specific, unique case.
To your baby, love, and joy filled future,
Dee & the Coho Fertility team
How can we help you? Send us a message below and we’ll come right back to you…
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