unexplained infertility

[skb]

For those of you who have been diagnosed with *primary unexplained infertility*, just curious about your experience. Was a more specific diagnosis ever obtained? Did you eventually conceive and have a child? With assistance? Over what type of time frames? Thanks in advance.

[Scooter]

We tried for year of charting with no success, and then immediately started seeing an RE. We did tons of testing, and found no explanation. I had a laparoscopy & hysteroscopy, as well as the usual diagnostic tests.

We then tried clomid for 3 cycles, moved to IUIs with clomid, then letrozole/femara, then one IUI with injectibles as a practice run before starting IVF the next cycle. Somehow, incredibly, that practice cycle worked (I really had no expectation) and we got pregnant! It was our 28th cycle of trying, and 5th & last IUI attempt. It was 2.5yrs from when we started--and we were definitely "trying" right from the start.

As for what the problem was, one thing we suspected was a possible immune issue. I had several other immune things going on, and where there's one there are likely a few more. We thought I may be conceiving but my body was fighting off the embryos as they tried to implant--never giving me the evidence of a positive beta. The problem is there isn't a wide range of evidence for reproductive immunology. The RE referred me to a Rheumatologist for some basic testing & an exam, but that didn't yeild any unusual results, either. Our plan was one attempt at IVF, and if that failed I was going to go see Dr Beer. I did contact his office and consulted with them--I was going to make an appointment as soon as I got news that the IVF failed. Sadly, he has very recently died and I don't know what people with immune issues are doing now, because he was the world's leading RI. According to him, most cases of unexplained infertility are immune related. The reason we didn't go to him before IVF was that RI is not covered by insurances & the basic RI testing was around $4000, with treatments following that were even more expensive than IVF.

The RE suggested we try the IVF first, because that is where many cases of unexplained infertility are finally understood. She said until they can actually watch the egg & the sperm under the microscope, they are limited on what fertility tests they can do. It could be a problem with the sperm having trouble penetrating the egg, the embryos formed could be poor quality and die early, there could be come genetic factors, or the egg's shell could be thick making hatching difficult. Those are some examples. I was *almost* disappointed in a way that we hadn't tried IVF, because now we're still "unexplained," whereas it's possible we would have had an explanation after wards.

HTH. :)

[kemorr]

We were diagnosed with unexplained infertility and never really obtained a more definitive diagnosis, even though we went through a million tests (including the basic immune tests and some advanced sperm tests that were only done because I specifically requested them). We did eventually conceive on our first IVF cycle but had 2 failed Clomid cycles, 2 failed Clomid + IUI and 4 failed injectibles + IUI under our belts before moving to IVF. IVF didn't really give us the answer either but my RE thinks it was because our embryo quality wasn't great. We had 13 eggs fertilize but only the 2 that were implanted grew to be good quality blasts. The remaining 11 made it to the blast stage but weren't good enough to freeze. Only 1 of the 2 implanted. They still don't know WHY the embryos weren't very good, as the embryologist said the egg quality was good and all the sperm tests we did were normal. I don't think we'll ever know for sure!

[mrselle]

We were diagnosed with unexplained infertility. We charted for fourteen months before we conceived, but I had a miscarriage at around 8 weeks. Seven months later we still had not conceived again. We tried three rounds of clomid with no success. We went through all the testing and never got an official diagnosis. After 2 1/2 years of TTC we started seeing an RE, who took one look at the films from my HSG and suspected that my right tube could be blocked. She didn't feel the need to explore that possibility any further so we went straight to IVF. Our first IVF cycle we had to cancel the transfer due to OHSS. Three months later we did an FET and conceived.

[Soulmate]

I technically had RPL (repeated pregnancy loss - 3+ miscarriages) but also had unexplained infertility on top of that (no known conception for a year). I never had formal testing besides progesterone and an HSG (RE was an idiot and put me straight on clomid) but I conceived and delivered w/o the help of traditional medicine (clomid didn't work) so I assume nothing major was wrong.

From the testing that *was* done, it was discovered that I had a low abnormal level of thyroid antibodies (autoimmune issue). Basically my immune system saw the baby like it would a virus and would attack it. I suspect I conceived more times than I know but the baby just couldn't survive. I was on baby aspirin daily until 36 weeks and took Folgard in the first trimester. Folgard is used when you have a certain protein (not related to food or diet) deficency that prevents your body from absorbing folic acid properly. It is basically an amped up B-complex vitamin. I was never tested for the deficiency because my RE didn't even know about the thyroid antibodies there was no way I would convince him to test me for the deficency. On top of baby aspirin and folgard I used acupuncture which worked the first cycle. He also treated my autoimmune issue.

I conceived my son in my 16th cycle and a year and a half of TTC.

[skb]

Thank you ladies for your responses. I am surprised that there are not more ladies who can share their experiences. But I'm happy to see the positive outcomes. We intend to begin IVF in the near future should all go well with our consult. I am hopeful for a positive outcome. Thanks again for sharing.

[Soulmate]

I know there are more posters with positive outcomes. Maybe you can ask to have this moved to the pregnancy or parenting section? I know I rarely come back into FP because I am not ready for my 2nd yet and am not in that place yet.

[Wrighty26]

I was also diagnosed with unexplained infertility. After countless blood tests, ultrasounds, and months on clomid/femara my Dr. wasn't any closer to figuring out why I wasn't ovulating at all. I was just about to dive into more serious and expensive treatments, but we decided to take some time off. That was a year ago--and about 2 weeks after we made that decision I got pregnant.

I still don't know what caused me to stop ovulating for 2 years (or why I ovulated last October when I wasn't on any kind of drug) --and I wonder what will happen now, but I guess we will cross that bridge once we are ready to even start thinking about #2.

I will say that it is very very frustrating not having a clear answer/reason for not conceiving/having your body properly function. At least when you have something like PCOS or endometriosis you have a diagnosis. I'm not saying it's any better, but at least you are able to take a plan of action. I felt very angry for a long time-- I still haven't come to terms with that diagnosis and will continue to search for answers.

[jjsanner]

I have been diagnosed with "secondary unexplained infertility". DS is 2 1/2 and was conceived on our first try (two weeks after we returned from our honeymoon, to be exact).

Prior to trying for #2, I went off the pill and charted for approximately 6 months. During this time we weren't really avoiding, but BD was never timed well. I did notice that I was o'ing late (usually after CD 20) but other than that my cycles appeared to be normal.

Then in May of '05 we jumped in and officially started *really* trying. By Oct. '05 I went to my Ob/Gyn who perscribed clomid/metformin combo to produce a stronger o/multiple follicles. I did 1 cycle of 50mg clomid and didn't ovulate. Next cycle he upped me to 100mg. I ovulated early that cycle (for me, anyway) on CD 13. Still nothing. At that point I was getting really frustrated and decided to seek help from an RE. The RE did basic bloodwork, scheduled an HSG for me and an SA for DH. All of these came back fine. Then in Jan., during a completely unmedicated cycle, we got pergnant on our own but it was a chemical and I started bleeding by 4 weeks. Back to the RE we went. Next we did another 3 rounds of 100mg clomid/trigger/monitoring, one with IUI. All BFN's. Then this past month we took another break, and got pregnant again on yet another non-medicated cycle. Another chemical. The doctors are all baffled.

We are debating what our next steps will be. I think we will embark on immunological testing to determine what is the root cause of our repeat pregnancy loss.

[Heidi9771]

What interesting experiences in this thread. Things you never would think of, but could be very acurate causes! I am not pg yet, but am x'ing my fingers that I will be able to pinpoint the reason if it comes to infertility...

[gmooter]

It took us 2 years to get PG with DD. We never had a diagnosis. What finally worked were injectibles on the 2nd round. We were blessed with a beautiful DD who is now 13.5 months old. And low and behold, we had a surprise when she was around 8 months old and we are expecting a baby boy in Jan!!

[Pookie]

I second moving this thread to Parenting. I almost never come in here.
Anyways it took us 19 months to get a sticky pg. We TTC for 12 months with the typical charting, ovulation kits, etc. After that I went to see my OB. She ran some tests and we did 3 round of Clomid. I had a m/c on my second round. After that we were sent to the RE. Started some testing with him and had an HSG. During this same time, I was sent to my endo since I have hypothyroid/ Hashimoto's. We had an IUI scheduled for September, but luckily didn't need it since DS was conceived during our HSG cycle. DS is now 19 months. We're planning to TTC #2 anytime from next month to 2-3 years from now. I've started charting again, but I do kind of wonder how long things will take. My OB says statistically if you have primary IF, you shouldn't have secondary. (That was true with my parents as well.) On the other hand, she will see me after 6 months instead of the standard year if things take awhile next time.

[skb]

Ok...how do we have the thread moved to parenting?

[hiphopgirl]

I'm bumping this thread up to see if we can get it moved to Parenting. I'd like to hear more about unexplained infertility. I'm looking at secondary infertility and I'm feeling very frustrated.

It took 5 months to get pg with my DS, but that's not a horribly long time (it just felt like it at the time). We got pg on the first try back in April 2007, but then I m/c in June. We got pg again on the first try in Aug 2007, but then I m/c in Oct. I have been having unprotected sex since then and I'm still not pregnant. Since I'm over 35 we started going to an RE last month. I'm ovulating on my own, I have normal FSH/Estridol levels, my 7DPO progesterone is normal, and I just had an HSG and my tubes get the all clear. My DH's sperm count and motility are a little low, but nothing that is concerning to the doctor. By all measures I should be able to get pregnant again.

We're going to try to do an unmedicated IUI this month. If it doesn't work (which I am very skeptical that it will) then we will do the Clomid challenge next month. Maybe we'll find out more about my problems with that.

[bug]

hiphopgirl- I don't have any info to offer on unexplained IF, but I did want to say that my first 2 IUI's were unmedicated and were unsuccessful--but one of these was my fault, I ovulated later & misread my body & OPK. The cycle I got pg, 3rd IUI, I was on clomid only, BUT we did two inseminations, 1 the afternoon of the +OPK & the 2nd 24 hours later. That cycle, around "O" time, I was taking OPK's 3x day to not miss it! If we TTC again, we will follow the same route & hope that this time it sticks.
Crossing my fingers that it works for you! :) If you are going unmedicated is it possible to do two inseminations? Oh--and I assume that you have had your TSH tested too right?

[hiphopgirl]

bug - The biggest concern with this cycle is the timing. I'm going out of town on Friday afternoon. There is a large possibility that the IUI won't even happen. Given that, we won't be able to do a 2nd IUI. All of our hopes are landing on one day. I'm not feeling overly optimistic.

[taffers]

Maybe you should start a new thread in parenting called "secondary unexplained infertility". This thread was started for primary unexplained infertility, and none of us would ever be in the parenting section. Not that we can't talk about secondary in here, but most people dealing with infertility are going to go to the infertility boards, not parenting.

Edited to add:

I just did a search and found this thread about secondary...hope this helps!
http://www.constantchatter.com/forum/showthread.php?t=12399&highlight=secondary+infertility

[Scooter]

I know it's difficult to figure out where to put threads sometimes, but there is just no one forum where you're going to reach everyone who's been through this. Most people who check the pregnancy forum are currently pregnant, and the Parenting section is actually 3 forums. The people with success stories are scattered through each of those. Moving it randomly to one isn't going to help. And when you start going in the other forums you open yourself up to people posting 'if you got pg the first time, just relax and it'll happen again.' In the end, this forum was created as a place just for these discussions. Also, if anyone wants a thread moved, please PM a mod/admin, because we don't read every thread on CC and will likely miss a request in a post.

/mod hat off

We did have secondary IF, but we had primary as well, so I'm not sure if that's the response you're looking for. Secondary is really not all that different, but it comes with its own emotions and challenges. The reasons are pretty much the same, regardless of whether you've been pregnant in the past or not. As I found out from my RE, pregnancy can actually cause problems, such as blocked tubes or scarring in the uterus from the placenta (although those are found by the HSG and aren't unexplained IF). It can also change your hormones so much that they could go back in balance but not be the same as pre-pregnancy. And you have to remember that age can factor in, too, because you're usually several years older than when you got pregnant the 1st time.

Also, Tough Second has been pretty inactive for a great reason--most of the members have been successful over the last few months. :) There are a few still out there, so you can always bump it up to see if it'll start up again, or check out SAI because sometimes people with secondary IF will post in there, too.

[hiphopgirl]

Taffers - Thanks, I bumped up that thread to see if I could get anyone to respond.

Scooter - Good point about moving threads around. I guess it is best to just leave it here and hope that someone might come back and see it. I think I'm just at the height of my frustration right now because there doesn't seem to be any good reason for it to be taking this long. Ovarian reserve/egg quality (i.e. age) is probably my problem, but I guess the CD2/3 test only tells you if for sure there is a problem and that a good result doesn't necessarily mean that my eggs are a good quality. I had noticed that most of the tough second people were pregnant so I'm happy for that. It is a good sign. I'm already active in the SAI thread. I think it's mostly first timers in there right now. Thanks.

[taffers]

Ovarian reserve/egg quality (i.e. age) is probably my problem, but I guess the CD2/3 test only tells you if for sure there is a problem and that a good result doesn't necessarily mean that my eggs are a good quality.

It could just be that it's taking you longer this time for no reason at, but yes, egg quality could be part of it as well. You are right that your good b/w results won't tell you if your eggs are good. Even if you do all the chromosomal testing, and it all comes back normal (as mine and DH's did), your eggs could still be poor quality. I've had 3 IVFs with all great quality eggs (in terms of cell count and ratings), but that STILL doesn't mean they weren't chromosomally abnormal because you can't tell that without PGD. Some clinics are now starting to do even more advanced testing than PGD, which tests ALL the chromosomes instead of just 12.

But what always keeps me going is even if you have some bad eggs, not ALL of them are bad! You can definitely find that good egg. :)

[BTB]

Of course true medical issues are a completely different story, but it's important to remember that it can take a very short time for #1 and a comparatively long time for #2, or vice versa, just by chance. Some of it is just dumb luck: say you have a fabulous cycle with impeccable timing, great hormonal support, and unbelievable egg quality in August. And you started TTC in August - you're in luck! But if you started TTC in March, it'll be a while before you hit that jackpot.

A woman in her early 20s takes an average of 4 to 5 months to conceive.
A woman in her late 20s takes an average of 5 to 7 months to conceive.
A woman in her early 30s takes an average of 7 to 10 months to conceive.
A woman in her late 30s takes an average of 10 to 12 months to conceive.

You may be doing everything "right", be in your 6th or 7th month of TTC, and still be "average".

*conception data from the National Center for Health Statistics

[hiphopgirl]

Wow BTB, I've never seen those numbers before. I guess that makes total sense. It's just weird that two times in a row I got pregnant on the first try, and now it's month 8 and nada. Crappy luck indeed.

Taffers - I hope you're right about the egg quality. Surely there is a good one in there. They can't all be bad :)

It's funny, after my last m/c I said (mostly to myself) that I don't care how long it takes to conceive, I just want the next one to produce a live baby. I guess I have to be careful what I wish for. :rolleyes: