Exploring Possible Cause Of Unexplained Infertility

In some cases all it takes is carefully analyzing the timing of intercourse, nutrition status, or investigating other health conditions, to understand possible causes of unexplained infertility.

Often we believe our healthcare providers might be covering all the basics, but it is possible to neglect aspects that may not seem as direct contributors to cases of subfertility.


Infertility Due To Autoimmunity

Autoimmunity is a state wherein your body’s immune defenses (antibodies) attack your organs and tissues. Well-known conditions of these include lupus, diabetes, celiac disease, and thyroid disorders. In certain cases, there might be no diagnosable condition, but antibodies attack fertilized eggs or sperms since these are foreign to the body’s tissues.

For conditions such as celiac disease, thyroid disorders, and diabetes; the cornerstones in management come from fine-tuning the diet. Undiagnosed celiac disease can be a significant risk factor for spontaneous abortions, which occurs due to the presence of anti-gluten antibodies. A simple way to manage this is through a gluten-free diet. Many autoimmune conditions are also interlinked, which means having celiac disease can heighten the risk for diabetes and thyroid dysfunction.

Multiple spontaneous abortions require the investigation of possible autoimmune processes, especially if hasn’t been carried out during your first panel of fertility tests.


Considering Sperm & Egg Health

Most tests check for either sperm or egg health only during the interim when you are having your tests done. Throughout the year, either your egg or your partner’s sperm can experience fluctuations in the basic function and their overall health. Often it is a misconception, as well, to consider that the cause for infertility might lie among those who have a uterus. However, in approximately 50% of cases of infertility, a male cause can be identified.

This makes it important to assess sperm and egg function at more regular intervals. This is especially true during periods of stress, lifestyle changes, and nutritional deficits. Even small fluctuations in any of these can affect overall sperm or egg health during each cycle, lowering your chances of conception.


Assessing Your Thyroid Function

The thyroid gland is the powerhouse of your body. It controls a lot of the general functioning within your body. Thyroid function should be among the initial evaluation conducted while other fertility tests are carried out. If you notice these tests being skipped during your routine tests, request for them to be carried out.

Thyroid dysfunction can result from an autoimmune process that can cause your thyroid gland to produce hormones in excess or lower than normal levels. This dysfunction can affect both sperm and egg function. Additionally, it might impact a fertilized egg, or also hamper a healthy pregnancy, by resulting in preterm birth or stillbirth.


Obesity’s Impact on Fertility

Obesity affects both male and female fertility. One of the prime concerns is its impact on hormonal function. Fat tissue is known to have its own hormonal functions increasing circulating estrogens. This is known to affect both ovarian and testicular function.

Additionally, obesity impairs normal menstrual cycles resulting in menstrual irregularities. Many cycles may not have ovulation taking place as well. Obesity can affect assisted reproductive techniques such as IVF. If conception does occur, obesity increases the risk of miscarriage and maternal and fetal complications during pregnancy.

Obesity also impacts overall health, hampering basic organ functions. As we discussed above, hormones like the thyroid hormone can be functioning below their normal level among those who are obese. Having a BMI over 30 kg/m2 substantially also increases your risk of developing heart disease, diabetes, PCOS, and hypertension, all contributing factors to unexplained infertility.

Underlying Reproductive Health Concerns

Often it is through the screening process for infertility that diagnosis for conditions like endometriosis and PCOS take place. Both conditions affect the ovarian and hormonal balance.

Endometriosis is 6 to 8 times more likely to be found among infertile women versus those who are fertile. The presence of uterine tissue outside its normal environment is the basis of endometriosis. As a consequence, there is increased scarring, adhesions, and limited uterine function. If endometrial tissue is found on ovaries it can also limit their function, both hormonal as well as for egg release. Those with endometriosis are also in a constant state of inflammation, a known hindrance to fertility.

Similarly, PCOS results in an imbalance of reproductive hormones primarily related to a dysfunction in the ovaries. PCOS has signs of irregular periods (most cycles with no ovulation), an increase in male hormones (acne, weight gain), and detection of ovarian cysts on ultrasound. You will be diagnosed with PCOS if you have two out of three of these signs. Globally, PCOS makes up around 80% of the infertility cases that occur due to irregular ovulation. Currently, it is the leading cause of infertility globally.

image of fruits, nuts and vegetables

Managing Unexplained Fertility Naturally

50% of young couples with unexplained infertility are capable of conceiving naturally within the following 12 months after receiving their diagnosis. This means it is crucial to continue trying to get pregnant, especially during fertile phases of the menstrual cycle.

For couples who are seeking to get pregnant immediately, it is only natural for healthcare providers to opt for more rigorous therapies such as induction of ovulation, hormonal therapies, and IVF. However, one of the first steps would be to evaluate your current lifestyle and nutrition to tackle more underlying reasons for subfertility.

Following a nutritionally adequate diet is one of the cornerstones of optimum fertility. A nutritionally adequate diet improves cell health and also fosters good egg and sperm health too. Suboptimal diet and nutrition can increase the risk of chronic inflammatory conditions such as arthritis, heart disease, PCOS, diabetes, and liver disease. All these are contributors to developing infertility. Conversely, diets rich in fruits, veggies, nuts, and legumes (often found in Mediterranean diets) is a step in the right direction to lower the risk of all these diseases and improve fertility.

Similarly, reviewing your lifestyle can enable you to analyze habits hindering your chances of a successful pregnancy. One of the foremost concerns for most of us is managing our daily stressors. During your periods of stress, your body is producing excess cortisol, the stress hormone. Which means it is reducing the production of other reproductive hormones. Stress also reduces key functions such as ovulation or sperm production. Stress affects sleep, another key element to optimum body function. Stress management plays a vital role in cases of infertility.

Staying hydrated, exercising regularly, sleeping well, and cutting out unhealthful practices are simple methods to navigate through a diagnosis of unexplained infertility. Sometimes laying out all your options, including checking in with a different healthcare provider might be a better solution that might work for you and your partner.


How Can Holness Nutrition Help Me?

Nicole Holness is a Registered Dietitian Nutritionist who is experienced in helping women with their hormone health, reproductive health (fertility, pregnancy, postpartum), gut health, and overall wellness. Adhering to the ideal nutrition and diet plan is one of the first steps toward managing subfertility. If you are looking for the best way to optimize your diet to help you tackle your fertility struggles, book a free strategy call. We are here to help you create a personalized nutrition, diet, and lifestyle plan which will then enable you to make more informed choices in your fertility journey.


1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4322174/ Unexplained Infertility, Management of Infertile Couples

2 https://pubmed.ncbi.nlm.nih.gov/25112489/ Definition and epidemiology of unexplained infertility

3 https://pubmed.ncbi.nlm.nih.gov/22284905/ Autoimmune basis of infertility and pregnancy loss

4 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4691969/ Trends of male factor infertility

5 https://pubmed.ncbi.nlm.nih.gov/22412113/ Obesity and increased risk of oligozoospermia and azoospermia

6 https://pubmed.ncbi.nlm.nih.gov/17982356/ Obesity and infertility

7 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941592/ Endometriosis and infertility

8 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4642490/ Treatment and infertility in women with PCOS

9 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723551/ Diet and Immune Function

10 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6079277/ The Influence of Diet on Fertility

11 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6016043/ The Relationship Between Stress and Infertility