Unexplained Infertility Explained: Causes, Treatments & More

Are you ready to make a baby, but don’t understand why it’s taking so long? Do you want an explanation for your “unexplained” infertility? Do you have PCOS or endometriosis and want to know what it will really take for you to defy the odds and have a healthy pregnancy? When you’re dealing with unexplained infertility, it can feel like there are so many questions without any answers.
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But in many cases, despite what you may have been told in your doctor’s office, there are answers to these questions. Most ovulatory infertility can be explained – if you dig deep enough. 

Let’s jump into some of the causes of unexplained infertility and make unexplained infertility explained once and for all. But first – let’s make sure we’ll all on the same page.

What is ovulatory infertility?

Ovulatory infertility is a medical term that describes infertility caused by an issue with ovulation. Your body may not be ovulating at all, you may be ovulating early or late in your cycle or you might ovulate irregularly and only occasionally.

The key is that when we’re talking about ovulatory infertility, we’re not talking about anatomical issues, like a blocked tube. This discussion is about what causes the hormone imbalances and poor ovarian reserve that make it harder to get pregnant (it’s not just age!) and what that means for dealing with unexplained infertility.

How Common Is Unexplained Infertility?

On average, about 10-15% of couples struggling to conceive are diagnosed with unexplained infertility. But while it’s often called unexplained infertility, ovulatory infertility has an explanation. It just might take a lot of digging to find it. 

What causes unexplained infertility?

With our detective hats on, there are three systems that we need to investigate to figure out why you’re not getting pregnant and explain “unexplained” infertility: 

1.Neuro-endocrine pathways 

(from your brain to your hormones). The same building blocks make both cortisol, the stress hormone, and your sex hormones. If there’s chronic stress at play, then your body is making more cortisol and less progesterone, which can hinder your body’s ability to ovulate normally. This chronic stress can be mental, emotional or physical, things like: 

  • Poor sleep
  • Over-exercising or under-eating
  • Emotional burnout 

Ever hear the old adage that as soon as someone stopped stressing over why they weren’t getting pregnant they suddenly conceived? Stress is actually one of the common reasons for unexplained infertility, so this theory actually holds water!

2. Digestive health

If exposed to a trigger (like gluten for those with Celiac Disease or gluten intolerance), your GI tract can be a source of chronic inflammation. Inflammation signals danger, warning your body that now is not a safe time to reproduce.

Your digestive tract is also the primary home of your microbiome – the colonies of beneficial bacteria that help you absorb nutrients, eliminate excess estrogen, stave off infection and control inflammation. A healthy microbiome is the seed to optimal health, and thus, fertility. 

If you’re dealing with unexplained infertility, consider following a healthy fertility diet and incorporating lots of complex carbs, healthy fats and protein into your everyday food.

3. Toxic burden

Although we’re all bombarded with environmental toxins as a part of modern living – think pollutants in the air, pesticides on food and chemicals in skincare – your body has natural defense mechanisms to prevent toxic overload.

This toxic burden can become one of the causes of unexplained fertility, however, when the amount of toxins coming in surpasses the capacity of your liver, kidneys and GI tract to eliminate those toxins.

Many of these toxins mimic estrogen and interfere with hormone balance, making it harder to get pregnant. 

Conventional fertility testing fails to explore all of these possible root causes

How do you fix unexplained infertility?

Overcoming unexplained infertility is a deeply personal journey. Treatment for unexplained infertility can vary significantly depending on the root cause.

Unfortunately, when you’re dealing with unexplained infertility, many doctors don’t look closely enough at these three systems when determining why you’re struggling to conceive. This is one of the reasons that working with a fertility dietitian is so important.

In my nutrition coaching program, the first step is to assess your overall health and wellbeing, looking at all the components- stress, digestive health, sleep, liver function, toxin load, etc. With this full, holistic picture of your health, we can identify what might be blocking your fertility and get to solutions more quickly. 

Your body is meant to reproduce – it wants to make a baby! Through functional testing, my job is to help you figure out what’s getting in the way and remove those barriers. 

Functional vs Conventional Testing for Unexplained Infertility

The key to making unexplained infertility explained, is functional testing. Functional testing differs from the conventional testing you will get with an OB/GYN or a reproductive endocrinologist (RE) in two key ways: 

  1.  Conventional testing only looks at a snapshot of your reproductive hormones. Functional testing looks upstream of your reproductive hormones at the brain-to-hormone pathways (see above) to get answers about what causes the hormone imbalances.
  2.  Conventional medicine defines “normal” lab values as just enough to prevent disease. In functional testing, desired lab ranges are based on what will promote optimal health, not just prevent sickness and disease.

Essentially, functional testing gets to the root cause of unexplained infertility and focuses on determining what may be keeping you (and your reproductive system) from optimal health. When you’re dealing with unexplained infertility, this is exactly the kind of information you need to move forward.

I use conventional and functional testing in my practice to understand your unique physiology and take out the guesswork about what will work to get you pregnant. 

If you haven’t done all of this testing, your infertility is far from “unexplained”! 

Learn more about testing and services I offer.

How do you fix unexplained infertility?

If you’re dealing with unexplained infertility and not satisfied with the help you’ve received from your OB-GYN, your next step should be working with a fertility dietitian on testing. 

There are a variety of conventional and functional fertility tests that could be performed, including:

Conventional Fertility Testing:

  • Hysterosalpingogram (HSG): An X-ray procedure to see if the fallopian tubes are open and to see if the shape of the uterine cavity is normal.
  • Transvaginal Ultrasonography:  An ultrasound probe placed in the vagina allows the clinician to check the uterus and ovaries for abnormalities such as fibroids and ovarian cysts. 
  • Basic hormone test: Blood tests can measure your levels of important thyroid hormones and reproductive hormones like estrogen and progesterone.

Functional Fertility Testing:

Functional fertility tests look at a broad range of body systems and markers, including:

  • Metabolic markers
  • Androgens
  • Lipids
  • Inflammatory markers
  • Advanced thyroid markers

The exact testing you’ll need to explore unexplained infertility will vary depending on your unique situation. I offer a free Fertility Strategy Session to help you interpret the testing you’ve already done and what further test you might need to fill in the gaps. 

Making a baby is natural, but that doesn’t mean it’s easy! I’m here to help you understand why and get to the solution faster.

Rooting for you,


Contact me today to learn more or to start your fertility journey