Dr. Nashat Latib

FERTILITY

5 Key Questions to Ask Your Fertility Specialist About Unexplained Infertility

By Dr. Nashat Latib • March 24, 2024

End confusion & start seeing better results.

Extensive research over the past decades has characterized patterns of human fertility over time, such as the notable decline in fertility rates observed globally over the last two centuries(1).

Coping with an idiopathic or unexplained infertility diagnosis can leave you feeling bewildered, helpless, and full of questions. Getting clear, complete answers from your fertility specialist is essential.  

But before you get there, it’s absolutely essential to find a fertility expert who understands you, looks at you as a complete person (not just the baby-making parts), and is willing to be with you for the long haul. 

Far too many of my clients come to me frustrated with the conception process. They’ve tried the traditional route and walked away with the bewildering diagnosis of unexplained infertility. They essentially feel like their doctors are telling them, “Sorry, we don’t know what’s wrong—you’re on your own.”

But I 100% believe there is no such thing as “unexplained fertility”

Functional medicine takes a holistic approach to health. We look at the entire person—not just the reproductive organs. Stress and toxicity are two of the key factors that, once addressed, yield massive results.

For example, one of my clients tried for many years to get pregnant, working exclusively with her insurance-assigned healthcare providers. At the end of her rope, she decided that in order to get different results, she needed to try a different approach. After all, what did she have to lose?

She signed up for one of our preconception detox programs, where we focus on the core principles of toxicity reduction, stress management, and personalized protocols. 

Recently she sent us an email that said, “I’m beyond excited to share with you that I’m pregnant!!! I can’t thank you enough for your support throughout this journey. I strongly believe that the changes I made on your plan contributed to this IVF cycle being successful. I have been waiting 5 long years for this news. You gave me hope when I didn’t have any.”

We are able to consistently deliver these kinds of results for our clients. Our success rates are high because we focus on root causes, not just the symptoms.

Of course, we are not saying to ditch your current fertility expert, healthcare provider, or medical team. Functional health complements and enhances the modern marvels of IVF treatment and IUI treatment for those who experience infertility problems. Treating the central reasons behind unexplained infertility helps improve the chances of natural pregnancy, as well.

I’ve put together 5 vital questions to ask your fertility specialist during appointments to better understand your prognosis, recommended testing options, and tailored fertility treatment plans available to you so you can partner more effectively on this sensitive journey.

5 Key Questions Your Fertility Specialist

Question #1: What Could Potentially Be Underlying Our Fertility Struggles?

Even with no definite root cause found yet in your test results, discuss any working theories your specialist might have based on health histories, prior pregnancy outcomes, subtle pattern anomalies, or puzzling inconsistencies that could warrant further exploration through expanded diagnostics. 

Probe whether very minor sperm abnormalities, silent endometriosis, precise hormonal deficiencies, genetic variants, undertreated thyroid dysfunction, undiscovered insulin resistance, immune system imbalance(2), or extremely low-grade infections could possibly be latent factors interfering with fertility.

Question #2: What Further Diagnostic Tests Do You Advise We Consider Next?

Inquire about the possibility of more comprehensive testing. Additional specialized diagnostic panels, screenings, or procedures may uncover issues affecting fertility more precisely. 

These may include:

  • Genetics tests
  • Detailed immunology panels
  • Comprehensive hormone profiles
  • Advanced sperm function tests,
  • Uterine and tubal imaging
  • Endometrial biopsies
  • Recurrent pregnancy loss screens

In our practice, we also often order gut microbiome tests and toxin tests to identify potential root causes most traditional healthcare providers ignore. For example, multiple studies have found that the microbiome affects testosterone levels and sperm production in male partners(3)

Discuss the potential benefits, limitations, discomforts, risks, and costs to help determine if pursuing more tests seems reasonable or necessary before deciding the next intervention steps.

Question #3: Realistically, What Are Our Chances of Conceiving Naturally Within X Timeframe?

Ask your fertility specialist to provide estimates for your chances of conceiving unassisted based on your complete medical history, age, length of infertility, any test results, identified risk factors, and other clinical predictive data. 

Get clarity on whether continuing to pursue natural conception for 6 months, 1 year, or longer still seems warranted or if escalating to fertility treatment is genuinely the optimal path forward.

It’s also worth consulting with additional fertility experts about your situation. Remember, in functional health, we’re about supplementing your care—not replacing it. Because we primarily focus on lifestyle changes, there are no real downsides to implementing the allopathic shifts we recommend.

Question #4: Which Assisted Fertility Treatments Do You Recommend We Prioritize First?

Review your doctor’s recommended first-line fertility treatments, such as oral ovulation induction medications, injectable gonadotropins, intrauterine insemination (IUI treatment), in vitro fertilization (IVF treatment), or surgical interventions to correct anatomical issues.

Consider projected success rates, procedures involved, medication protocols, monitoring needs, costs, insurance coverage, and overall physical, emotional and financial demands of proposed interventions. 

While you are considering your options, it’s often helpful to address environmental factors affecting fertility, add high-quality supplements to resolve nutrient gaps, and implement anti-inflammatory strategies to help your body heal naturally.

Question #5: How Often Should We Follow-Up Throughout Treatment to Track Progress?

Your body is as unique as you are. The best way to see results is to design an individualized plan for follow-ups at strategic intervals to review the response to any fertility interventions underway. 

Discuss protocols for when and how to assess the efficacy of current approaches, determine appropriate timing for potential treatment changes if progress stalls or plateaus, troubleshoot new questions, and mutually support one another through the ups and downs.

Conclusion

Asking these questions puts you in the driver’s seat. All too often, the lack of clarity about why you’re not conceiving can make you feel hopeless or lost. Sometimes all it takes to make a real difference is asking the right questions.

I know it may seem impossible to crack the code on your body… but it’s only because you haven’t learned the language of your body. It’s complex and really comes down to your personal biochemistry.

By working together, I’ll partner with you to uncover what has really been hampering your ability to get pregnant. To me, there really is no such thing as unexplained infertility

There is always an answer—it just comes down to asking the right questions and finding the right fertility specialist for you.

If you would like our support to walk through the process step by step, we are here for you! Watch our free, on-demand masterclass here and take the action step to apply to work with us. We’ve helped countless couples like you succeed in optimizing their fertility, even when they are starting a family a little later in life.
 

References

  1. Sear R, Lawson DW, Kaplan H, Shenk MK. Understanding variation in human fertility: what can we learn from evolutionary demography? Philos Trans R Soc Lond B Biol Sci. 2016 Apr 19;371(1692):20150144. doi: 10.1098/rstb.2015.0144. PMID: 27022071; PMCID: PMC4822424.
  2. Ehsani M, Mohammadnia-Afrouzi M, Mirzakhani M, Esmaeilzadeh S, Shahbazi M. Female Unexplained Infertility: A Disease with Imbalanced Adaptive Immunity. J Hum Reprod Sci. 2019 Oct-Dec;12(4):274-282. doi: 10.4103/jhrs.JHRS_30_19. Epub 2019 Dec 17. PMID: 32038075; PMCID: PMC6937763.
  3. Magill RG, MacDonald SM. Male infertility and the human microbiome. Front Reprod Health. 2023 Jun 9;5:1166201. doi: 10.3389/frph.2023.1166201. PMID: 37361341; PMCID: PMC10289028.