Ep 346 “Unexplained Infertility” Might Not Be What You Think
On today’s episode of The Wholesome Fertility Podcast, I dive deep into the topic of unexplained infertility, a term often given when standard fertility tests show “normal” results, yet conception still isn’t happening. I share how Traditional Chinese Medicine (TCM), functional testing, and a deeper mind-body approach can offer clarity where conventional medicine falls short.
We’ll explore key overlooked areas such as egg and sperm quality, thyroid health, gut imbalances, endocrine disruptors, and the vital role of nervous system regulation. Whether you’re newly diagnosed or years into your fertility journey, this episode will empower you with insights that go far beyond the typical lab work.
Key Takeaways:
TCM can detect subtle imbalances long before they appear in clinical tests.
Factors like egg quality, sperm DNA fragmentation, endometrial inflammation, and thyroid health are frequently missed.
Nervous system regulation and stress support are essential but often overlooked in fertility care.
Gut health and exposure to endocrine disruptors significantly impact hormonal and reproductive function.
Disclaimer: The information shared on this podcast is for educational and informational purposes only and is not intended as medical advice. Please consult with your healthcare provider before making any changes to your health or fertility care.
For more information about Michelle, visit: www.michelleoravitz.com
Check out Michelle’s Latest Book: The Way of Fertility!
https://www.michelleoravitz.com/thewayoffertility
The Wholesome FertilityFacebook group is where you can find free resources and support: https://www.facebook.com/groups/2149554308396504/
Instagram: @thewholesomelotusfertility
Facebook: https://www.facebook.com/thewholesomelotus/
-
Michelle: if you've been told that your labs are normal, your uterus looks fine, everything is clear, all the tubes are clear, your partner's labs are normal, and that there's no further explanation to why you are not conceiving. You might have been given the diagnosis of unexplained infertility.
So in Western or conventional medicine, unexplained infertility is a diagnosis of exclusion and typically it is given after a woman or a man gets all the testing that is needed and they look [00:02:00] at labs, they look at the uterus, they do ultrasounds, and they pretty much do all of the major workup.
Uh, the, they consider major because not all doctors will do a thorough workup. And this is why I'll be talking about the importance of really looking into everything. But they do the workup that they standardly do in trying to see what is causing issues for couples when they're trying to conceive and when they find that nothing comes back, they may call it unexplained infertility.
But as you might know, I have a background in Chinese medicine and we look at things before they really become clinical. So we're able to see that there's patterns and things that kind of lie beneath the surface. And so from my perspective, there's a lot more that can be unearthed [00:03:00] and there's a lot more that can be explained than meets the eye when it comes to conventional labs.
So what happens typically if people are given the unexplained infertility diagnosis, their next step is maybe to look into IUI or any kind of a RT, which is assisted reproductive treatments. So things like I-U-I-V-F, um, or even maybe taking certain, Medicines such as Clomid or Letrozole to see if they can help get the couple pregnant.
So the downside to that is that when people get fast tracked into other medical interventions, they may not really look into what [00:04:00] is possibly going on beneath the surface that Western or conventional medicine is not looking into. And here are a couple of things that I wanna mention that are incredibly important, but are things that are not easy to really look into and it's not really standardized to look into.
And these are some things that functional testing can help. Then sometimes even just understanding the pattern from a Chinese medicine perspective, that can also help and really understanding what the lifestyle and really looking into the symptoms and experiences that a person feels through their menstrual cycle and many, many different things.
So I'm gonna look into some of the testing that may not be looked at when it comes to conventional medicine and when it comes to fertility workup.[00:05:00]
So the first thing that I wanna talk about is egg quality. So while egg quantity can be measured through things like a MH, which is anti-malaria and hormone egg quality is really difficult to measure. And one of the only ways people can. Possibly take a guess that there's an issue with egg quality is when they're going through IVF and they're seeing that the embryos are not developing correctly, or it has genetic mutations, doesn't appear to be genetically normal.
And those are some of the things that can happen after a person goes through a more invasive treatment, such as IVF to see what the egg quality really looks like. However, many people don't know that and many people don't wanna go through IVF in order to see how the quality of their eggs are. So this is something that can oftentimes not be measured through a lot of these.
Normalized tests and baseline tests that are [00:06:00] usually ordered by the doctors. So egg quality is something that personally, as a fertility acupuncturist, I always work on, regardless of what the person is doing, whether they're trying for IVF or they're trying naturally, it's always something top of mind, just like sperm quality is always top of mind.
Regardless of what they're doing, because all of those things can only help. And if you are. Treating the body overall and getting the body to work more functionally like better, and increasing the qi, increasing the blood. You're automatically going to be supporting egg and sperm quality just as you are going to be supporting a more anti-aging.
Process in the body, and those are things that you want because anti-aging really means an increased in vitality and a decrease in oxidative stress, and I will talk about that in a little bit. [00:07:00] Another thing that can be really missed is sperm, DNA fragmentation. Typically, doctors will run a semen analysis and that will look into sperm count, the sperm motility, and the sperm morphology, which is the shape of the sperm, but it also looks at volume.
Semen and many other things, and this is a great baseline, but it does not look at the sperm DNA fragmentation, which basically reflects the sperm DNA and how it could be impacting the quality of the embryo and the ability for that embryo to flourish. Because if there's some issue with the DNA of the sperm, that will impact either.
Implantation not to occur because it's not fertilizing correctly, or it can also impact many miscarriages. So a lot of people think that the miscarriages really are on the woman, but it [00:08:00] could be because of the sperm.
Another thing that I often see when I have patients is that for many, many years, they try not only naturally, but also try many failed transfers once they do have the embryos. Frozen. They'll do many transfers and they keep failing and they're saying it's unexplained. However, after many years and many times that they're trying and it fails, the doctor finally decides to look into the environment of the uterus and find out that they have either an a lot of inflammation or there's some kind of inflammatory condition or an issue with a microbiome.
So this is something that is often missed for many years and is really put off as unexplained when it is really explained. And it could be just one course of [00:09:00] antibiotics that can resolve it.
So when that does happen and there is a lot of inflammation in the endometrium. That can cause issues with implantation and it can cause issues keeping a baby, and it can cause issues even
with transfers as well. So those are really important factors because people can spend years going through this without even knowing that that is an issue.
Something else I often see is when people are checking their thyroid ~~and many times they when, ~~and many times when people are going through fertility challenges, they go first to their GYN and the GYN will. Often look at the TSH just by itself and not do a full thyroid panel. They'll [00:10:00] just do a more generalized workup of their hormones.
And what they find is that it might be sort of above what's ideal for for for fertility, but it's still considered normal. So they don't flag it as abnormal. Maybe because the GYN doesn't usually work with infertility. So oftentimes this could be missed and it can be kind of like, okay, it's. Maybe it's a three, it should be two or less, and that's not something that they really pay attention to.
And then I've seen also a lot of times patients asking for more of a thorough. Full thyroid panel and that often is also dismissed and they have to kind of go get a second opinion in order to get it. So this is just something that I see often, and it's not to knock any doctors, it just happens because they're human and everybody has a different perspective on what they think is important.
What I often suggest is. Go to a reproductive endocrinologist if you are going through fertility [00:11:00] challenges, even if you're not planning to do IVF, it's really because they understand they have a lens to understand the body. And to really take the thorough examination. So those are things that are really important and the thyroid is actually, it could be a very easy fix if it is just a low functioning thyroid condition.
You need to do a lot of times is take medicine to help your thyroid function better, and that can really make the huge difference between getting pregnant and also sustaining the pregnancy. And. Just wanna mention, I'm not giving medical advice. This is all things that you wanna talk to your doctor about because your doctor knows exactly what you'll need, and they do the measurements and the right tests for it.
But these are things that you might wanna ask.
And if it is [00:12:00] something like Hashimoto's, you can also get medicine for that as well. But you can also look into maybe changing your diet because there are a lot of diet protocols that can help with that as well.
Something else that I often talk about is really the nervous system. So while many times the idea of chronic stress is not something that is really flagged as an issue, ~~I. ~~It can really impact fertility health, it can impact the menstrual cycle. So chronic stress is one of the things that I even notice when people come to me and they're looking for more alternative care.
They will eat the right things, they've done all the function, even functional testing, and they'll go through the whole list of everything. They remove endocrine disruptors. They'll really do everything on the list, but the last thing that they will focus on is the stress levels, because I think it's [00:13:00] invisible.
It's not something that we see with our eyes. It's not something that we can often measure, but it's a state of being. So it feels a little bit more kind of under the radar and not something that most people think about. However, I do see anecdotally from my own perspective, that when people work on the nervous system and I work on it with them ~~in ~~in my clinic with acupuncture or many other ways to do this through mindset, tools, and techniques, and I do see that that has a huge impact and people do really well with it, and I've seen it also impact.
Their ability to conceive in a much shorter time after many years of trying. So ~~I also, ~~one of the ways that I can measure it and really see it is typically they will start to feel happier. They'll start to feel more in charge, and ~~they'll be, ~~they'll be able to get back and kind of, ~~uh, ~~rebound from difficult experiences.
So if they have the normal [00:14:00] disappointments, the two week wait, all of those things that are pretty common when people are going through the fertility journey, they feel a little bit more empowered and they can rebound from those disappointing times. Whereas when their nervous system is a little more off in the beginning, when they start to come see me, it takes them a little longer to move from one state to another.
That kind of rebound tells you that your nervous system is a little more stronger, the vagal tone is stronger than it was. ~~Maybe when people first start. ~~Another thing that can often be missed, and I touched upon this a second ago, is endocrine disruptors. ~~So, ~~and endocrine disruptors are things that we can find everywhere ~~we can find.~~
They're really, a lot of times chemicals or things like xenoestrogens, which mimic estrogen and confuse the hormones. So those things can be found in plastics. It can be found in chemicals and cosmetics ~~in. ~~In cleaning supplies, in materials and receipts. I mean, ~~there's like it, ~~the list goes on and on and it can be very [00:15:00] overwhelming at first, but when you realize ~~the ~~two things ~~is ~~one, how to find good resources and start to really clean out what you typically buy for more.
Clean products, that's number one, but also two, which ~~is ~~actually should be number one, which is the most important, is to know that you're never gonna get it perfect. And that's okay. It's not about getting it perfect, but it's ~~also ~~supporting your own body's detoxification and minimizing the impact so that maybe it's not perfect, but for the most part, you are drinking out of glass or out of stainless steel and you're cleaning out your most typical.
Ingredients to be more clean and less endocrine disruptors.
And then this one is huge, which is gut health. ~~So ~~oftentimes when you go to conventional medicine, they're not gonna really focus on gut health when it comes to fertility. ~~Health and ~~gut health is huge [00:16:00] because it can impact inflammation in the body. ~~It ~~dysbiosis can also cause, ~~um. ~~Autoimmune conditions.
There's a link between autoimmune conditions and gut health, but it can also cause stress. So when your gut is imbalanced, it can cause you to be in a more stressful state. And if that is the case, then it also impacts hormones. It really impacts you overall. So those are all things that are definitely important to check, and many times you're not gonna get those tests with conventional medicine.
And while conventional medicine is amazing and it's very, very pivotal and important in your journey, you also wanna couple it with maybe other things. Chinese medicine, but also nutrition, functional nutrition, functional medicine doctors. There's many people out there that do a little bit more detailed functional tests, and those things will look at gut microbiome.
They'll look at food sensitivities. They'll look at also your hormones throughout the day. There's something called the Dutch [00:17:00] Test, which is another one, and it's something that I offer, and these are really important because you will find details. That you'll not find in conventional testing and.
The only thing is that it is out of pocket. So that's sort of the, you know, the drawback. But if you're already in this process, it's much better to spend money on that than to go right into IVF, which even if you do IVF, you wanna look at these things because you wanna like save your time so that you're not in a situation where you're wasting time and money and not really unearthing what's going on beneath the surface.
So I had mentioned previously a little bit about how TCM traditional Chinese medicine views the body. We look [00:18:00] overall at patterns. So for example, somebody could be blood deficient, right? And they still don't come out as anemic, but. That person if, if that person has severe blood deficiency, that could actually show up as anemia.
So this is something that can happen for many years chronically and can cause an end stage of anemia. So by the time it actually shows up clinically, it is a lot more further along than when we pick it up so we can pick it up way before it becomes clinical. So those are things that we detect. There are a lot more subtle.
We can also detect subtle gut imbalances, and we can see this through behavior, through how a person feels their energy. And we can see it also by their digestion. And those are things that are a little more obvious to people is when they're feeling digestion, but they don't like digestive issues and [00:19:00] discomforts.
That could be a little more obvious to people, but. Things that are not so obvious to people could be just energy. They can feel really fatigued and not realize why. And it can be just because their body is not absorbing the nutrients correctly and that can cause an issue with their blood and their cheek, and they might not realize that the two have any kind of connection with each other.
So this is why typically people come to me once they have been unexplained and they don't know what else to do and they'll find a Chinese medicine physician. And I'll be honest, that was my story with my menstrual cycle. So I wasn't necessarily trying to conceive at the time, but for many years I was given the birth control pill as my only option, and I eventually found a Chinese medicine doctor who was able to resolve my.
Irregular periods, and this is after 12 years of having the same thing. So it was really amazing that after 12 years of the same thing, having something [00:20:00] so chronic could make anybody believe that that's just the way my body is and it's always gonna be that way. However, it did resolve my issues and I was regular since then in So I know it works and this is really why I got into it myself.
~~Oh.~~
So I also wanna mention, even though we spoke a little bit about sperm quality, it is really important to look into that as well. I have heard many times women getting tested and then the husband not getting tested at all, and that is wrong. You have to test both. You have to test both couples. When people are going through fertility challenges, because it takes two really to conceive.
So it's very important that everybody sees the partnership in this and to understand that both egg and sperm are just as important, and if one has any conditions, it's going to impact the other because they need both to work. So those are really important things to consider.[00:21:00]
And if you feel like you need a little bit more insight or help, I have a membership that has many tiers depending on where you're interested, whether it's mindset. Nervous system regulation or menstrual cycles or everything altogether, plus group coaching. All of that could be found in the episode notes,
so be sure to check that out if you want a little extra support. And always feel free to reach out to me on Instagram and my handle is at the wholesome lotus. Fertility and DM me there. If you have any questions or any topics or ideas that you'd like me to cover, I [00:22:00] don't always reply right away, but I try my best to reply every single message.
So thank you so much for tuning in and have a beautiful day. ~~I.~~
[00:23:00]