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Unraveling Unexplained Infertility

Updated: Nov 29, 2023

Embarking on the path to parenthood is a deeply personal and cherished dream for many. However, for some couples, the road to conception becomes an unexpected puzzle with no clear answers. Unexplained infertility is like an enigma, leaving hopeful parents in the dark about the cause of their challenges.

More than 10% of couples trying to conceive are diagnosed

with unexplained infertility.

The diagnosis of unexplained infertility often comes when conventional methods have exhausted their standards of lab testing and everything comes back "normal". This leads to couples feeling frustrated and unsure of what their options look like. In my practice, I focus on addressing possible underlying issues that may not have been investigated from a traditional sense. The examples below are some of the common causes that I see.

HPA Axis Dysfunction

The HPA axis, responsible for managing stress and hormone production, can experience disruption when stress becomes chronic and overwhelming. This could be due to physical stress, mental stress, or from chronic infection and inflammation. This imbalance affects the harmony of reproductive hormones, potentially impacting ovulation, egg quality, and implantation. Picture this: your

HPA Axis image from research article

hypothalamus, pituitary gland, and adrenal glands are like a hormonal rock band trying to jam together, but sometimes they get a bit out of tune. When life's stressors go wild, this hormonal orchestra can get imbalanced, messing up the rhythm of important reproductive hormones like cortisol, ovulatory hormones (LH, FSH), and things like DHEA, testosterone, estrogen and progesterone. HPA Axis dysfunction is something that can also lead to recurrent miscarriage.

Gut Dysbiosis

Dysbiosis, an imbalance in this gut microbiota, can lead to inflammation and nutrient absorption issues, affecting not only our general well-being but also our reproductive health. Research suggests that dysbiosis may be linked to conditions such as polycystic ovary syndrome (PCOS) and endometriosis, contributing to unexplained infertility. Think of your gut as a bustling city with trillions of tiny residents, living it up and influencing your health. But sometimes, a few bad apples disrupt the harmony, causing chaos. If you're also dealing with leaky gut, or increased intestinal permeability, this can increase your risk of miscarriage.

Vitamin Deficiencies

Picture vitamins as the essential building blocks supporting our bodily functions. When these vitamins become scarce, various aspects of fertility may be affected. Vitamin D deficiency has been associated with reduced fertility and pregnancy complications. Vitamin B12 deficiency can impact ovulation, and folate deficiency may increase the risk of miscarriage and fetal abnormalities. Ensuring adequate vitamin intake through a balanced diet or supplements can be a simple yet impactful step in supporting reproductive health. Oftentimes, suboptimal vitamin levels may be a result of poor absorption from sub-par gut health.

Insulin Resistance

Insulin resistance, a condition where cells do not effectively respond to insulin, the hormone

insulin resistance image from research article

regulating blood sugar levels, may have far-reaching effects on reproductive health. Disruptions in insulin signaling can lead to hormonal imbalances and interfere with ovulation, complicating the journey to conception. Imagine insulin as the traffic cop trying to regulate sugar levels in your body. But, oh no! Here comes insulin resistance, the reckless driver who ignores the signals and causes chaos. This hormone havoc can mess with your ovaries, leading to hormonal imbalances and throwing ovulation off its well-timed schedule. This may also be found in PCOS, which is a common cause of infertility. Addressing insulin resistance through lifestyle changes, diet, and, supplementation interventions can be instrumental in restoring fertility.

Environmental Toxins

The modern world is brimming with environmental toxins, some of which may pose unexpected challenges to fertility. Pesticides, plastics, and pollutants can disrupt our delicate hormonal balance, affecting reproductive function. Minimizing exposure to environmental toxins through conscious choices, such as opting for organic products and adopting eco-friendly practices, can create a healthier environment for fertility.

Bacterial Vaginosis (BV)

Imagine your vaginal ecosystem as a delicate garden, with a variety of bacteria coexisting in harmony. BV can be a come into this garden and disrupt the harmonious balance by disrupting the natural

woman with hands over uterus and urinary tract

balance of good and bad bacteria, causing an imbalance of bacteria (similar to gut dysbiosis). This can lead to inflammation, affecting the quality of your cervical mucus and making it difficult for sperm to navigate to the egg. Many times, there are no glaring symptoms to alert you of its presence. No itching, no burning, no red flags. There are tests that can asses for the overall health of your vaginal microbiome (including both good and bad bacteria).

Heavy Metals

These elusive substances can sneak into our lives through various sources, including contaminated water, certain foods, and environmental pollution. Heavy metals, such as lead, mercury, and cadmium, are known to disrupt hormonal balance and impact reproductive health. They may accumulate in the body over time, causing silent yet significant damage to fertility. Reducing exposure to heavy metals through water filtration systems, avoiding certain seafood, and making environmentally conscious choices can safeguard reproductive well-being. By recognizing the potential influence of heavy metals, we can add another vital puzzle piece to our journey toward understanding and conquering unexplained infertility.


Testing can vary from person to person depending on what the whole picture looks like. To assess the issues above, there are a number of things you can look at.

woman getting her blood drawn

HPA Axis Testing-

The best way to test for this would be a salivary cortisol test. I recommend a Cortisol Awakening Response (CAR) test. This requires you to test cortisol levels throughout the day.

Vitamin Testing-

Vitamin D, B12, B9 and iron levels can be tested any day of your cycle. This one is drawn via blood and can be done with a routine blood draw. You don't need to be fasting for this blood draw.

Dysbiosis Testing-

This typically involves stool testing. I typically use labs that look for viruses, bacterial overgrowth, parasites, yeast, and pathogenic bacteria. This type of testing will also look at digestive markers, levels of inflammation, and immune responses. In some cases, this can also test you for leaky gut.

Insulin Resistance-

This can be evaluated for via a simple blood draw. You should be fasting and there may be other labs we look at to assess your overall metabolic health.

Environmental Toxins and Heavy Metals-

This type of testing can be done via several methods and labs. These can assess for recent exposures as well as previous exposure. These are non-invasive tests.

Bacterial Vaginosis-

One bacteria in particular can typically be checked for at your doctor's office. However, I recommend a more in-depth test that looks at your entire vaginal microbiome to assess for other potential disruptions.

Final Thoughts

The journey through unexplained infertility may seem like navigating a complex maze of mysteries, but with an in depth approach, we can inch closer to unlocking the answers. From the delicate balance of the HPA axis to the significance of gut health and vitamins, each puzzle piece contributes to the intricate picture of reproductive well-being. Remember, you are not alone in this quest, and with each step taken, you move closer to the possibility of fulfilling your dreams of parenthood.


Work With Me 👇

If you are looking for preconception counseling, are having difficulty conceiving, and/or have suffered from miscarriage(s) you can click here to sign up with a complimentary 15 minute phone call with me. We can discuss your goals at that time and determine whether or not we will be a good fit for each other. We will discuss necessary nutrients, dietary options, as well as lifestyle and exercise programs catered to YOU specifically to help you reach your health goals.

Dr. Katie Zaremba natural fertility doctor

About Dr. Zaremba:

Dr. Zaremba received her bachelor's degree from Western Michigan University in Biomedical Sciences and minored in Chemistry and Psychology. She completed her doctoral training at Palmer College of Chiropractic. During her time in school, she took post-doctoral training through The Clinic on Disease and Internal Disorders (CDID) earning her a Diplomate from the American Board of Chiropractic Internists (DABCI).


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