4 questions to ask your doctor, after an unexplained infertility ‘diagnosis’

Effective unexplained infertility treatment really depends on the care you’re getting from your doctor and team. In a situation where there are so many missing puzzle pieces – and one big question – over our fertility, we want clarity. A set of initial questions to ask, next steps from our doctor, success rate details and treatment levers to pull.  

If it’s more a case of ‘we give up’, or your team are reluctant to turn some stones and look at the latest tests and treatment, it may be time for a second opinion.  

Note, with the cutting-edge results delivered by testing options like the ReceptivaDX™ BCL6 Test – which we covered here earlier this year – unexplained infertility isn’t a ‘diagnosis’, but a placeholder ahead of your unique test and treatment plan.  

Or, at least, it should be. Team TRB are excited to partner with ReceptivaDX – part of Cicero Diagnostics, Inc – raising awareness around the primary causes and breakthrough treatment for unexplained infertility, repeat IVF failure and pregnancy loss, implantation issues and other factors, from deep inside the TTC (trying to conceive) community. Before ordering the groundbreaking ReceptivaDX™ BCL6 Test – read our unexplained infertility diagnosis – next steps guide and BCL6 testing 101 for all the info on getting started – and watch out for more insight across the next few months.  

All caught up? Skip straight to more info on the BCL6 Test here. When you’re ready, book yours with $75 off, using code TRB23. We’re so excited for what this groundbreaking option could mean to our fertility community – do DM us any queries over on our social channels.  

Now, here are our top four questions to put to your doctor or team, after that unexplained infertility initial ‘diagnosis’.  We encourage you to get all your questions answered before taking the next step of IUI or IVF but if you have already gone through one cycle of IVF and failed, definitely stop and have the conversation before accepting the common response of “its common for women to fail their first transfer”. 

1. What are the next steps?

It sounds obvious. But if there aren’t any next steps, or the answer is simply we try again,  red flags should go off in your head including thinking about taking our fertility journey elsewhere. 

If there’s one thing we’ve learned, on our various and unique family building journeys, there is always – absolutely always – something else to try. Whether it’s a simple tweak, a brand new test or a dynamic change in approach, we’ve learned to be proactive, and work with teams who are keen to move things forward, rather than dismiss us as a puzzle. 

So, after their diagnosis, ask your doctor for their recommended next steps. These will – ideally – cover the following (if they miss any, get them to fill in the blanks): 

• do you suspect a cause or causes that we can investigate?
• depending on how many suspected causes: where do you recommend we start based on my situation?
• are there treatments available for the suspected causes you mentioned, and do you offer them all? 
• if not, are you able to refer me for specialist support? 
• what testing options haven’t we tried, from BCL6 and silent endometriosis to egg health and immunology?
• are there any underlying medical conditions or hormonal issues we should look into?
• what about dates – when can we get going with the plan, and when should I start treatment?

You’ll think of lots more questions, depending on your unique situation, but this is a starter pack to bring to that discussion.

2. Should we look into silent endometriosis?

The starting point here is to get endometriosis – silent or otherwise – into the conversation. Ask your doctor what they think about endo as a factor, and whether testing – or further testing – would be sensible.

A test like the ReceptivaDX™ is designed to help patients and doctors narrow down and rule out the possible causes of unexplained infertility, either detecting endometriosis, or eliminating it from the list. So starting here may be helpful to get the plan moving.

Without the more outward and obvious symptoms, silent endometriosis can be difficult to recognize. Testing for BCL6 – allows your doctor to take a biopsy and send it off for analysis, looking to see if levels of BCL6 are present, and potentially causing inflammation of the uterine lining. They should get the results back within four to five business days.

If recurrent miscarriage is part of your story, and your doctor isn’t sure why, again testing for BCL6 and silent endo could be a turn-key. Endometriosis causes inflammation in the uterine lining, which can make it difficult for a fertilized egg to implant successfully. This may then lead to early pregnancy loss – or a miscarriage further into your first trimester, if the egg hasn’t implanted properly.

3. Let’s talk IVF, IUI and other treatment. What are the success rates?

From IVF and IUI to other forms of treatment – this could include endometriosis treatment, investigative treatment and more – your next question is around setting out all the options available.

Treatment like IVF and IUI can offer a higher chance of conception, but may fail for various reasons, often separate to your unexplained infertility. That said, endometriosis is one of the leading causes of failed IVF – and there will be other common factors at play too – so going for the very latest testing before you begin any ART (assisted reproductive technology) option is sensible.

Sorting out endometriosis – silent or otherwise – can increase the chances of successful IVF or IUI, but it can also support natural conception. So before you move forward with your treatment plan, make sure all the bases are covered with testing, first.

Finally, don’t forget to ask about IUI and IVF success rates, and how they stack up for someone in your situation, with your current team and across the board. Having this detail and perspective helps, when working out what to do next.

4. Is there anything else I can do, myself, to support my fertility?

Just like our first question, this may sound silly. Of course we’re doing absolutely everything – throwing all we’ve got at our dreams for a family. But with so much information available online (and from people we speak to), it can be hard to factor everything in, and know which levers to pull.

Every situation is unique. Losing weight may be a great idea for some, but for others it may be the very thing not to do. Obviously, we’re not smoking. But does our doctor know a really great holistic practitioner they’ve seen results with, or would they recommend specific supplementation, or micronutrient testing?

It’s almost always worth asking, and can be a real help to have goals and actions to tick off at home, while you’re waiting for test results or treatment. I know that, during my journey with recurrent miscarriage, starting acupuncture was a turn-key for me – it gave me concrete, positive action (and dynamic results), while waiting for treatment.

Ready to tick off Question 2 (and rule out endometriosis)? Head to ReceptivaDx™ to book your test, or ask your doctor about it today. TRB readers are eligible for $75 off a ReceptivaDX™ test – just use code TRB23 on your test request form.