During my first visit to the fertility clinic, my doctor told me that when it comes to deciphering what’s preventing a woman from getting preggo, there are both macro and micro problems. Macro is the big-picture stuff — Are there functioning sperm? Are you ovulating? Are you a senior citizen who shouldn’t really be doing this in the first place? Are your tubes blocked? Then there’s the micro stuff that often goes undetected until the IVF stage — Do you have natural killer cells? Chromosomal issues? A missing protein in your uterine lining? Basically, I was told that, in my case, we were dealing with a micro issue. But looking back, I am pretty sure I know what it was: Itsy bitsy but super fucking problematic blockages in my fallopian tubes that were undetectable with an HSG.
Considering every single test I ever did was perfect, and I clearly am not dealing with repeat miscarriages or embryos that won’t implant into my lining, and considering that every single IUI failed, and that the only other time I got pregnant was with an ectopic, I’m almost certain that my problem comes down to my tubes. The difficulty with a saline sonogram is that it involves shooting water into the uterus and then, with some pressure, shooting that water through the tubes to check that they’re clear — and, well, this is hardly comparable to a teensie tiny egg making its way through. I would imagine that even the most microscopic bumps or scar tissue in a fallopian tube (that you wouldn’t detect with an HSG) would look like bloody Everest to your average egg and effectively prevent it from reaching its destination. And if it does get fertilized? Even worse, because it starts becoming stickier and stickier as the days go by.
So, why would I have a bunch of speed bumps in my tubes, you ask, especially if all my other tests come back with A+ on them? Well, my doctor-mom very bluntly informed me that I probably got chlamydia at some earlier point in my life when I wasn’t using condoms (thanks for the “freedom”, birth control pill!), had no symptoms whatsoever, and it went away on its own, but left scar tissue in my fallopian tubes. Not enough to fully block them (which is too bad, because in that case our provincial healthcare system would have paid for my IVF), but just enough to mess with me for two years.
Anyway, that’s my theory. And considering there are TONS of women out there dealing with “unexplained infertility” and the only way to test our fallopian tubes is by sticking a hose up our bits and turning the water on to full blast, I’m thinking REs should maybe look into this a bit more carefully, or at least skip to the IVF stage a bit faster when they get a patient like me (rather than doing 6 useless IUIs).
Thoughts?
Yeah, Science! 
Sounds plausible to me (said the woman who doesn’t know a whole helluva lot about fallopian issues), especially considering your ectopic pregnancy. Is there even a way to check for those sorts of small bumps and blockages, though?
Being stuck with the diagnosis of “unexplained infertility” stinks. Though infertility always sucks, there’s at least some sense of closure in knowing WHY one is having trouble conceiving. It’s strange to say, but I’ve always felt lucky in knowing that my problem was crappy old eggs and DOR.
It must be unbearably frustrating to be unexplained. The explanation that you mom/you came up with sounds believable to me… but it still must suck so bad to not REALLY know. It makes me feel lucky, too. Even though we have our issue, it’s never been a question at all. We had a clear problem and were given a clear (expensiiiiivveeee) solution.
It is kind of freaky how much we don’t know about our own bodies. Like every time I get an abnormal pap (a few times now) and then three months later it magically becomes normal, I can’t help but wonder what’s really going on there. STDs of days gone by do come to mind, but the gynos never seem too concerned, so I let it go. I’m glad your mom had the knowledge to at least give you a possible explanation.
What strikes me the most about this is that your mom seems A-OK with the fact that you might have had chlamydia! I mean, I’m pretty sure my mom is wilfully blind to the fact that M and I do sex on a regular basis (even though she knows we’re trying to conceive)…so any idea that I might have had unprotected sex before my husband came along and she’d be sticking her fingers in her ears screaming “LA DEE DAH I CAN’T HEAR YOUUUU!!!” That said, it’s a very interesting theory. Any way they can screen for chlamydia antibodies in your blood or something to check it out? (I have no idea if those even exist, but…science!) *jazz hands*
Know how you feel. Done 6 IUI and 2 IVFS, now doing DEIVF. Wishing they would just cut the bull and tell us the truth before our eggs get that ancient that they can’t be used.
Yes, actually I made this comment in one of your earliest posts (think I was “Kate” then). Everything points to a tubal problem (and I’m assuming you’re living a healthy lifestyle and have a healthy BMI)
Sorry that free IVF came down to a stupid test, that is some serious BS. You would think the ectopic alone would have been a qualification.
So happy that the pregnancy is progressing nicely!
Wow, that is so interesting! I know many other ladies who were very healthy, but had issues with their tubes. It can be any number of things. Sometimes Endometriosis/scar tissue likes to nestle in there. I know one girl who had her appendix removed when she was a young girl, and later on ended up with useless tubes due to scar tissue. It seems weird it would just float up there of all places for a surgery like that. I’m so glad you guys found the answer and were able to get the treatment you need. I’m so happy for you, and can’t wait to follow your pregnancy journey!!! :D
I heart science so much. But medical science, especially Lady Bits Medical Science is still sorely, sorely lacking answers! I, too, am “unexplained” with perfect tests all around for me and hubs (even laprascopic surgery to remove “endometriosis” that wasn’t there at all! sweet.) I ended up choosing my RE based on one answer “I don’t know.” He was the first and Only RE to admit that he doesn’t have all the answers at this point and that if we were trying 30 years from now, they might find that missing protein or whatever it was and fix it. No IVF necessary. Or maybe you still need IVF but at least you know WHY.
Sorry, enough about me, what I meant to say was, yes! I think you’ve nailed it. Pesky tubes! I believe that we know our bodies better than these (usually male) doctors. I’m glad that you are currently preggo, have 18 more chilly babies waiting for you AND have figured out your “unexplained.” Wooohooo!
In the UK you are tested for all STIs before IF treatment. My chlamydia titre came back at 256. Chlamydia is like chicken pox in that the antibodies will stay in your body forever. I was not aware I had ever had Chlamydia so had not been treated for it. Cue a heap of worry about what kind of havoc it had wreaked on my insides. So at the consultants suggestion I had a laparoscopy which fortunately revealed no scarring or adhesions to my tubes.
This was one of the articles which helped me to decide to go with the lap http://humrep.oxfordjournals.org/content/18/9/1841.long It was actually written by my consultant although I didn’t realise that until I just dug it out again to post the link here!
It is a good theory, but because I’ve been on this road for sooo long, I’ve got to see many cases of unexplained that went to have babies and there is really no explanation. I think it could be your tubes or some other thing that has not been discovered that mysteriously resolved it self. I have a friend in real life that had been trying for 2 years in her early 30’s, she passed all tests with flying colors, did IUI’s and nothing then decided to do IVF. IVF #1, perfect embryos, perfect lining, perfect everything and nothing. IVF#2, same thing. 2 months after her 2nd unexplained failed IVF she got pregnant on her own. She has now a 2 year old daughter. How can we possibly explain that? Obviously, “something” wasn’t right, not in the 2 years trying naturally or her IUI’s or IVF’s.
Yes, in your case it could be your tubes, or it could be “something” that science hasn’t discovered yet that also resolved itself… And like this one, there are tons of cases. So frustrating for so many of us.
Good theory though!! :)
Hi! I’m new to your blog (love it so far). Here’s some food for thought…. an HSG showed that I had a blocked left tube, but it wasn’t until I demanded a laparoscopy (history of horribly agonizing periods) that they discovered my tube wasn’t blocked at all! It was TWISTED. How in the world that happened is beyond me (though I think endo is to blame)! They also discovered that I did indeed have stage IV endo, which as you probably know helps explain many “unexplained” cases of infertility. I begin BCP this coming Sunday, then it’s on to stimulating hormones. Because of my endo their may be many other weird drugs involved (forced menopause through Lupron, to name one). My point? Perhaps your tube or tubes are twisted like mine…. wonder if insurance would cover untwisting them? Also, do you have a history of painful periods? If so, most insurance companies do cover a lap if it’s medically necessary. Good luck and I look forward to reading more!
i totally agree with Kharini. I think that there is still something else that science hasnt picked up about fertility yet
I am 25 yrs and have been ttc with “unexplained infertility” for ages. All my test results came back excellent. No pcos or endo, normal hsg etc my partners sperm count was excellent too, couldn’t have asked for any better. so we are dealing with a “micro” issue. Considering that I was diagnosed with chlamydia about 6 months ago, and that i too didn’t use condoms in the past, I may have the same issue with damaged tubes which couldn’t be seen on hsg. I am starting IVF in a month. I am very scared and nervous. I think there needs to be more awareness that even if you don’t test positive for an std, there is still a lot of different types of bacteria that can damage your tubes. but this isn’t well known.
Many people claim that “unexplained infertility” is just those couples who have been “unlucky” so far and there is really nothing wrong with them. But I definitely disagree. I think it’s a fallacy which needs to be stamped out. More research needs to be done on “unexplained infertility”. Despite being only 25 I have had “unexplained infertility” for ages but all my family get pregnant so fast. My mum conceived all three of her children in the 1st month (and that was when she was over 30). So was she just “lucky” that she conceived in the fist month all three times and I was just “unlucky” that after 18 months I am not pregnant??? Sooo unlikely it really isn’t plausible at all…