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Unexplained Infertility: The Quest for the Reason Why

By Tara Simpson, Psy.D.

Tara Simpson, Psy.D.
Tara Simpson, Psy.D.

Every person follows their own process in working through fertility struggles. Each individual and each couple has a unique journey in getting “through” it. Thankfully, we can feel united with others who also have dealt with–or are dealing with–infertility diagnoses. The experience of infertility can make you want to seek out other people who understand the emotional, medical, and physical aspects of it.

While there are commonalities in relating to others who have struggled with fertility, there are also differences that can make even the shared experience seem isolating. Approximately one in five couples who are struggling to conceive will experience unexplained infertility, despite completing a full infertility work-up. It is hard enough to have a reason to attribute to having trouble conceiving, but NOT having a reason has inherent liabilities and difficulties. You may feel different from other couples with infertility who know the cause of their problem and are concentrating their efforts and energy on finding the best treatment for that identifiable issue.

The Quest to Know Why

The following statements are often made by women and men coping with an unexplained infertility diagnosis:  “I am so healthy yet feel so defective.” “I have beautiful eggs/embryos, my fallopian tubes are clear, the hormone levels are fine, and/or my sperm count is good, yet pregnancy is still not happening.” “So many tests and exams, but there is still no answer.” “If I/we could just find an answer then it could be fixed.”

plant shootsIt starts to become essential to know WHY and the belief becomes that if you just knew why then it would be better. This leaves a never-ending quest for “the” reason, which demands a great deal of mental and physical energy.  Finding THE answer becomes the focus and we can often lose ourselves in that quest.

The common belief in society is that if you work hard enough, you can get what you want. Yet fertility difficulties, despite your best effort, time, and attempts at treatment, sometimes don’t always yield overt answers to the question of “why?” Trying to find a reason can be time-consuming, financially draining, and emotionally exhausting. The emotional response to hearing “there is no apparent reason for your infertility” is often one of hopelessness and frustration.

Well-meaning friends and family members may start sending you articles about some cutting-edge treatment or state-of-the-art fertility clinics. The underlying message is that if you go to the “right” clinic or the “right” doctors, they will find out what is wrong and fix it. Or you may be told you are too “stressed” or too “uptight,” which only makes you feel more uptight and stressed.

“You may feel you are entering a state of limbo.”

Facing an unexplained reason for not conceiving a pregnancy can often result in feelings of sadness, helplessness, and anger. The realization that one has had to struggle to get pregnant can result in a sense of a loss of innocence. More specifically, most people assume that when they decide to have a baby that they just will. It is believed that wanting to get pregnant is a conscious choice and when it doesn’t happen we can feel bewildered, cynical, and/or confused.

Guilt can also become a pervading feeling. Some of these guilt feelings may go unspoken because of previous reproductive health choices, because you believe you took so long to even begin trying to have children, or because you are convinced that your anxiety and obsession with your infertility may be complicating it further. People often feel as if they have failed as a man/woman and/or husband/wife. The difficulties can be generalized to the individual or couple as “I/we are a failure.”

You may feel you are entering a state of limbo. One of the most challenging aspects of struggling with infertility is the ambiguity. It is difficult to be in a situation in which we have no control and have no idea how long that out of control feeling will even last. You may feel stuck–unable to grieve and get on with other options because you hold onto the hope that the cause of your infertility will be revealed in the next test or treatment. Your sadness may intensify as time passes and you find no medical or emotional resolution.

It can be essential to figure out what we CAN control. No one likespeople sitting together to feel as if they are in a never-ending state of medical free fall. We can control our body in how we treat it while going through infertility treatment. Acupuncture, massage, yoga, meditation, exercise, and an overall healthy lifestyle makes our body, and the mind, its most optimal, in order to tolerate that small aspect of our bodies that we seemingly don’t feel like we can control.

We can also control our mood by talking with others who understand, or at the very least those who will validate or support our thoughts and feelings. Support groups and counseling can help you process your thoughts and feelings to make you feel more in control of your emotions as you proceed forward or take a break.

You are not a failure—there just fails to be an answer as to why you are having difficulty conceiving. There is a big difference between the two.

Dr. Tara Simpson is a licensed psychologist in Maryland. Her special interests include providing counseling to individuals with issues related to reproductive health, including infertility and pregnancy loss/miscarriage. Dr. Simpson sees clients in her Towson, MD and Columbia, MD private practice offices.

If you would like to learn more about Shady Grove Fertility’s support groups or to schedule an appointment, please speak with one of our New Patient Liaisons at 877-971-7755.


  1. Anonymous

    September 29, 2015 - 6:31 pm

    I am a patient of shady grove and I have unexplained infertility what are the treatment options you offer for unexplained infertlity
    No one clearly communicates the treatment options at your facility. It might help if you blog about treatment options rather than talking about
    support group. There are institutes like sher facility who provide treatment by checking if the patient has any immunologic disorders. I am frustrated at this moment
    that without clearly trying to diagnoise the problem we are talking about things that we already know.

    • Shady Grove Fertility

      September 29, 2015 - 6:45 pm

      Good Afternoon – I can certainly appreciate your frustration, especially when dealing with unexplained infertility. Without knowing what is wrong, it can seem very difficult to find a solution.

      Treatment options will depend on a variety of factors including maternal age and length of infertility. In many cases, your physician may recommend to start with a low-tech treatment option such as intrauterine insemination (IUI). For others, or in the case IUI doesn’t work, in vitro fertilization (IVF) may be recommended.

      I understand this is a vague answer, but fertility treatment isn’t a one size fits all. You physician should give you a recommendation of where to start. He or she may even offer the option, as some patients may prefer to start with IUI because of the lower cost or their insurance may cover that treatment. But again, this is all based on your individual factors.

      If you haven’t already, please reach out to your physician or medical team to help identify your treatment options.

  2. Shady Grove Fertility

    April 29, 2015 - 5:56 pm

    Thanks Ruth! I’m really happy to hear that this post was helpful. Our support team will be writing monthly blogs to offer advice and encouragement to our patients.

  3. Ruth

    April 6, 2015 - 8:11 pm

    I’m so thankful for this post. Thank you Tara for addressing the implications of unexplained infertility. I am a patient with unexplained infertility and it’s helpful to have someone dive into the aspects of the frustration and helplessness that I feel. I hope to be able to read more of your advice for encouragement and hope.

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