Unexplained Infertility: 6 Factors to Investigate

If you’ve ever been handed a diagnosis of “unexplained infertility,” you know how frustrating—and frankly, invalidating—it can feel. But what if “unexplained” just meant “we haven’t asked the right questions yet”? That's been the case for many of Dr. Jessica Christie's clients. In this episode of the Root Cause Medicine Podcast, we sit down with Dr. Christie—a naturopathic doctor, clinical nutritionist, and integrative fertility expert—to discuss the 6 factors she assesses first when investigating potential root causes of unexplained infertility. Bonus, we hear some uplifting stories about the happy endings that can result when you find a heal one of these root issues.

What Unexplained Really Means (and What It Misses)

Dr. Christie breaks down what most conventional fertility workups overlook. According to research, “unexplained infertility” is a diagnosis of exclusion—but the criteria for exclusion often leave out critical root-cause contributors like immune dysfunction, gut dysbiosis, subclinical hypothyroidism, and toxin burden (Abdallah et al., 2020).

She reminds us that just because standard labs look “normal” doesn’t mean your body has everything it needs to conceive.

The Six Hidden Root Causes of Fertility Struggles 🧩

If you’re trying to conceive (TTC), or you support patients who are, these six overlooked areas should be on your radar:

1. Subclinical Hypothyroidism 🦋Even a slightly elevated TSH (above 2.5 mIU/L) can be associated with reduced IVF success rates (Cho et al., 2015), and treating it can improve fertility outcomes. Functional ranges matter here.

2. Autoimmunity 🧬Autoantibodies (like ANA, anti-TPO, or ovarian antibodies) are linked to miscarriage and implantation failure (Demir et al., 2009; Shahbazi et al., 2019). Testing matters—so does addressing inflammation.

3. Inflammation 🔥Elevated CRP or IL-6 may point to chronic inflammation that interferes with conception (Sauer et al., 2010; Jalilvand et al., 2023).

4. Gut & Vaginal Dysbiosis 🦠The microbiome matters more than we think—gut and vaginal dysbiosis can impact egg quality and uterine receptivity (Tersigni et al., 2014; Patel et al., 2022).

5. Nutrient Deficiencies 🍊Deficiencies in selenium, vitamin D, B12, and iron are some of the most common we see in women struggling to conceive (Skoracka et al., 2021; Ji et al., 2023).

6. Environmental Toxins 🧪From BPA to phthalates, toxin exposure impacts hormones and implantation. Functional testing can help identify and guide safe detox strategies (Jain & Singh, 2022; Pizzorno, 2017).

Labs to Consider 📋

If your workup has left you with more questions than answers, here’s a root-cause-informed panel to discuss with your provider:

• TSH (goal: <2.5)

• Autoimmune markers: ANA, anti-TPO, ovarian antibodies

• hs-CRP, IL-6

• Vitamin D, B12, iron panel, selenium

• Stool testing for gastrointestinal dysbiosis

• Vaginal swab for bacterial vaginosis (BV)

• Urine toxin panel (heavy metals, plastics)

• Comprehensive hormone panel (serum or month-long)

Real Stories, Real Solutions

In this episode, Dr. Christie shares patient stories that give me chills—in a good way. Stories of people who felt dismissed or hopeless, only to uncover one or two key imbalances that, once addressed, opened the door to conception.

That’s the magic of root-cause medicine. We don’t promise quick fixes—but we do promise to keep looking, testing, and believing that your body has wisdom and potential beyond what conventional algorithms can predict.

A Final Word of Hope

Unexplained infertility doesn’t have to be the end of the road. Sometimes, it’s the start of a deeper inquiry.

Whether you’re on your fertility journey or walking beside someone who is, I hope this episode reminds you of what’s possible when we ask better questions, trust the body, and treat the whole person—not just the diagnosis.

🎧 Listen to the full episode wherever you get your podcasts.

Warmly, Dr. Kate