Understanding Unexplained Infertility – When There Are No Clear Answers

Few diagnoses are as frustrating and emotionally draining as unexplained infertility. It's a term used when all standard fertility tests come back normal—hormone levels are balanced, ovulation is regular, fallopian tubes are clear, and sperm analysis looks healthy—yet pregnancy still doesn’t happen.

This diagnosis affects up to 30% of couples struggling to conceive, and it often feels like an answer that provides no real answers at all. For many, it brings a confusing mix of relief (that nothing is “wrong”) and despair (because there's no clear solution). The uncertainty can take a significant emotional toll—fueling anxiety, self-blame, relationship stress, and deep grief.

As a fertility acupuncture specialist, Dr. Cindi works with individuals and couples navigating this difficult space, supporting not just the physical body, but the emotional and energetic systems that are also affected. Unexplained infertility doesn't mean there's no cause—only that current medical testing hasn’t identified it yet. Acupuncture and holistic approaches may help uncover and address underlying imbalances that are harder to detect through conventional means.

Here are five treatment paths to explore that may improve your chances of conceiving and help restore a greater sense of balance and hope on your journey to parenthood:

Lifestyle adjustments | Even when medical tests come back normal, subtle lifestyle factors can impact fertility. Chronic inflammation, poor sleep, unmanaged stress, and undiagnosed nutritional deficiencies may all play a role. Supporting your body through foundational changes—such as getting quality rest, eating a nutrient-rich diet, staying hydrated, and addressing underlying autoimmune or metabolic conditions—can improve your chances of conception. Reducing stress is especially important, as high cortisol levels may interfere with hormonal balance, ovulation, and embryo implantation. These lifestyle shifts may seem simple, but they lay the groundwork for a healthier reproductive system.

Medications | In cases of unexplained infertility, your doctor may recommend medications to gently support or enhance your reproductive function. These might include ovulation-stimulating drugs (like Clomid or Letrozole), medications to regulate menstrual cycles, lower prolactin levels, or address insulin resistance. Even without a clearly identified cause, these medications can help shift your hormonal environment into a more favorable state for conception, especially when combined with other supportive therapies.

Give it a little more time | For couples under 35, doctors often recommend continuing to try naturally for a bit longer—typically up to 12 months. Sometimes, conception simply takes time, especially if cycles are irregular or life stressors have been high. This approach depends on your overall health, emotional bandwidth, and how long you've already been trying. If you're over 35, it’s generally recommended to seek further evaluation after six months of trying. While waiting can be emotionally challenging, some couples do conceive naturally during this watchful waiting period.

IUI or IVF | When time is a concern—or when the emotional toll of trying without answers becomes too heavy—assisted reproductive technologies like IUI (Intrauterine Insemination) or IVF (In Vitro Fertilization) may be recommended.

IUI is often considered a first step before IVF, especially when unexplained infertility is the diagnosis. The procedure involves placing washed, concentrated sperm directly into the uterus around the time of ovulation, increasing the chances of fertilization. IUI is less invasive and more affordable than IVF, and it may be paired with ovulation-stimulating medications to improve success rates.

If IUI isn’t successful after several cycles, or if additional factors such as age, egg quality, or prolonged infertility are at play, IVF may be suggested. IVF offers a more controlled environment by combining eggs and sperm in a lab, then transferring a healthy embryo into the uterus. It can bypass potential issues that are difficult to detect—like fertilization problems or subtle sperm or egg dysfunction.

Typically, if you’re under 35 and have been trying for a year without success, or over 35 and have tried for at least six months, your fertility specialist may recommend exploring IUI or IVF to increase your chances of conception.

Acupuncture | When conventional medicine doesn't reveal a clear answer, holistic approaches like acupuncture may help fill in the missing pieces. Rooted in Traditional Chinese Medicine (TCM), acupuncture works by improving the body's internal balance and optimizing the flow of energy. It’s been shown to regulate hormones, improve blood flow to the uterus and ovaries, reduce inflammation and stress, and support ovulation. Acupuncture also pairs well with IVF or IUI, improving outcomes by up to 40%.

How Acupuncture can Help with Unexplained Infertility

When you’re told there’s “no clear reason” you’re not conceiving, it can feel like you're left in limbo, waiting for answers that never come. Acupuncture and TCM offer a powerful and supportive path forward, especially in cases of unexplained infertility. Acupuncture doesn’t wait for a diagnosis—it works to bring the entire body back into balance, enhancing fertility naturally and complementing any Western treatments you may be pursuing.

A Holistic Approach to Fertility | In TCM, fertility is seen as a reflection of the body's overall health. When energy and blood flow freely, the reproductive organs are nourished, hormones are more regulated, and conception is more likely to occur. Acupuncture addresses subtle imbalances that often don’t show up on lab tests, such as stress-related disruptions, poor circulation to the uterus, or underlying inflammatory patterns.

What the Research Says | Modern research supports the use of acupuncture for fertility. A 2018 meta-analysis published in Reproductive Biomedicine Online found that acupuncture significantly improved clinical pregnancy rates in women undergoing IVF when performed around the time of embryo transfer. Another study published in Fertility and Sterility showed that acupuncture can help improve ovarian function and menstrual regularity—even in women with no identifiable reproductive issues.

In cases of unexplained infertility, acupuncture is thought to:

• Improve blood flow to the uterus and ovaries, enhancing egg quality and endometrial receptivity

• Regulate the hypothalamic-pituitary-ovarian axis (HPO axis), which controls reproductive hormones

• Reduce stress and lower cortisol levels, which may otherwise disrupt ovulation and implantation

• Support healthy luteal phase development, increasing the chances of implantation

• Improve outcomes of assisted reproductive technologies like IUI and IVF
  

Emotional Support and Nervous System Regulation | One of the most profound—and sometimes overlooked—benefits of acupuncture is the emotional relief it can provide. The experience of infertility can be incredibly isolating, anxiety-inducing, and emotionally taxing. Acupuncture helps regulate the nervous system, shifting the body out of "fight or flight" mode and into a more restorative state. Many patients report feeling calmer, more emotionally grounded, and better able to cope with the ups and downs of their fertility journey.

This reduction in emotional stress isn’t just comforting—it can have a real physiological impact. Chronic stress can affect ovulation, hormonal balance, and even uterine blood flow. By helping you relax deeply and regularly, acupuncture creates a more favorable environment for conception.

Laying the Groundwork for a Healthy Pregnancy | Whether you’re trying to conceive naturally or preparing for IUI or IVF, acupuncture acts as a form of reproductive "pre-care." Weekly sessions over the course of several months help regulate your cycle, improve cervical fluid, optimize hormone function, and build overall vitality. This foundation not only enhances your chances of conceiving, but also supports a healthier, more sustainable pregnancy.

Ready to Take the Next Step?

Unexplained infertility can leave you feeling powerless—but you don’t have to walk this path alone. Acupuncture offers a safe, gentle, effective, and science-supported way to support your body, reduce stress, and enhance your fertility journey, whether you're trying naturally or preparing for treatments like IUI or IVF. The key is working with a practitioner who truly understands reproductive health.

Dr. Cindi Ignatovsky is a fertility-focused acupuncturist serving Campbell, San Jose, and the greater South Bay area. With over twenty years of experience helping individuals and couples facing PCOS, endometriosis, thyroid imbalances, elevated FSH, irregular cycles, male factor infertility, and recurrent pregnancy loss, she provides personalized, integrative care that goes beyond symptoms, to treat the whole person.

If you’re ready to explore how acupuncture can support your fertility, emotional well-being, and overall health, Dr. Cindi welcomes the opportunity to work with you. Schedule a consultation today and take the next step toward your goal of growing your family. •