If the cost of IVF is not an issue, by all means go straight to IVF. There is no set way to go about TTC with ART...if you have the money/insurance, the docs will go as aggressive as you wish so long as it isn't medically counter-indicated.

Anonymous wrote:How exactly does one ask to go to IVF with unexplained? I am almost 35 and in the same boat as OP - finished with first round of tests at SG. I look at the stats and think - why can't we just skip to IVF? I know it's expensive and physically and emotionally grueling, but so is many, many rounds of drugs and IUI while you're getting older. DH agrees with Dr. that we should try least invasive first, but I just want to get this over with.

you just come out and ask. I was 31 at the time of IVF for unexplained infertility. Had almost 2 solid years of timed intercourse.
The stats gave me a less than 15% chance of IUI working and a 60% of IVF working. I just told the doctor that given the financial cost (we had 50% coverage for IVF and none for IUI) that I would prefer to just move to IVF.

How exactly does one ask to go to IVF with unexplained? I am almost 35 and in the same boat as OP - finished with first round of tests at SG. I look at the stats and think - why can't we just skip to IVF? I know it's expensive and physically and emotionally grueling, but so is many, many rounds of drugs and IUI while you're getting older. DH agrees with Dr. that we should try least invasive first, but I just want to get this over with.

I was unexplained as well at age 31 and again at age 34. Tried for >18 months each time. I have regular 28 cycles, used OPKs, the monitor, had well timed sex each month and still---nothing ever happened. We went straight to IVF and it worked the first time each time. Now we're trying for a third and still not getting pregnant naturally (we're in month 4). Not sure if we'll do IVF again.

Unexplained fertility is very frustrating. I know I ovulate eggs, I know my husband has good sperm and yet the 2 never meet. I think psychologically it's harder than having a diagnosis. Every month I get my hopes up because there's no apparent reason why it shouldn't and it does for just about everyone else.

Anonymous wrote:15:50 here.

At 33, the max I would do would be 2 clomid + IUI and the 2 injectable + IUI before moving onto IVF.

Do you know your AFC? (antral follicle count is taken on CD3)
FSH + AFC + AMH will give your RE a better picture of your ovarian reserve and how you might respond to medications

Unfortunately there are no tests available to detect egg quality, but at 33 you should be okay.

I am still learning all the lingo. Is the AFC count the number of resting follicles when they do the CD3 ultrasound? If so, I had 5 one side and 9 on the other.
I am almost certain the FSH and AMH was tested on CD3 too.

I was 33, had the same story after 30 timed cycles. We got pregnant on our first clomid+IUI with injectibles and went back a second time, got pregs on second clomid+iui injectibles. Keep the faith!

15:50 here.

At 33, the max I would do would be 2 clomid + IUI and the 2 injectable + IUI before moving onto IVF.

Do you know your AFC? (antral follicle count is taken on CD3)
FSH + AFC + AMH will give your RE a better picture of your ovarian reserve and how you might respond to medications

Unfortunately there are no tests available to detect egg quality, but at 33 you should be okay.

Unexplained is a tough diagnosis because it's hard to know when to move on to IVF. It's important to keep in mind that it doesn't mean nothing is wrong but that they just don't know what is wrong.

Have you tested for AMH levels? My initial test results showed everything was normal but my AMH levels were low, indicating diminished ovarian reserve. I guess not every place checks for AMH. Turns out I'm a low responder to stims and we're on our 4th IVF attempt. You may want to make sure that test was done and if it wasn't have it checked.

I am unexplained. Have been bbt charting since before we started ttc. We did four natural cycle IUIs, one clomid plus fsh and timed intercourse and are now moving on to IVF next cycle. I am not wasting anymore time with IUIs or meds.

I am also 33 and have been charting and doing TI for a year and like OP, was just diagnosed with unexplained. We are doing Clomid + IUI next month with Sacks at CFA. I am also interested in others who have BTDT, what to expect, what questions to ask, anything to maximize our chances.

OP, I was also given a diagnosis of unexplained infertility at 33 after the standard tests you mentioned. We started with Clomid (I think 4 times) then did a few rounds of IUIs and then did a few rounds of IVF. My one piece of advice would be to move along faster to IVF. Give the less invasive treatments a try because they work for some people, but the success rates are actually fairly low, so don't keep trying them if they don't work immediately. I feel like we wasted a lot of time before trying IVF and when we did I found out that I had almost no response to the drugs, which indicates POF. The only way to diagnose POF is a poor response to IVF drugs. I did eventually have a baby using donor eggs, but if I had done IVF sooner, we would have known about the POF earlier, moved onto donor eggs immediately, and could have cut our IF journey by years. You are unlikely to have to go as far as donor eggs. I don't mean to scare you. Most people get a better result with other treatments. But, be aggressive with the process. When you are fairly young, the doctors take an attitude that you have lots of time to keep trying low success, but less invasive, tactics. But, that isn't always in your best interest.

I'm 33 and have been charting and doing timed intercourse for a yr.

How old are you?

First steps would likely be Clomid + IUI, unless you can afford the time and want to do timed intercourse. They'll monitor your bloodwork & ovary activity through the cycle, likely control ovulation using a trigger drug and then do IUI or TI 36 hours later.

We just finished all of our diagnostic testing at SG. All of our test came back normal, no issues anywhere. We did CD3 bloodwork and u/s, Sonohysterogram, HSG and semen analysis.
I guess that technically puts us in the "unexplained infertility" category. So what's next? We have our follow-up next week, I'm just curious what others have experienced.