There’s Hope: Maybe He’s Not Infertile!

They’ve been trying to conceive for almost two years with no luck. She’s been checked out and he’s been checked out and they’re both “fine.” That’s called unexplained infertility.

It’s often at this point that I see couples, shoulders shrugged, saying: “We’re hoping you can figure out why we’re not conceiving!” And this scenario is quite common, given that almost half of all infertile men present for care with a normal semen analysis.

After seeing thousands of couples like this over the course of many years, I changed my view of unexplained infertility to the following: I do good work and I am a details guy. Maybe I should trust that my evaluation of infertile men is telling me the truth and there is nothing hidden.

And perchance that observable truth is not “Sorry, I can’t explain why you are infertile” but instead, “You are not infertile. You are in fact fertile and the problem lies elsewhere.” I liken this to receiving a kickoff in a football game: Instead of catching the ball and just standing there while the opposing team barrels down on you, take the ball and run! Go on the offensive. In a word, I began trusting my gut.

Tell It Like It Is

Soon after, upon evaluating infertile men and finding nothing wrong with them, I started telling them: “You’re fine. Don’t ever change. Something else is the problem.”

I then decided to formally study the issue and have now published the findings. In our study, men were evaluated for male infertility and followed for at least one year. In all cases, the evaluation showed a clean history, unremarkable exam and normal semen analyses, and I “cleared” men from further medical care. I offered the following advice:

• Keep trying to conceive
• Use timed intercourse
• Exercise
• Use antioxidant supplements
• Maintain a healthy weight
• Follow a good diet

In no case did I offer formal medical or surgical treatment. Pregnancy rates were evaluated one year later through a telephone survey.

The Truth Works

Although couples had been trying to conceive unsuccessfully for an average of a year and a half before my male evaluation, 65% conceived naturally (average nine months) after the evaluation. Another 3% of couples conceived with IUI and 13% conceived with IVF. Honestly, we cannot offer pregnancy rates this good with any of our classic male infertility treatments or even with IVF. The study concluded that natural conception rates among men with unexplained infertility are high and suggested that many of these men are in fact truly fertile. Maybe Mother Nature knows best how to help couples conceive in cases of unexplained infertility.

In the words of Lao Tzu: “Nature does not hurry, yet everything is accomplished.”