Unexplained infertility: when your diagnosis feels like a shrug
Can “we don’t know” really be the official position on your body?
There are diagnoses that tell you exactly what you need to do.
Take this tablet. Stop eating this. Monitor this monthly. Have this removed. See this specialist, and this one too. Here’s your sick note.
Others tell you absolutely nothing, and unexplained infertility belongs firmly in this category.
When I first heard it in combination with my body, my hand clutching my partner’s under the desk, it felt like the kind of conclusive and clinical answer we’d been waiting for. In that moment I felt like I could breathe, the kind of glorious release that loosens the nerves that have gripped your chest for months.
Finally, a diagnosis.
But as time went on, and I waited for instructions and definitive answers, it has come to feel more like a shrug.
Our worlds are full of labels that we either accept, ignore or learn to live alongside.
I can now exist with being anxious, introverted, and an over-thinker after years of trying to mend them as I would my car or our leaky laundry tap. Yet similar to my old VW Golf, I’ve come to learn that they’re not fixable.
Then there are ones that demand immediate attention. For example, diabetes: you monitor, medicate, change your diet and manage. Or cancer: there is surgery, chemo, more monitoring.
Even when the path ahead is dark and difficult, it still exists — you’re told by experts what comes next.
Unexplained infertility — described as a diagnosis given when standard tests cannot identify a clear reason for a couple’s inability to conceive after 12 months or more of unprotected intercourse — is neither.
There is no clear course of action to follow across the board, or definitive label to accept or reject, rather just the knowledge that something obviously isn’t working — oh, but no one can tell you exactly why.
At first, it drove me mad.
The word infertile had always scared me because it felt so final.
Growing up I’d always thought once a doctor declared you infertile then your journey towards biological children would immediately change course towards an existence without them.
But now that I’m immersed in the supportive community of fellow IVF warriors (and worriers) I’ve come to realise it’s a stopgap label, because there are so many shared experiences of “infertile” women having babies.
Unexplained on the other hand felt wishy-washy, a bit lazy.
As if, with all the advances in medicine (and sending people to the moon?!) the official position on my body was: we dunno, soz.
That’s not a slight on all of the specialists I’ve sat across from (my current one least of all, I trust her completely), rather it’s frustration at the hazy wording of the diagnosis itself and that the woeful underfunding of women’s health research that means it can still, in 2026, be considered a complete answer.
Ahead of that first appointment with a sought-out specialist I assumed we’d stroll out — Nicole Kidman-esque post Tom Cruise divorce, dancing into the sunshine — lighter, and with answers. Perhaps with a prescription for some daily medication, or a request for more blood tests — that was, if there was any blood left after all the times I’d sat in the chair (sweetie knew nothing then of how much blood the human body contains). Surely something solvable that would get us on the right track.
Instead the pathway initially narrowed — IUI was ruled out and ICSI was presented as the only real option. No tablet, no extra testing, just the one big scary procedure I was positive I wouldn’t be able to endure. Then it expanded until I couldn’t see the boundaries anymore.
Along the way — four egg retrievals, a laparoscopy, 105 injections, over 27 blood tests, 18 internal scans and a hysterosalpingogram later — I’ve come to learn that some people view unexplained as a space that needs to be filled with opinions, theories and possibilities. And at first I welcomed it.
Well-meaning practitioners over the years have told me I could get pregnant naturally and I’d lap their promises up with renewed optimism. Now, I mostly ignore it. Not because it isn’t possible — my dwindling flicker of hope thinks maybe, perhaps, please — but it doesn’t actually mean anything because there is no structure around it, no evident plan.
And that’s the most annoying and disorientating part of it all.
In a court, having “unexplained” as part of your defence simply wouldn’t fly. If my boss asked me why I decided not to rock up to work one day, I can hardly use it as my reasoning.
In the medical world, though, it’s a common diagnosis.
One of my most frustrating conversations was with my private health fund who wouldn’t cover a procedure in the 12-month wait window because of, you guessed it, unexplained infertility. But how could they prove that I was infertile, and if they could, could they please share that information with me?!
I was reading this week about liminal spaces, in Greek liminality translates to threshold, reflecting a state of being on boundaries, or between rooms.
For quite a lovely word, it can be a shitty place to be.
It’s the awkward time before breaking up with someone, but knowing you have to. Grieving the life you had with a loved one before they’ve passed. Getting a diagnosis of unexplained fertility with a wobbly next step at best.
You exist in this liminal state because you’re not fully reassured, but you’re no longer completely guessing or procrastinating getting a diagnosis. You’re just waiting for answers that may or may not exist while going through a hugely invasive process as if they do.
Because riddle me this, if my problem is unexplained, then what exactly am I trying to fix???
Please feel free to share your own frustrations, liminal experience or vents with me anytime!