What is the Best Treatment for Unexplained Infertility: Clomid, IUI, and IVF?

Unexplained infertility is the diagnosis given when a woman is not getting pregnant and there is no medical reason found to explain why.  It is a particularly frustrating diagnosis because as you go from intervention to intervention you get increasingly desperate.  If they don’t know what’s wrong, how can they fix it?

Treatment Options:

There are a number of options anyone experiencing unexplained infertility can try.  I’ll explain them here from least invasive to most invasive.

Keep Trying

When I look back on my journey to motherhood, I regret jumping into the medical interventions so quickly.  Once you are on that trip it gathers momentum quickly and you can soon feel like you are spinning out of control.

From where I am now, I think it would have been better to give it six more months from the time I was diagnosed with unexplained infertility.  I would have started with tracking my cycle and with alternative therapies.  You can read more about my experiences with alternative treatments in, “Does Acupuncture Really Work for Unexplained Infertility; What are the Benefits of TCM Treatments?” and “Mayan Abdominal Massage: Arvigo Therapy.”

I can recommend the book Taking Charge of Your Fertility by Toni Weschler, MPH.  It is a great resource for getting to know your own unique body and figuring out when you are most fertile.  Timing could be your only problem and you could be one of the lucky ones that can avoid the stress and cost of medical interventions as well as the hormonal hangover they induce.

I was terrified by the diagnosis and the possibility of never having a child.  This clouded my judgment and led me to accept everything my doctor recommended, which was so not me.  I became addicted to the quest of conceiving and I fed that addiction with treatment after treatment.

The first doctor I worked with most certainly did not have my best interests at heart, and I often wonder how different things could have been if I had taken a little time to increase my chance of conceiving naturally, before jumping into invasive treatments.  For tips on choosing a fertility specialist see my post, “Top Fertility Clinics are not Created Equal; My Unexplained Infertility Success Story From NYC.”


Clomid is often the gateway drug for those suffering from unexplained infertility.  It stimulates ovulation and increases the number of eggs you drop each month, therefore increasing your chance of conceiving.  It comes in a pill form and is generally taken for 5 days during your cycle.

Clomid also increases your chance of getting pregnant with multiples.  The risk of multiples is low, but it is something to consider.  Most clinics will recommend that you carry no more than twins.  If you get pregnant with triplets or more they may recommend that you reduce to twins.  Reduce is a euphemism for abort, so if you have reservations about abortion you should discuss them with your doctor before you start the medication.

Clomid is the least invasive place to start and in my opinion a very wise place to start.  Why put your body through more than you have to?  If you’re gonna do drugs isn’t smoking a little weed better than shooting up smack?

I hadn’t heard of Clomid and wasn’t offered it when I started my trip, but I’ve heard that the side effects are similar to really bad PMS.  Fertility drugs take their toll, and if you end up with a variety of treatments the cumulative effect can wear on you.

Intrauterine Insemination (IUI)

IUI is where we started.  We skipped the weed and went straight for the ecstasy.  IUI involves your doctor placing the sperm right where they should be, by way of a catheter, just before and generally again just after ovulation.  This is done in conjunction with Clomid or injectables so again you are dropping more than one egg and there is a chance of multiples.

Injectables, like Clomid, stimulate ovulation, but they are stronger and require more monitoring by your doctor.  They used to knock me out.  I’d give myself the injection at 8:00pm and be passed out on the couch at 8:05.

IUI is a killer party, lots of sperm and lots of eggs all swimming in a sea of ecstasy where the hormones are raging and the drinks are flowing.  Someone’s gotta score don’t they?

In Vitro Fertilization (IVF)

IVF is your crack cocaine.  This is the one that you will be reaching deep into your pockets for.  It doesn’t come cheap and it doesn’t come easy.  When you hit IVF you know you know you are in deep, and you don’t care anymore.  You will remortgage your home, you will mug an old lady on the train, or you will do what I did, call your mother hysterical and sob about how you will never give her a grandchild.  I got an interest free loan from Mom and Dad to support my habit.

You are on injectables for an IVF cycle, the difference is that when these eggs mature they will be surgically removed and mixed with healthy sperm in a laboratory.  There is even a procedure called Intracytoplasmic Sperm Injection (ICSI) where a sperm can be injected directly into an egg to help ensure fertilization.  If your egg and sperm refuse to mingle at the party, they can be slipped a mickey and wake up wondering what happened.

A few days after the egg retrieval, usually on either day 3 or day 5, your doctor will have you return to the office for your transfer.  This is when they put the most viable embryos into your uterus via a catheter and when you find out if there are any additional viable embryos.

With IVF there are decisions to make, if you have extra embryos what do you want to do with them?  Most doctors will recommend that you have two or three embryos transferred to give you the best chance of conceiving but also to lower the risk of having to reduce.  If you have a number of viable embryos, you will need to decide if you want to freeze them to use in the future, discard them, or donate them to science or another infertile couple.  This decision can be difficult, I had a hard time with it, and I think it deserves some thought before you are so hormone induced that your lucid moments are fleeting.

Advice From a Former Addict:

My advice is to realize that these are all options that are available to you, but you don’t have to attend every party you’re invited to.  Do just as much as you can handle both financially and emotionally.  If you have a hormonal hangover, are grieving the loss of a miscarriage or failed attempt, or are having trouble paying your bills, take some time off and don’t feel guilty about it.  This party is not going to stop anytime soon, so you’re not missing anything, just taking a break so that you have the stamina for your next all nighter.

I also recommend that you start to build a support system.  If you have a friend or family member who is on a similar trip, make use of that connection.  If not, strike up a conversation with the woman next to you in the waiting room or find an online forum.  People who have not had to deal with infertility do not know how to handle you.  They will treat you with kid gloves, and everything they say to you, no matter what they say to you, will be the wrong thing, so find someone to confide in who will understand.  I wish you the very best of luck on your trip!

About Jody Tilbury

5 Responses to “What is the Best Treatment for Unexplained Infertility: Clomid, IUI, and IVF?”

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  2. Vanessa says:


    I am so grateful for your blog and thanks for sharing your insight and experiences with me, from which i learned so much, and it helps me to a different stage of this fertility treatment.

    I am very interested in Chinese Medicine and Acupuncture to get my body ready, can you please share with me where and who should I go and see?

    I will have my endo cysts removed in 3 or 4 weeks, shall i wait to have those CTM and acupuncture after the treatment.

    Thanks so much. Vanessa

    • Jody Tilbury says:

      Hi Vanessa, I’m so glad you found the blog useful and wishing you the very best of luck. If you can’t get a personal referral for an acupuncturist in your area than I think acufinder.com is a good place to start. About.com also has a post that gives a list of questions to ask when you’re looking for a fertility acupuncturist. As far as when to start acupuncture, I think it’s a personal decision but if you do decide to start before you’ve had the surgery than you’d definitely want to let your doctor know about your TCM treatments and your acupuncturist know about the surgery. If it were me, I’d probably wait until after the surgery and use the next month to find an acupuncturist that I felt really comfortable with. Let me know how it goes.

  3. Rachel R. says:

    Thanks for sharing your experience – I like the street drug/partying analogies to lighten the mood 🙂 I’ve done 3 cycles of Clomid with no improvement, and we are now at a crossroads where we are deciding how to proceed next. I just had my first acupuncture treatment and am hoping that helps. I appreciate hearing your side of things, I know it’s a difficult thing to discuss.

    • Jody Tilbury says:

      I really hope the acupuncture works for you. I know it’s not an easy place to be. Wishing you well!