Anne is back tackling the most frustrating diagnosis in fertility medicine: unexplained infertility. She breaks down why this label almost always means the right questions haven't been asked yet, not that there's actually nothing wrong.

She explains how varicoceles affect DNA fragmentation even when sperm count looks perfect, why DOR is overdiagnosed and often not the real problem, how failed IUIs and euploid transfer failures point to lining and immune issues that standard testing misses, and what tests actually matter—CD-138 staining for chronic endometritis, hysteroscopy for microadhesions, endomapping for endometriosis, and immune panels that most clinics won't offer.

This episode is for anyone told everything looks normal but nothing is working, anyone about to start IVF without knowing what they're solving for, or anyone realizing that unexplained infertility is just fertility care that hasn't been explained yet.

00:00 - Intro
03:13 - Question 1: How do you define unexplained infertility?
05:10 - Seed, soil, environment: The gardening framework for fertility
09:15 - Varicoceles and DNA fragmentation testing
13:45 - Why ICSI doesn't fix DNA damage
17:36 - Varicocele repair: Finding qualified surgeons
22:36 - Question 2: DOR—How can I improve my egg quality?
23:15 - Do you actually have DOR or just low AMH?
25:08 - Immune dysfunction vs. diminished ovarian reserve
28:20 - Maternal immune tolerance and implantation
31:45 - Fertilysis testing for immune issues
34:20 - Question 3: Spontaneous pregnancy once, many failed IUIs—why?
36:02 - Chronic endometritis and CD-138 staining
40:15 - EMMA/ALICE testing vs. CD-138: Which comes first
43:50 - Hysteroscopy for microadhesions and tissue inflammation
46:20 - Why letrozole can thin your lining
48:45 - Endometriosis as immune dysregulation, not just pain
51:45 - Endo mapping and finding qualified endo surgeons
55:36 - Closing: Unexplained means unexplored