Jen Walpole Registered NutritionistBy: Jen Walpole, Registered Nutritionist

Clients frequently come to see me for nutrition advice to support their fertility, without a diagnosis on what may be hindering their journey. Unexplained infertility affects as many as 1 in 5 couples struggling with infertility. Often, some simple testing can be hugely beneficial to understand more about what might be going on for couples. Continue reading below to learn more about these tests and how they can help you achieve your fertility goals.

Underactive Thyroid

Did you know that women are five times more likely than men to be diagnosed with hypothyroidism? A recent study found that women that struggled with unexplained infertility had significantly higher levels of TSH than those that did not. Ruling out an autoimmune condition such as hypo or hyperthyroidism is an important part of your fertility picture. Testing not only TSH and T4/T3, but looking at the autoantibodies as well is crucial. Elevated levels of those autoantibodies may indicate autoimmunity, which needs to be addressed with a personalised approach. Nutritional strategies work well alongside medical treatment to support autoimmunity issues.

Male Factor

The male factor should not be overlooked in your fertility picture. Often, women focus on and change their own lifestyle and nutrition habits to support their fertility journeys, without addressing that of their partners. We know that semen quality has declined to a low level, possibly due to modern lifestyle factors, including exposure to environmental toxins. A systemic review and meta-analysis in 2015 reported a significant decline in sperm concentration over the years 1938-2013. 

If you have been trying to conceive for six months or more, it is a good idea to carry out a semen analysis. You may also wish to consider DNA fragmentation testing, which is an additional parameter that can be useful in some cases, such as with recurrent miscarriage. Spermatogenesis (sperm production) takes place within approximately 72 days, so it’s important to remember that your current habits won’t be reflected in the sperm until more than two months from now. For this reason, I encourage a whole-couple approach for my clients. It’s important for both parties to address their nutrition and lifestyle in preparation for starting a family.


Inflammation can affect ovulation and hormone production and is also associated with endometriosis. Whilst there is little nutritional intervention when it comes to endometriosis, an anti-inflammatory diet may be a helpful approach. Inflammation can be assessed with a simple blood test, whilst vaginal inflammation may be diagnosed via a swab. In addition, autoimmunity plays a part in this picture, as this is where the immune system mistakenly attacks your body. A study found that premature ovarian failure was linked to autoimmunity in 50% of cases. The Mediterranean diet is the most widely studied for its anti-inflammatory nature and positive fertility outcomes.

Underlying Infections

It’s important to rule out any sexually transmitted infections ahead of conception, many of which may be completely asymptomatic. For example, Chlamydia trachomatis may result in infertility in 10% to 30% of infertile couples. Additionally, human papillomavirus (HPV) in sperm negatively affects pregnancy outcomes and may reduce the embryo’s ability to implant. If you or your partner haven’t been tested for the duration of your relationship, it may be an important test to seek out to rule out any underlying infections.

Microbiome Imbalance

Most people are aware of the importance of the gut microbiome, but did you know about the vaginal microbiome? Lactobacillus is the most abundant species of beneficial bacteria in the vagina, however, up to 33% of women lack considerable numbers. It’s important to consider the vaginal microbiome in your fertility picture. Additionally, the seminal fluid has its own microbiome and variations to this have been linked to a variety of disorders, including sub infertility and poor semen quality. Testing the vaginal microbiome is something I routinely run in my clinic in order to ensure that things are looking optimal ahead of conception. 

Oxidative Stress

Oxidation is something that is always happening in the body, which is where antioxidant foods come in to play to help counterbalance this. However, elevated oxidative stress, brought about by certain lifestyle and dietary habits such as alcohol intake, caffeine, smoking, poor diet and obesity, may impact fertility. Therefore, living a healthier lifestyle, rich in micronutrients and antioxidants, limited caffeine and alcohol, avoiding smoking and maintaining a normal BMI with regular physical exercise may promote fertility. Personalised support during your fertility journey, which addresses those factors, is really going to be the best approach.  


We know that during pregnancy, the immune system is downregulated in order to support the growth of the embryo, and therefore results in a positive pregnancy. However, when autoimmunity occurs the body attacks its own healthy tissue and this can therefore be underlying in unexplained infertility cases. Autoimmune disorders such as coeliacs, diabetes, autoimmune thyroiditis, and systemic lupus erythematosus may be implicated in reproductive issues and may especially play a role in unexplained cases of infertility. Overall activation of the immune system or immune system reactions may lead to ovarian failure and infertility. One study detected antibodies in the preovulatory follicle and concluded that specific treatment could improve the pregnancy rate in those women. Often, some simple testing to get to the bottom of an immune condition is needed to rule out autoimmunity in cases of unexplained infertility and it is advisable to pursue this testing ahead of further treatment such as IVF.

Hopefully, you find these tests helpful in gaining a better understanding of what may be causing unexplained infertility. To learn about how OvuSense can help meet your fertility goals, visit

If you would like to find out more about working one-on-one with Jen Walpole, contact her via her website, Instagram or her email ([email protected]).