IVF and Secondary Unexplained Infertility

Dear Professor Winston,

We have been trying for our second child for at least 8 years. Our daughter is now 13 years old, normal pregnancy but I lost my father when I was 4 months pregnant. It took under a year to conceive our daughter, after a long labour she was born ventouse.
We have been diagnosed by health professionals as having secondary unexplained infertility. I’m 41 and my husband is 44. We’ve had many tests over the 8 years, all come back as normal.

The mental exhaustion is taking its toll, we are strong as a couple but I feel our family isn’t complete. Should we try IVF or can you recommend any further tests.

Thank you for your time


Dear I.,

You give me a very little detail about the investigations. However in view of your age I would first suggest that you get your FSH levels checked 2 or 3 times because it may be that your ovaries are beginning to produce insufficient eggs and this could be a cause of the infertility. If the FSH is over 10 international units, this may well be the case.,At the same time I would recommend an AMH test which, if low also argues ovarian failure.

But given that you had a complicated delivery, I would strongly suggest are You consider having a telescope inspection, a laparoscopy, which will help to see whether you have any damage outside the uterus, or around the ovaries or involving the fallopian tubes which may be causing the infertility. After a complex delivery of any kind secondary infertility is rather more likely due to inflammation leading to adhesions, and a laparoscopy is the key investigation.

The other suggestion must be a womb x-ray (HSG). In my view, this is the best way of deciding whether you have any scar tissue are you trying cavity following your delivery. I consider that until you’ve had this battery of tests you cannot guard your infertility as unexplained.

Best wishes

Robert Winston