When I first entered the world of infertility, I thought IVF would be the answer. I believed what many women do, that if you can afford the treatment, you can eventually take home a baby. But after multiple miscarriages and years of heartbreak, I discovered what no one had thought to test for: my immune system was at the root of it all.
Like many women, I was told I had unexplained infertility, a diagnosis that accounts for nearly 30 percent of all infertility cases. But unexplained does not mean nothing is wrong. It often means we simply have not looked in the right place.
In my case, an overlooked autoimmune condition was causing my body to reject my pregnancies. It was not until I found a reproductive immunologist who ran advanced immune testing that I finally got answers. I was diagnosed with an overactive immune response and elevated natural killer (NK) cells. My body saw pregnancy as a threat and was shutting it down.
Through a rigorous protocol that included immunosuppressive medications, IVIG infusions, 36 ultrasounds, and a highly disciplined anti-inflammatory diet and supplement regimen, I was able to carry my son to term. After his birth, I experienced another devastating loss. This time, my immune system caused my water to break at just 13 weeks. It was then that I realized my body could no longer carry a pregnancy safely. Years later, my daughter was born via a gestational surrogate, an experience that brought profound healing and a new chapter in our family's story.
When I was going through it, I found myself experiencing a strange kind of jealousy toward women who lost pregnancies due to genetic issues. As painful as that path is, they had something I did not: an answer. A reason. A concrete explanation they could hold onto as they grieved. I was left with the devastating knowledge that it was my own body, my immune system, that ended my pregnancies. The very body meant to love and protect my babies had instead attacked them. There was no peace in that. No clean explanation. Just an overwhelming sense of betrayal by a system that is rarely understood for its role in infertility.
But that pain eventually became purpose. I stopped accepting unexplained as the final word and started searching for real answers.
What I Wish More Women Knew About Unexplained Infertility
Many reproductive endocrinologists are trained to focus on the ovaries, uterus, and tubes, but the immune, endocrine, and metabolic systems also play a significant role in whether or not a pregnancy will succeed. And in most standard fertility workups, these systems are not thoroughly explored.
According to the American Journal of Reproductive Immunology, 65.5 percent of women with unexplained infertility show immune system abnormalities. 73 percent are deficient in vitamin D or B vitamins. And 56 percent have signs of metabolic dysfunction.
These numbers tell a clear story: there is often a root cause. We are just not looking for it.
The Signs We Might Be Missing
Before I knew my immune system was involved, I had dozens of food sensitivities, gut issues, and autoimmune flares that no one connected to my fertility. Now I understand these were early warning signs.
Pregnancy is not just a hormonal event. It is an immunological one. For a pregnancy to thrive, the maternal immune system must go through an extraordinary process of adaptation. It has to recognize the embryo as a semi-foreign presence, because half of the baby's DNA comes from the father, and then choose to tolerate it rather than reject it. This requires a carefully calibrated balance between immune activation and suppression. If that balance is off, if certain immune cells like natural killer cells are too aggressive or if inflammatory cytokines outweigh protective ones, the body can interpret the pregnancy as a threat and end it before it has a chance to grow. This is not rare. It is just rarely looked for.
Many early pregnancy losses, particularly those that happen in the first trimester and are not genetically tested, may be far more complex than they appear. When there is no chromosomal explanation, the immune system should be considered. A healthy pregnancy requires the maternal body to shift into a more anti-inflammatory state, allowing it to tolerate the embryo instead of treating it as a threat. But when there is underlying inflammation or autoimmune dysfunction, that shift may never fully occur.
In many cases, the body allows conception to happen, but it cannot sustain the pregnancy. This is why so many women with undiagnosed immune issues can get pregnant but struggle to stay pregnant. These are not isolated tragedies or bad luck. They are part of a larger, under-recognized pattern that we urgently need to talk about.
Steps to Consider
If you have been diagnosed with unexplained infertility or experienced recurrent pregnancy loss, here are some steps to consider.
Ask for a deeper panel. Inquire about an immune antibody panel, TH1/TH2 ratio, NK cell activity, and ANA (antinuclear antibody) levels.
Push for answers beyond genetics. If you have experienced a miscarriage where chromosomal abnormalities were ruled out, your doctor should be investigating secondary causes. This includes immune dysfunction, clotting disorders, thyroid issues, and inflammatory markers.
Support your microbiome. Gut health plays a critical role in immune balance. Consider probiotics, prebiotic fiber, and anti-inflammatory nutrition.
Look for a specialist. Reproductive immunologists or clinics familiar with immune-related fertility issues can offer testing and support beyond traditional IVF protocols.
Do not ignore your symptoms. Autoimmune issues often present as fatigue, inflammation, digestive issues, or hormone imbalance. These are not normal. They are messages.
It Is Time to Expand the Conversation
I launched BOND after realizing just how many women were silently struggling like I was, navigating a system that left them without answers, direction, or hope. Our mission is to give women the tools to better understand and support their bodies before, during, and beyond fertility treatments, and to change the culture of waiting until things go wrong to finally dig deeper.
We need to move away from the outdated notion that infertility starts and ends with the ovaries. Fertility is a whole-body experience, one that involves the immune system, the gut, the endocrine system, and far more than most women are ever taught.
I hope we can challenge the idea that infertility must remain unexplained. Because when we start asking better questions about inflammation, immunity, and what our bodies are trying to tell us, we get closer to answers. And when we get answers, we get options. That is where healing begins.
Not sure where to start? Take our Hormone Quiz for a personalized recommendation.
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