This is Infertility is a bi-weekly podcast where we fuse narrative storytelling with experience and science to give you a new perspective on what it’s really like to go through a family building journey. Each episode dives into the emotional, physical, and financial burdens carried by those who experience infertility on their path to parenthood. Be it IVF, IUI, egg freezing, surrogacy, adoption, etc., the path is never the same and it can be long, painful, and lonely. It’s our mission to give those struggling a platform to be heard, a community connection, and an opportunity to raise awareness of the 1 in 6 who, for many reasons, struggle with infertility.
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This is Infertility

Episode 162: Fertility 101: Unexplained Infertility

The Fertility 101 Series, because there’s no shortage of daunting terms to keep your mind running, is a quick and dirty breakdown on a specific topic with insights from a fertility expert. 

In today’s episode, Dr. Callum Potts breaks down the unexplained infertility diagnosis. He walks us through the four factors of fertility, how they work collectively to create a natural pregnancy, and why these four factors could test normally without positive results. Dr. Pott’s discusses treatment options such as IUI and IVF, and how someone may decide on which path to take.  

While an unexplained infertility diagnosis is frustrating, Dr. Potts emphasizes that treatment options are not limited and testing normal is a positive thing.    

Guest: Dr. Callum Potts, CCRM Miami 

Host: Dan Bulger, Progyny 

For more information, visit Progyny’s Podcast page and Progyny’s Education page for more resources. Be sure to follow us on Instagram, @ThisisInfertilityPodcast and use the #ThisisInfertility. Have a question, comment, or want to share your story? Email us at 

Here are some highlights from this episode: 

Four Fertility Factors

02:47 – 05:09 

Dr. Callum Potts: We kind of think about four big things that we need to conceive a pregnancy. One is sperm. And so, an evaluation of infertility always involves the male partner, if one is present, looking at a semen analysis to look at various parameters of sperm function, and making sure that those are within normal ranges. We look at various factors involved in how an egg is released, we can look at factors involved in ovarian reserve, which is basically the number of eggs that exists in ovaries, there are blood tests and ultrasounds that we can do to look at that ovarian reserve number. And there are also a range of hormonal tests that we can do to look at how an egg is being released how the brain and the ovaries are talking to each other. And making sure that reproductive access is intact. And so there are hormones from the brain like follicle stimulating hormone or FSH, luteinizing hormone or LH, thyroid stimulating hormone or TSH, prolactin, there are other hormones from the ovaries themselves like estrogen and progesterone that we can interrogate and look at to see if there’s a specific hormonal reason why an egg may not be being released in an adequate fashion. Egg and sperm meet in the fallopian tube. So, the third thing that we investigate is the fallopian tubes with an imaging study just to show that they are open or not. Once egg and sperm meet, they become an embryo in that fallopian tube, and they travel down into the uterine cavity to implant to become a pregnancy. So, the fourth and last thing that we can investigate is that uterine cavity. Many patients’ tests will come back to normal. And that really gets us to that, that unexplained infertility diagnosis.

Three Paths to Parenthood

08:43 – 12:05 

Dr. Callum Potts: The first option is always you can do nothing, you can kind of expectantly manage the process, there is an approximately three percent chance per month of achieving a pregnancy. So, it’s not high, but it’s not nothing. The first or the kind of least invasive treatment option that we could recommend would be some combination of oral ovulation induction medications. So, these are medications like Clomid or Letrozole as well as an intrauterine insemination. So, if we can do this IUI procedure and bring in a million purified and activated sperm into the uterus to meet not one egg, but maybe two or three eggs, that combination of factors can help to increase the chance of pregnancy to somewhere between eight and twelve percent each month. So, it’s not super high. But it certainly gives you a substantial increase over just trying naturally at that point. And then the other big treatment option that we have is IVF. And that’s the most complicated, it’s the most expensive, it’s certainly the most likely to be a successful treatment option. 

Dan Bulger: It’s a person-by-person decision. And there are more factors at play than just medical concerns, given the cost of these treatments. But I asked Dr. Potts, if there were any factors that could help people in choosing what path might be right for them. 

Two Functions of IVF

12:55 – 16:59

Dr. Callum Potts: For couples that are 38 years or older, I think there’s also a reasonable recommendation to go straight to IVF. The likelihood of having a live birth and kind of the accelerated chance of having a live birth really becomes more important in the slightly older age groups just to really get to the endpoints as quickly as we can. That being said, you know, it’s not wrong to choose either option, you know, outside of those recommendations. So, for example, my wife and I have unexplained infertility or had unexplained infertility. Our goals were to try and achieve pregnancy as quickly as possible. IVF is certainly the most likely treatment option to get to that point as quickly as possible. So, we chose IVF. 

Dan Bulger: So, IVF would have the highest likelihood of leading to a baby quicker than the other options. And for those who are choosing to move to IVF, there’s also an added factor at play to there is a diagnostic element to IVF. I don’t mean that people should do IVF to diagnose their problem. The point of IVF is not diagnostic, but an IVF cycle can actually answer a lot of these unexplained questions.

Dr. Callum Potts: You know, IVF is a great way for us to learn about some of those factors that we can’t test for ahead of time. When we retrieved the eggs from the body, we get a chance to look at them under the microscope. 

Dan Bulger: So unexplained infertility isn’t the end of the road. I think of it as bad branding. You never want to hear your doctor say they diagnosed you and also say it’s unexplained at the same time. But semantics aside, an unexplained infertility diagnosis can be seen as an opportunity.

Dan Bulger


Dan Bulger
Producer at Progyny

Dan has been in the healthcare industry for the past ten plus years as a multimedia content producer. Better known as ‘Video Dan’ he has interviewed numerous doctors, patients and other experts in the world of fertility. He’s also the producer for this podcast, This is Infertility and the producer behind the Progyny YouTube Channel which features interviews with dozens of the nation’s leading fertility specialists. On a personal note Dan’s parents started fostering kids when he was four years old, and he considers himself a proud older brother to over 100 foster children.

Dr. Callum Potts


Dr. Callum Potts
CCRM Miami

Dr. Potts is the Practice Director, founding physician and a reproductive endocrinologist at CCRM Fertility of Miami. He is a board-certified Obstetrician Gynecologist by the American Board of Obstetricians and Gynecologists and is board-eligible in Reproductive Endocrinology and Infertility.

During his career, Dr. Potts has held several leadership positions within the American College of Obstetrics and Gynecology and received awards for teaching and clinical excellence during his training. Dr. Potts has published and presented his research at numerous state and national conferences on topics including fibroid management, ovarian hormone synthesis, endometrial receptivity, and the relationship between menopause and cognition.

Dr. Potts and his wife have twin boys from their own journey through fertility care with CCRM, and he is delighted to be able to offer the same world-class care to his patients at CCRM Fertility of Miami. When he’s not running after his boys, Dr. Potts is an avid foodie and an enthusiastic member of the U.S. Medical Soccer Team.

Music From This Episode:

Artist: Jahzzar
Track: Curves

Track: Fabonacci