Evidence-based · Written by Dr. Leila Fazlicic, D.Ac, L.Ac · Reviewed June 2026
If you are reading this at 2 a.m. after a cycle that didn’t work, there is a sentence running underneath every other thought: it was something I did. You replay the two-week wait. The coffee. The stress at work. The night you didn’t sleep. The clinic said “unexplained,” and somehow “unexplained” landed on you as “unexplained, and probably her.”
I want to be precise with you, because precision is the only thing that actually lifts this weight. The biology does not support the verdict you’ve handed yourself.
“Unexplained” means “we didn’t find it,” not “it was you”
An unexplained result is an honest admission of a limited search. A standard IVF workup looks hard at the female partner — hormones, ovarian reserve, the uterus, the transfer. It looks much less hard at the male partner, usually stopping at a basic semen analysis. When a cycle fails and everything the clinic checked looked acceptable, the file reads “unexplained.” That is a statement about the boundaries of the testing, not a finding about your body.
Here is the part that almost no one says out loud in the clinic room: roughly half of the genetic material in that embryo came from him. And male factors are involved in approximately half of all infertility — solely responsible in about 20% of couples and a contributing factor in another 30–40%.[1][2] A failed cycle is, at minimum, a two-person biology. Treating it as a referendum on you alone is not humility. It’s a measurement error.
The factor that’s rarely tested — and frequently the answer
A standard semen analysis measures whether sperm exist, swim, and are shaped correctly: count, motility, morphology. It does not measure whether the DNA inside the sperm is intact. That’s a separate test — the DNA Fragmentation Index, or DFI — and it is not part of routine workups.
This matters because sperm with fragmented DNA can still fertilize an egg and produce an embryo that looks fine on day three, then quietly fails to develop, fails to implant, or ends in early miscarriage. In studies, higher sperm DNA fragmentation is associated with lower live birth rates after IVF and ICSI,[3] and couples with idiopathic recurrent pregnancy loss show significantly higher fragmentation than fertile couples.[4] It is one of the most consistent “silent” contributors to exactly the outcome you’re grieving — a cycle that should have worked and didn’t.
This isn’t a fringe theory. The American Urological Association and the American Society for Reproductive Medicine specifically name sperm DNA fragmentation testing as reasonable to consider in cases of recurrent pregnancy loss, recurrent assisted-reproduction failure, and unexplained infertility.[5] If your cycle was called unexplained and his DFI was never measured, then the most informative test for your situation may simply never have been run.
Why the blame defaults to her — and why that’s a problem
There’s a reason the weight lands on women, and it isn’t biological. The female partner carries the cycle physically — the injections, the monitoring, the retrieval, the transfer, the wait. When something goes wrong inside a process that is happening inside her body, the mind reaches for the nearest variable, and she is standing right there. Clinics, exhausted of answers, often don’t correct it. The male partner, having passed a basic semen analysis, is told he’s “fine” and exits the conversation.
But “the semen analysis was normal” and “his contribution was fine” are not the same statement. The first is a narrow test result. The second is a conclusion the test was never designed to support.
I am not telling you this to relocate the blame onto him. Blame is not a useful input for anyone’s biology — his or yours. I’m telling you this because the story you tell yourself at 2 a.m. determines what you do at 9 a.m. If the story is “I failed,” the next move is more self-punishment, more restriction, more cortisol — none of which improves egg quality. If the story is “we have an incomplete picture, and there are specific things we haven’t checked or addressed,” the next move is a plan.
What this means for your next cycle
Two things change once you put the weight down.
First, the workup gets completed. If sperm DNA fragmentation was never assessed, that’s a concrete question to bring to your reproductive endocrinologist or a urologist before the next cycle. It is a test, not a verdict, and it’s one of the few that can convert “unexplained” into something addressable.
Second, the work becomes shared. Sperm take roughly 74 days to develop; the final maturation of the eggs you’ll retrieve runs over roughly the preceding three months. Those two clocks run at the same time, which means both partners changing inputs starting now is not twice the effort — it’s the same window, used by both of you. The most concrete way a partner can take weight off you is to stop being a bystander to his own biology.
You did not fail. You ran a complex, two-person biological process with half the information, and you’re now choosing to gather the rest. That’s not guilt. That’s a plan.
What we do with this
The Failed-IVF Clarity Audit reviews both partners’ biology — egg quality, sperm DNA-fragmentation risk, inflammation, stress, sleep, and your timing window before the next cycle — and you leave with a written next-cycle blueprint: what deserves attention for her, for him, and your shared timeline.
Book your Failed-IVF Clarity Audit →
This article is educational and reflects coaching, not medical care. Your reproductive endocrinologist remains in charge of your medical protocol. See full medical disclaimer.
About the author
Dr. Leila Fazlicic, D.Ac, L.Ac is a holistic fertility expert with 15+ years in fertility-focused practice. She works with both partners simultaneously over the 12 weeks before IVF to optimize the biology of sperm development and final egg maturation — in parallel with the couple’s reproductive endocrinologist, never instead of medical care.
References
- RESOLVE: The National Infertility Association. Male Factor Infertility. https://resolve.org/learn/infertility-101/underlying-causes/male-factor/
- Schlegel PN, et al. Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline (Part I), 2020. American Society for Reproductive Medicine. https://www.asrm.org/practice-guidance/practice-committee-documents/diagnosis-and-treatment-of-infertility-in-men-auaasrm-guideline-part-i-2020/
- Simon L, et al. Sperm DNA fragmentation: relationship to reproductive outcomes — a systematic review and meta-analysis. PubMed 25530036. https://pubmed.ncbi.nlm.nih.gov/25530036/
- Association between sperm DNA fragmentation and idiopathic recurrent pregnancy loss: a systematic review and meta-analysis. Reproductive BioMedicine Online, 2018. https://www.rbmojournal.com/article/S1472-6483(18)30658-8/fulltext
- American Urological Association / ASRM. Sperm DNA fragmentation testing in recurrent pregnancy loss, recurrent ART failure, and unexplained infertility — AUA/ASRM Guideline. https://www.auanet.org/guidelines-and-quality/guidelines/male-infertility