What is Unexplained Infertility
Infertility is the inability to get pregnant even after 1 year of regular natural intercourse. A couple is typically diagnosed with unexplained infertility when all of thesestandard diagnostic tests (typically for semen, fallopian tubes and uterus) reveal no cause for infertility:
- semen analysis
- ovulation test
- ovary reserve assessment
While the best available diagnostic tests today can definitely pin-point the main reasons for infertility, but not all of them. So all of those un-identified reasons are collectively clubbed under the terms ‘unexplained infertility’. For instance, it may include a fine factorsuch as the poor quality of egg.
In fact, the first and foremost thing to understand in the case of ‘unexplained fertility’ is that it is the limitation of the present state of medical diagnostic technology, and the couple should not take it personally. This is because whenno cause is detected even after undergoing many tests, a couple trying to have a baby can get very disheartened.
Around 20 percent of our infertility patients are diagnosed with unexplained infertility.
Diagnosis and Treatment
Since by definition itself, the cause of unexplained infertility is unknown, its treatment is essentially based on observations and experience. Further, in the initial stages, such a treatment might not attend to any specific problem or functional disorder.
At the same time, the experience of the doctor comes in handy while deciding the optimal treatment strategy for a couple as per their unique needs to be based on individual patient attributes like age and effectiveness of therapy.
The leading treatments for unexplained infertility are observation with scheduled intercourse and lifestyle changes, clomiphene citrate and intrauterine insemination and IVF.
Further, it is always preferable to initially begin with the least intrusive options. They should always be tried before deciding for any intervention based treatments.Just to give you an idea, around one-third of our patients who are diagnosed with unexplained infertility do conceive with medications and inseminations, without the need for any intervention.
TYPES OF TREATMENT
The couple should immediately adopt a healthy lifestyle. It includes quitting excess caffeine intake, cigarette smoking, drugs intake, heavy alcohol consumption, building a recommended body mass index (BMI), for both the partners.
Ovulation Predictor Kit
We sometimes advise couples (for female ages 35 and less) to use an at-home ovulation predictor kit and plan intercourse accordingly for few more weeks. For older couples, time is more crucial so type of this treatment could be ruled out.
According to our experience, IVF is known to be quite successful in treating this condition, even though each case is unique and may be treated differently. In fact, IVF may reveal minute or subtle infertility causes that other diagnostic test could have missed like embryo development.
A laparoscopy based diagnosis could be recommended for couples with unexplained infertility, in cases where the female has indications of endometriosis or a tubal disease. In case a mild endometriosis is actually detected, it might be surgically removed as per doctor’s advice, and may improve the chances of conception.
COH (clomiphene citrate or gonadotropins) with IUI
In intrauterine insemination or IUI a washed sperm is placed inside the uterine cavity while ovulation., which increases the fertilization possibility. Additionally, COH helps find fine ovulatory defects that might have got unnoticed missed during standard tests, and may raise the number of eggs for fertilization.
Finally, it is saddening, very difficult and mentally stressful for couples with unexplained infertility to keep trying to look for a cause. As a part of the treatment itself, they should join some support group or seek a psychological help to sail through this tough phase.