The cause of infertility can be a simple or a complex reproductive disorder. It can emerge from one or more abnormal conditions in the reproductive system. Which sometimes makes it tough to find the cause and, therefore, the treatment to circumvent the hurdles in achieving pregnancy. Yet, IVF treatment stands out to be the most effective treatment for unexplained infertility.
A couple regularly trying for conception has a 16-18% chance of success per month. It means that 80% of the time, they may struggle to get pregnant because of reduced fertility or infertility. If a couple regularly attempts conception for over a year and still can’t get pregnant, then they shouldn’t wait and consult with a fertility expert.
10-20% of infertile couples or individuals seeking fertility help are diagnosed with unexplained infertility, meaning the underlying cause of infertility is unknown even after a comprehensive diagnosis.
What is unexplained or unknown infertility?
The first step in treating any medical condition is to diagnose the underlying cause; the same goes for infertility.
But what if we can’t find the cause?
Unexplained infertility is the case where the medical evaluation of the couples or individuals reveals that they are, in fact, fertile, yet they can’t get pregnant despite multiple attempts. In the report, everything is fine – ovulation is regular, ovarian reserve seems normal, uterus and fallopian tubes are healthy, and semen parameters are adequate; decent sperm count and motility, still negative results.
Nonetheless, Unexplained infertility can put salt into the wounds of couples longing for a child.
Only a fertility assessment test can discover the cause of infertility. A comprehensive diagnosis of infertility can include the following tests and imaging:
For female:
- Blood Tests: Hormonal evaluation, thrombophilia test, etc.
- Routine gyno exam
- Ultrasound imaging for the uterus
- Hysterosalpingogram (HSG)
- Diagnostic Hysteroscopy and Laparoscopy
- Sonohysterogram
- Endometrial biopsy
- Infectious disease tests, e.g., HIV, AIDS, Hepatitis B and C, Tuberculosis, etc.
For male:
- Routine urologist exam
- Semen parameter Analysis
- Semen function test
- Blood tests: hormonal evaluation
- Infectious disease tests, e.g., HIV, AIDS, Hepatitis B and C, Tuberculosis, etc.
- Assessment for testicular abnormalities, testicular biopsy
Additional genetic screening may be suggested for patients with a family history of genetic disorders.
If the reports of fertility evaluation seem “normal,” then the infertility is categorized as ‘unexplained.’ Nonetheless, it is vital to recognize the cause of infertility to provide a suitable fertility treatment.
Potential cause of unexplained infertility
The limitation in diagnosing the cause of infertility could be a shortcoming in the medical assessment technology or techniques. For this reason, IVF is considered an ideal procedure for unexplained infertility because it can either determine the cause or provide a solution for infertility. Here are some possible causes of unexplained infertility:
- Poor egg quality despite normal ovarian reserve (premature ovarian insufficiency), or It can be because of age
- Sometimes mild tubal diseases and endometriosis get misdiagnosed
- Cervical factors
- Sperm DNA fragmentation
- Functionally incompetent sperm
- Poor embryo quality
- Undiagnosed medical conditions, such as Tuberculosis, thyroid, Celiac disease, etc.
- Presence of anti-sperm antibodies
- Autoimmune infertility: where the body’s immune system rejects sperm or embryo
- Inadequate thickness of the uterine lining
What are the Treatments for Unexplained infertility?
Couples or individuals with unexplained infertility have a narrow conception window without fertility help. In the case of an unknown cause of infertility, the approach for treatment is empirical. Some treatment options and their chance for conception for unexplained infertility are:
- Regular intercourse schedule with ovulation ~ 2-3%
- Fertility medications: Clomid, Letrozole, and Gonadotropin ~ 4-5%
- IUI Treatment: 6-9%
- IUI Treatment with fertility medications ~ 10-20%
- IVF Treatment ~ 30-50%
Fertility drugs and IUI are considered first-line treatments for infertility. But if more than three cycles of IUI result in failure, then IVF treatment is suggested for patients with unexplained infertility.
Why and How is IVF a preferable treatment for unknown infertility?
Before IVF treatment, you may undergo other less complex fertility treatments, such as IUI. However, after 3-6 failed IUI cycles, IVF is considered the right choice.
As we know, in vitro fertilization is performed in the laboratory; this gives us an advantage in selecting the quality of eggs, sperm, and embryos during the IVF procedure.
We can almost customize the fertilization and implantation procedures in IVF treatment to ensure pregnancy. It accounts for the high success rate of IVF treatment for unexplained infertility in both men and women.
The IVF treatment offers the following alternatives for unexplained infertility:
- Quality of Eggs and sperm: IVF gives an insight into the quality of eggs and sperm. Embryologists can monitor and evaluate quality gametes for fertilization.
- Fertilization: In the IVF laboratory, embryologists can observe whether sperm can fertilize the eggs or not.
- IVF, with other ART treatments, can further ensure fertilization and implantation.
- IVF with ICSI can nail the process of fertilization.
- Embryo development: Embryo development can be monitored to evaluate the efficiency of the embryos
- Blastocyst Transfer: it is observed that blastocyst embryos are more capable of implantation than average 2-3 day embryos.
- PGS and PGD: Preimplantation genetic screening or diagnosis gives us embryos’ chromosomal and genetic analysis, respectively. With the help of embryo screening, we can judge whether or not an embryo will implant. IVF with PGS and PGD also prevents early miscarriages and children from inheriting genetic diseases from their parents.
- Laser-assisted hatching, in case of previous implantation failure: It may ensure embryo implantation for further development.
- IVF procedures give us a perception of cell development and fragmentation in eggs, sperm, and embryos for quality control.
IVF is a multi-step complex procedure that allows us access to quality control for the treatment.
We like to add that even though IVF treatment has the highest success rate for unexplained infertility, the success rate is still a varying factor. The age of the female dramatically influences the success rate of IVF treatment; therefore, you shouldn’t wait too long to get fertility help.
Consult our fertility specialists for your unexplained infertility and find an effective treatment at a reasonable cost.
Takeover
Infertility is infuriating, and if the cause is unknown, it can be even more vulnerable for the intended parents. However, there’s always hope. We can acknowledge that IVF covers a broader area when it comes to the journey of achieving a pregnancy. That’s why, with IVF treatment, one may not only find the underlying cause of infertility but also achieve conception.
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