Unexplained infertility
Unexplained infertility is a condition where the basic fertility tests are normal and still a couple is unable to conceive. Estimates suggest that 10% of couples having trouble in conception have unexplained infertility.
What are the basic fertility tests?
The tests which are carried out during your consultation with a fertility specialist include:
- Ultrasound scan to look for the ovarian reserve (number of follicles in your ovary) and ovulation.
- Imaging studies to ensure that the uterus is normal.
- Tubal patency test such as hysterosalpingogram/ sonosalpingogram/ laparoscopy to ensure that the fallopian tubes are patent.
- Hormonal evaluation is normal.
- Semen analysis of the male partner to look for sperm count, motility, morphology and vitality.
What are the causes of unexplained infertility?
Unexplained infertility may be due to causes in the male or female partner which are not tested. These include:
- Poor quality of egg/ sperm.
- Minimal or Mild grade endometriosis which cannot be picked up on scan or other routinely done tests. Laparoscopy will help in the diagnosis of this condition.
- Inadequate endometrial lining or altered endometrial receptivity which alters the interaction between ovum and sperm.
- Cervical mucus abnormality.
- Inadequately defined immunological causes.
What are the chances of conceiving with unexplained infertility?
Studies have shown that about 92% of couples with unexplained infertility eventually conceived naturally or with treatment. The good news is that everything is normal in the couple evaluation. The bad news is that there is no cause of infertility identified in the evaluation. However, the prognosis is not too bad with timely intervention.
What are the treatment options available?
Assisted reproductive techniques help in conception. These include:
- Ovulation induction with oral medications such as Clomiphene citrate or letrozole with or without gonadotropins.
- Intrauterine insemination will overcome the cervical barrier and lead to pregnancy.
- IVF/ICSI may be useful as the quality of egg, sperm and embryo can be assessed prior to embryo transfer leading to successful pregnancy outcomes.
The choice of treatment depends on various factors such as age of the couple, duration of married life, preference of the couple and previous treatment taken.
Healthy lifestyle goes a long way in favor of conception both naturally and by Assisted Reproductive Techniques.
When should I/we consult Fertility specialist?
Its time to consult a fertility specialist :
- If female is <35 years and has had regular unprotective intercourse for 1 year with failure to conceive.
- If female is >35 years or has irregular cycles and has had regular unprotective intercourse for 6 months with failure to conceive.
Which doctor is best for unexplained infertility treatment?
Dr Sneha J is a Gynecologist and best fertility specialist. She has completed MD OBG from the top university AIIMS , Delhi and University fellowship in Fertility/ Reproductive medicine. She had further training in dealing with these conditions, as a visiting fellow at high output centres in Madrid, Spain and Chicago,USA. A Gynaecologist with training in Reproductive Medicine is best for unexplained infertility treatment.
