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Solving the Mystery of Unexplained Infertility

A diagnosis of unexplained infertility can be frustrating, and defeating, for many couples. After seemingly countless tests and procedures designed to uncover the reasons behind your inability to become pregnant, you still don’t have an answer. What’s more, until you have an idea of the source of your infertility, you aren’t sure how to proceed with treatment.

Infertility is an immensely emotional journey. You’re hopeful one day, and may find your optimism waning the next. When you’re told you have unexplained infertility it only adds to your frustration and dismay. What’s next? Does your infertility truly defy any explanation?

How Unexplained Infertility is Diagnosed

The term “unexplained infertility”, frustrating though it may be, is not necessarily conclusive. Unexplained infertility is the diagnosis given after all standard fertility tests-checking the egg supply, examining for blockages in the fallopian tubes, assessing the ovaries, analyzing the sperm-have come back normal. An estimated 15% to 20% of all couples receive a diagnosis of unexplained infertility at this point in their journey.

Going Beyond Standard Testing

Solving the mystery of what’s causing your inability to conceive often involves going deeper into the diagnosis process which is what we specialize in at LA IVF. Because the success of your treatment, and the odds of becoming pregnant, are improved with more definitive answers, advanced testing offers the best option for answers. Some of the advanced tests for unexplained infertility include:

  • Ovarian Reserve Testing: This is essentially a test to determine a woman’s egg supply. Levels of certain hormones can help fertility specialists understand the number of eggs in reserve. The measurement of the antral follicle count, when used along with hormone measurement, helps determine what action needs to be taken to ensure the best possible outcome.
  • Detailed Transvaginal (Pelvic) Ultrasound: While a transvaginal ultrasound is often used in the initial rounds of standard fertility tests, a more detailed pelvic ultrasound is highly effective in assessing the presence of fibroids, cysts, tumors, and polyps, as well as the condition of the fallopian tubes, ovaries, and the uterus.
  • Hysterosalpingogram: Known as HSG, this imaging test helps fertility specialists recognize and diagnose certain tubal, and uterine impairments that may interfere with conception. HSG may have already been performed and reported as being “normal” due to the basic findings by the radiologist, but upon further assessment and review of the actual images which is what Dr. Bayrak would do in each case would then help identify the main issue that may have been overlooked.
  • Pelvic Laparoscopy: A laparoscopic evaluation of the pelvic organs provides the clearest view of that region. Some cases of unexplained infertility are related to lesions, scarring, and adhesions present in the pelvic organs. Being able to view these, as well as fibroids and endometriosis cysts, via laparoscopic procedure allows your fertility specialist to pursue treatment more effectively.

 

What Comes After Advanced Testing

If the results of your advanced testing for infertility are still inconclusive, there are options to increase your odds of pregnancy. Your odds for conceiving naturally are around 1-3%, as compared to fertile couples (female age less than 38) who have a 10-20% chance of conception each month. Of course these percentages are averages. Chances for natural conception decrease with the female partner’s reproductive age.

If, after a certain period of time, pregnancy hasn’t happened, there are ways to increase your odds. Superovulation, which is ovulation assisted by hormones, either Clomid, or injectable, combined with intrauterine insemination (IUI), increases your chances for conception. Superovulation is essentially multiple ovulations. An increase in the number of eggs boosts your odds that one, or more, will result in a successful pregnancy.

The superovulation process isn’t as successful with women of advanced maternal age. This is due to their low reserve of viable eggs. In this case, IVF is the most reliable solution to your infertility. In fact, if superovulation and IUI aren’t successful in younger women, then IVF is the surest route to pregnancy.

 

No Two Diagnoses of Infertility Are Alike

Each and every case of infertility is unique. There may be an underlying cause that standard testing cannot uncover. Advanced testing, by a fertility specialist, offers the best hope for identifying and treating infertility that seemingly has no cause.