Infertility, in and of itself, is a frustrating experience. Beginning with trying to conceive for a year or more (six months for those over 35) and having zero success to the tests and ultimately, hopefully, a treatable diagnosis. The entire endeavor is somewhat grueling emotionally and physically, but oh the payoff! You finally realize your dream.
A diagnosis of unexplained infertility makes the frustration you feel even stronger. Where do you go from there? Is this a real diagnosis or just some medical “cop-out”? How do you and your fertility specialist overcome a diagnosis of unexplained infertility?
Unexplained infertility is a very real diagnosis and there is treatment. It’s estimated anywhere from 5%-10% of couples who experience infertility receive a diagnosis of unexplained infertility. Although treatment isn’t as exacting as when treating a known condition your physician will prescribe a course of action improving your odds for successful pregnancy.
Unexplained Infertility Defined
According to the definition of unexplained infertility, it occurs when the standard tests for infertility are inconclusive and unable to pinpoint a cause for the inability to conceive. After a fertility specialist conducts a comprehensive series of tests and is unable to identify a cause, the patient’s diagnosis is deemed unexplained. Some doctors may refer to unexplained infertility as idiopathic infertility however this term is typically used when referring to infertility that is unexplained, however, it is narrowed down to male factor or female factor.
Testing for Infertility
According to the American Society for Reproductive Medicine and National Institutes of Health, doctors cannot conclude a diagnosis of unexplained infertility until patient(s) receive a thorough evaluation and standard fertility tests. These tests include:
- A thorough physical exam
- Complete medical history and complete sexual history
- Assessment of the woman’s ovulation
- An evaluation of the woman’s ovarian reserve
- Analysis of the man’s semen
- An evaluation of the woman’s uterus and fallopian tubes (typically by x-ray) called a hysterosalpingogram
- Further tests include a laparoscopic procedure to view the reproductive organs. While minimally invasive, your doctor performs this procedure to view and confirm suspicions of endometriosis, adhesions or scar tissue, ovarian cysts and uterine fibroids.
Diagnosis of Unexplained Infertility
Once both the man and woman receive a full and complete series of tests and the results show that-
- You are both physically healthy
- Ovulation is regular
- Egg reserve appears healthy
- Fallopian tubes are clear, open and healthy
- There are no issues with your uterus
- Semen analysis is normal for count, motility and shape of sperm
Causes of Unexplained Infertility
The definition of unexplained infertility is the inability to determine a reason for a couple’s unsuccessful attempts to conceive. Because of the imperfect nature of medical testing, there’s a chance these tests missed some subtle indications or defects.
Mild endometriosis is difficult to diagnose. With severe endometriosis a woman experiences painful periods. Often the endometriosis prevents passage of the egg into the fallopian tube or even ovulation itself. But with mild endometriosis you may not have any discernible symptoms and it may be present just enough to interfere with conception.
Poor egg quality is another possible cause of unexplained infertility that’s also easy to miss. The closer you are to menopause age your eggs may become less viable. Certain underlying medical conditions also result in poor quality eggs.
The quality of sperm may also be at the root of unexplained infertility. Even when the sperm count, and the motility and form are normal sperm DNA issues are more prevalent in older men. Often, when both egg and sperm look healthy, but fertilization simply fails to occur it could indicate a problem with egg or sperm quality. There is also a possibility of the sperm fertilizing the egg, but the cells fail to grow and form a fetus.
Luteal phase defect is another possible cause for infertility as well as multiple miscarriage. The luteal phase is a stage of a woman’s menstrual cycle that occurs after ovulation but before your period. After ovulation your ovaries make the hormone progesterone. Your uterus reacts to this hormone by thickening the lining. If you are not pregnant the lining sheds as a period. If your egg is fertilized, it implants into the thickened uterine lining. If your uterus does not respond to progesterone a fertilized egg cannot attach and grow.
Treatment for Unexplained Infertility
Every experience with unexplained infertility is unique and without a known cause for your infertility it’s difficult to treat. However, there are some common treatments that are often successful in such cases.
- Timed Sexual Intercourse: Your fertility specialist educates a couple on how to time intercourse with the woman’s ovulation for optimum opportunity for conception. This is an especially successful treatment for young couples.
- Clomid or Injections with IUI: IUI (intrauterine insemination) occurs when the fertility specialist collects, washes and concentrates the sperm then places it directly into the woman’s uterus at the time of ovulation. Using the ovulation stimulating medication Clomid or FSH injections with IUI increases the opportunity for pregnancy.
- IVF: In vitro fertilization is the most effective treatment for unexplained infertility. The lab creates the embryos from a couple’s egg and sperm and can test the embryos for viability and chromosomal abnormalities prior to implanting your embryo(s).
Your Partner in Overcoming Infertility
Assisted reproductive technologies and reproductive medicine in general constantly strive to improve your odds of overcoming infertility. At LA IVF we understand just how frustrating a diagnosis of unexplained infertility is, and we partner with our patients to help them grow their families as they’ve dreamed of. Contact LA IVF today and together we’ll work to overcome your infertility.