Unexplained Infertility: Or just a case of inaccurate diagnosis?

2 December 3, 2015

The struggle to conceive can be emotionally draining for a couple. Coming to terms with the fact that they will be able to have a child only after fertility treatment can be distressing, and if given a diagnosis of ‘unexplained infertility’, they are left feeling even more confused and unsure of the next step.

Typically doctors initiate infertility evaluation once a couple has been unable to conceive after trying for a year. In cases where the standard infertility evaluation does not find an underlying cause, the diagnosis of unexplained infertility (also known as idiopathic infertility) is assigned.

As per studies, the incidence of unexplained infertility in couples undergoing infertility tests ranges from 15% to 30%.*

Patients diagnosed with unexplained infertility often move from pillar to post in the quest of finding a doctor, who will be able to provide a ‘magic cure’ to them. They opt for varied opinions and treatment options ranging from naturopaths to indigenous miracle cures that often compound the problem than solve it. Do not lose faith if your doctor has said that reasons for your infertility are unexplained. Here fertility experts from Gaudium help you understand all about unexplained infertility and ways to manage it.

How did my doctor arrive at this diagnosis?

A couple is said to have unexplained infertility if they are unable to conceive in spite of the following:

  • Normal ovulation and healthy fallopian tubes in female
  • Absence of endometriosis in the female
  • Normal sperm count, viability, motility and morphology in the male partner
  • Positive Sims Huhner test (also known as the post-coital test in which the ability of the sperm to reach the cervix and survive in the female reproductive tract is checked)
  • High frequency and well-timed (close to ovulation) unprotected sexual activity

Unexplained infertility: A misnomer?

The experts at Gaudium believe that most cases of infertility have an underlying cause and should not be dubbed as unexplained. The diagnosis of unexplained infertility is arrived at through exclusion, that is, if the accepted infertility tests for both partners are carried out and do not point to any abnormalities, your doctor may conclude that you have unexplained infertility.
However, the frequency of this diagnosis depends on the testing standards of your fertility clinic. A fertility clinic equipped with advanced diagnostic techniques will, more often than not, be able to predict the actual cause of infertility. It has been found that in many cases of unexplained infertility the real reasons were conditions such as endometriosis or immunological infertility (the woman’s body produces anti-sperm antibodies that attack the sperm) which were missed out during more traditional testing.

Also traditional testing methods are able to identify more obvious factors such as lack of sperms in male or blocked fallopian tubes in the female, however there may be more subtle factors at play such as low egg quality or genetic abnormalities in the egg or the sperm because of which the fertilized embryo does not survive. These issues are not easily identifiable and require expertise and experience at the fertility doctor’s end.

Is pregnancy possible with unexplained infertility?

Today with advances in reproductive technology, some of the so called unexplained causes of infertility are being dealt with easily. As discussed above apart from certain identifiable causes of infertility which some doctors may miss due to limited diagnostics (such as endometriosis growth, subtle tubal abnormalities), there may be other causes which are not easily identifiable like inability of the embryo to implant normally or abnormal cell division in the embryo.

Couples diagnosed with unexplained infertility may explore multiple avenues in consultation with an expert fertility specialist. Some of the available options are:

  • Ovarian stimulation through fertility drugs: Medication may increase ovulation and help in pregnancy in such cases.
  • Intrauterine insemination (IUI): Specially washed sperms are injected directly into the uterus at the precise time when ovulation occurs. This can increase chances of fertilization.
  • In vitro fertilization (IVF): This procedure involves retrieval of eggs and sperms and fertilizing them in a lab and later transferring the resultant embryos into the uterus. As per a 2010 study (FASTT trial), IVF technique may be the quickest route for pregnancy in couples with unexplained infertility.**

At Gaudium we employ the latest testing techniques and offer the world’s most advanced fertility treatments to our patients. Our patient-centric approach and the expertise of a team of super-specialists have helped more than 6700 couples achieve the joy of parenthood.

If you would like a Free Second Opinion for your infertility diagnosis, please get in touch with us here.

References

*http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2505167/
** http://www.ncbi.nlm.nih.gov/pubmed/19531445

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