Unexplained Infertility: Diagnosis and Treatment 

Have you been struggling to conceive for more than a year and your doctor is unable to detect an obvious problem? Are the fertility test results normal and yet the fertility specialist cannot find a detectable cause? This condition is called unexplained infertility and millions of couples around the globe are dealing with this. Does this mean you can never have a biological child or is there a way to treat this? From diagnosis to treatment to lifestyle changes – we will tell you all about unexplained infertility.

Unexplained Infertility: An Overview

Infertility in men and women can be of various types. While sometimes, doctors can easily identify the causes and provide the treatment, other times the causes remain elusive. Unexplained infertility means when it is difficult to find out why a couple is unable to conceive. The other name for it is idiopathic infertility and in such cases, the tests reveal:

• There is no blockage in your fallopian tubes.
• You ovulate at regular intervals.
• There isn’t any uterine abnormality or structural issue with the uterus.
• The semen analysis of your partner is normal in terms of amount, shape, count, and motility.
• The levels of reproductive hormones in your body are normal.
• You have a good ovarian reserve (egg count).

Note: 43% of couples get pregnant after opting for fertility treatment.

Causes of Unexplained Infertility

Technically, the cause of unexplained infertility is not known. However, there can be some unexplained infertility reasons that are delaying your journey of parenthood. Healthcare providers list these as the possible causes:

An undiagnosed underlying condition:

It can be challenging to be completely sure about how certain conditions impact fertility. Scientists are constantly studying to know more about how human bodies function. For instance, did you know that celiac disease is a kind of gluten allergy that can contribute to a person’s infertility? Thyroid and diabetes are underlying health conditions that too can affect fertility.

Endometriosis:

Endometriosis may have some or no symptoms at all. Even endometriosis can stand in your way of becoming pregnant.

Learn more about Endometriosis And Fertility

Cervical mucus:

The cervical mucus plays a key role in implantation as it allows sperm to swim up and get united with the egg when you are ovulating. If the cervical mucus is not transparent and watery but thick, sperm might fail to travel through the cervix and vagina to finally reach the uterus.

Sperm quality:

The quality of the sperm is also a contributing factor to infertility. So, a sperm analysis is necessary if there is any problem with the sperm. There can be other sperm-related issues that are making implantation impossible.

Egg quality:

With the help of an ultrasound, your healthcare provider can see your number of eggs. However, ultrasound gives no information about the quality of eggs. Blood tests in addition to ultrasound will give some idea about egg quality, but even this isn’t considered a definitive diagnosis.

Uterine lining:

The lining of the uterus is known as the endometrium. For implantation to be successful, the embryo needs to attach itself to the uterine lining. If your endometrium cannot thicken, then it is not prepared to accommodate a fertilized egg. In a thin uterus lining scenario, even if the sperm fertilizes the egg, the egg cannot implant as your endometrium is too thin. Hence, the pregnancy test results will be negative.

Poorly timed sexual intercourse:

Having coitus won’t get you pregnant unless you do it strategically. The timing, frequency, and position are all important aspects to keep in mind when having intercourse with the purpose of making a baby.

Sometimes, the cause of unexplained secondary infertility is too hard to detect and therefore, treat. While some people can get pregnant without much effort, for others, many things need to happen simultaneously to achieve results.

Diagnosis of Unexplained Infertility

Doctors perform a series of tests to diagnose the irregularities that are causing infertility. According to the American Society for Reproductive Medicine (ASRM), the following should be included in fertility testing:

• A detailed physical exam
• A complete sexual and medical history
• Testing the ovarian reserve
• Semen analysis
• Blood tests that show hormone levels
• Keeping track of ovulation
• Assessment of the ovaries, uterus, and fallopian tubes through ultrasound or the latest imaging tests such as laparoscopy and hysterosalpingogram

Treatment for Unexplained Infertility

If unexplained infertility exists, so does its treatment. Hence, without further ado, let us find out the best treatment for unexplained infertility.

1. IUI (Intrauterine Insemination)

IUI is one of the assisted reproductive technologies that can increase the chance of pregnancy for an infertile couple. This kind of artificial insemination follows diverse steps like concentrating sperm and placing the sperm directly in the uterus at the time of ovulation. Many fertility specialists prescribe Clomid with IUI for the best results.

2. IVF 

Although expensive, IVF (in vitro fertilization) is a reliable treatment option for a couple with unexplained infertility. When none of the other treatments work, fertility doctors suggest IVF for unexplained fertility and it has a high success rate.

During the treatment, the doctor will collect mature eggs from the ovaries and bring them into contact with sperm in the lab. When the eggs are fertilized, multiple embryos will be placed in the uterus.

One complete IVF cycle takes 2-3 weeks and it can be done with the couple’s sperm and eggs or with eggs and sperm from a fertile donor. Don’t panic if you do not see results as most patients require multiple IVF cycles.

3. Medications

There are many medications for stimulating egg production and facilitating ovulation. Your doctor may prescribe medications only or give them along with IVF and IUI treatment. Clomiphene and gonadotropins are the usual medications and sometimes, letrozole is also given.

Gonadotropins have hormones that are necessary for egg production and treating issues like low sperm count. On the other hand, clomiphene stimulates the ovaries and encourages the production of more eggs. When more eggs are produced per cycle after using the medicines, the chances of having multiple babies also increase.

4. Timed intercourse 

Since you are trying to conceive, make sure you are doing it right to maximize the chances of conceiving. You might be having sex regularly, but what if you miss the 48-hour window when the chances are the highest? Your fertility specialist will tell you how to time coitus so that it coincides with your ovulation.

There are excellent ovulation tracking kits that can assist you in tracking your ovulation. There are also other ways of understanding that you are ovulating if you notice the changes happening in your body. A few days before ovulation, the vaginal mucus becomes slippery and clear like the white portion of an egg. There can also be a spike in your libido and take this as a clue to have sex.

Lifestyle Changes to Make Infertility Treatment More Effective

Several of your lifestyle choices have long-term implications on your reproductive health. So, if you have made up your mind to become a parent, both you and your partner should do the following.

• Bid adieu to obesity by exercising daily (for at least 30 minutes) and cutting down on unhealthy foods.
• Try to limit contact with any kind of toxic chemical in home and work environments.
• Besides exercising regularly, eat a balanced, nutrient-rich diet to become more fertile.
• Take an iodine and folate supplement to get rid of deficiencies (women only).
• Manage stress and sleep well at night.
• Avoid smoking and the consumption of alcohol.
• Have less caffeine.
• If you suspect inflammation or infection, see a doctor at the earliest.

The Bottom Line

We may conclude by saying that infertility can be an emotionally taxing and challenging journey for many couples who are eager to start a family. But you must not lose patience as thousands of couples with unexplained fertility issues are now leading a happy life with their healthy babies born with the help of IVF treatment or naturally.

So, although it seems challenging to get pregnant at the moment, there is no need to feel despondent. Consult an accomplished fertility expert in your city to receive quality unexplained infertility treatment.

Best Fertility Specialist in Jaipur

Dr Ritu Agarwal

Dr. Ritu Agarwal is an appreciated IVF expert in Jaipur for IVF therapy, owing to her more than ten years of experience in this field. She is the top IVF specialist in Jaipur who makes every attempt to provide correct counseling and emotional support to patients in order to help them find the ideal solution for becoming parents.