Approximately one out of five couples struggling to get pregnant is told that they have unexplained infertility. The doctor explains that there is no medical reason why they did not get pregnant after doing thorough examinations and tests. Hearing this statement from the doctor, many couples feel frustrated and think “if everything is fine then why isn’t it working?” Unexplained infertility is frustrating for couples and their doctors. Since finding a solution to a known problem is easy than dealing with an unknown can be stressful to both infertile couples and the treating doctor.
Infertility is defined as the inability to become pregnant after about a year of appropriate and well-timed efforts. Whenever a couple visits a fertility center they are subjected to undergo a few tests to find the underlying abnormalities.
These tests include the husband’s semen analysis, wife’s ovulation study, hormonal profile, pelvic ultrasound, and tubal patency test.
When no apparent reason is detected and all of the above tests are normal then the couple is labeled as unexplained infertility.
Causes of infertility:
When a noticeable cause is not identified on routine investigations, defects in basic things which form the pregnancy can be suspected like a problem with sperm function, egg quality, sperm and egg interaction (fertilization), functional defect in Fallopian tube lining leading to transportation defect, subtle anatomical abnormalities, disturbed tubo-ovarian relationship, immunological alteration in the womb causing implantation failure, early Endometriosis and Luteal phase defect.
Apart from the above, infertility may also happen because of lifestyle-related issues like bad food habits, obesity, alcohol, smoking, improper sleep, certain psychological conditions, toxins, and environmental pollutants. Therefore, multiple factors play together and can affect the fertilizing process and pregnancy.
Even though the couple’s infertility is “unexplained”, treatment to help them have a baby can proceed. By using advanced technological approaches like sperm function evaluation, immunological tests, and diagnostic hysteroscopy- laparoscopy can help identify the cause.
Unexplained infertility does not mean that you cannot get conceived. The treatment plan will be difficult to formulate for unexplained infertility. But there are many possibilities to treat this cause.
- Take more time: Many with unexplained infertility will become pregnant on their own simply with more time. Because couples earlier are not aware of the fertile period. By knowing the fertile period with timed intercourse for three months may work out for young couples.
- IUI- couples with unexplained infertility can be treated with Insemination therapy if the women’s egg supply is adequate. Insemination or IUI is when sperm is collected, washed, and introduced into the uterus at the time of ovulation. The rate of success with IUI is high when fertility drugs are used. 15-20% of couples have good chances of pregnancy within the first three cycles.
- IVF- if in case insemination fails, then the doctor will recommend for IVF. Medications are given to stimulate woman’s ovaries and then eggs are collected. Sperm is introduced to the eggs and fertilization is done in the lab. When embryos are formed they are placed in the womb. The pregnancy rate of success in IVF is very high in unexplained infertility since healthy sperms, eggs, and embryos can be selected for a healthy pregnancy. In this process of IVF, it also explains why the couple was not getting pregnant.
- Lifestyle changes- good eating habits, exercising, avoiding alcohol and smoking, and managing stress help the treatment given and improves live birth rate.
The good news for unexplained infertility couples is that fertility treatments help them when undergone in a stepwise approach. The best thing is that the problem resolves spontaneously.
Couples who are traveling in this journey of unexplained infertility are frustrated and stressed, but should take heart and work with their infertility specialists because the prognosis is quite good.