Unexplained Fertility

The reason behind an infertility diagnosis in both women and men is not always easy to determine. It is estimated that 1 in 5 couples struggling to conceive have been diagnosed with unexplained infertility. This is because everything can seem to be normal for an outwardly healthy couple trying to conceive, when, in fact, something acute is the culprit, such as inconsistent sperm motility or a microscopic uterine fibroid.

Infertility can be diagnosed through infertility testing. These tests are performed after about a year of unsuccessful conception attempts, without a specified cause; and even more often, abnormalities are uncovered but disregarded as the cause. This ambiguity can be frustrating for people who want to understand why they haven’t yet conceived a baby.

The key to overcome this frustration is focusing on the word “yet.”

Just because your unique infertility challenge is unknown, that does not mean it can’t be overcome. Here’s how prospective patients are advised to proceed:
• Think positive thoughts and prepare for pregnancy. start taking prenatal vitamins, moderating your diet and exercise routine for optimum health, and getting plenty of quality sleep.
• If, after a few cycles of IUI, you still have not conceived a baby, your fertility specialist might recommend advancing fertility treatment to in vitro fertilization (IVF). In many cases, IVF will be enough to achieve success.
• When it comes to unexplained infertility, your best chance of getting pregnant usually rests with IVF, especially if you are under age 35. You should seek treatment as soon as possible if you have been trying unsuccessfully to get pregnant for more than a year (or six months if over age 35). Even if IVF doesn’t work for you, there are other methods of conception to explore with your fertility specialist.

According to a research: There are generally 3 main overlooked explanations for unexplained infertility:
1. Premature Ovarian Aging: Also known as diminished ovarian reserve, this condition is marked by follicle stimulating hormones or anti-Mullerian hormone levels being lower than they should be in consideration of the patient’s age. This issue is often overlooked because it can occur in young women who have regular periods and appear, at first glance, to have normal hormone levels. When compared to other women their age, however, it is often discovered that those levels are lower than they should be, or are exhibiting other abnormal signs which should raise concerns.
2. Tubal Disease or Endometriosis: Not all hysterosalpingograms (a test for determining tubal efficiency) are conducted or read correctly. In some cases, there is a tubal issue which goes undiagnosed because the radiologist performing the test may not have known exactly what to look for. Often these difficult to detect tubal blockages can be an indication of endometriosis, which can only be diagnosed with surgery and is therefore routinely overlooked as a possibility when there are no other symptoms to observe. Both conditions can inhibit fertility, even when they are in the earliest stages.
3. Immune Issues: Autoimmune conditions can occasionally result in a woman’s body rejecting pregnancies at an early point, meaning she may experience chemical pregnancies while still going on to have her period on time. Doctors don’t always think to look for immune issues in these cases, despite the fact that an autoimmune panel could grant a clear understanding of what is happening.

WHAT CAN YOU DO TO IMPROVE YOUR ODDS FOR HAVING A BABY?

If you have not already did so, improve your lifestyle habits.
• Cut back on caffeine consumption (less than 1-2 cups a day) as well as alcohol (down to 3-4 drinks a week) as there are studies suggesting that excess consumption of these may adversely impact fertility.
• Smoker? Quit now!!!
• Definitely drop any recreational drug use.
• Maintain a healthy BMI (Body Mass Index) as both overly low or elevated BMIs have been associated with fertility (and miscarriage) problems.
• While stress isn’t generally thought to be a cause of infertility, it definitely doesn’t help. Try to alleviate stress and anxiety by seeking help from a mental health expert; working with an acupuncturist; meditating; doing yoga or some other workout that clears the mind (at least temporarily).

In women, the causes of infertility can include anatomic malformations as well as endocrine and ovarian problems. The causes of infertility in men include abnormal semen and sperm. Infertility treatment is based on the underlying cause, but may not always be effective, and in 10 to 20 percent of cases, no cause, in either the man or the woman, is found to explain a couple's inability to become pregnant: There is normal ovulation, healthy fallopian tubes, normal uterine cavity and normal semen analysis.

Low thyroid, or hypothyroidism, can affect fertility by causing irregular menstrual cycles and abnormal ovulation.

But what about women whose thyroid function is within the normal range but who have levels drifting toward the abnormal limits?

To make the diagnosis of unexplained infertility, our patients have a complete infertility evaluation including semen analysis, and evaluation of the uterine cavity and fallopian tubes, as well as confirmation of regular ovulation and normal ovarian reserve. Patients under 35 years of age have all this testing done after one year of trying to conceive without success and for patients over age 35, after six months of inability to conceive. We also confirm that there are no underlying medical conditions such as uncontrolled thyroid disease.

After all of these testing, everything can still appear to be normal. Everything should be working properly but, for an unknown reason, is not.

“Unexplained” does not mean a couple is never going to have baby, it just means it’s taking longer than it should and we don’t know why. We review with patients a number of options to improve the chance of pregnancy, going from the simplest to the most complex.

In vitro fertilization (IVF) works extremely well for unexplained infertility.
What we don’t know in terms of determining what is causing the infertility is whether there is a problem with the sperm getting to the egg or the sperm and egg interaction. IVF can help us identify the problem as well as treat it. When performing IVF, the fertilization takes place in a lab, where we can see what occurs when the sperm and egg come together.

Many of our patients with unexplained infertility have very high pregnancy rates with IVF.
They generally have healthy sperm and eggs and a normal uterus. So, when the eggs and sperm come together during IVF, it leads to a successful pregnancy.

The bottom line is just because it is unexplained that does not mean it is untreatable.
We do have treatment options that give women a good chance of achieving a pregnancy.
“There is always an explanation. You just have to find it.”
To start down your path to overcoming infertility, even if you’ve already been tested and received an unexplained infertility diagnosis, contact First Step IVF today.