Unexplained infertility and the treatments that are used to tackle it

agosto 29, 2022URE Centro GutenbergLifestyle and fertility

The inability to conceive naturally is a common problem in our society. In fact, recent studies indicate that infertility is currently affecting between 18% and 20% of the world population. But… what is the cause of these issues that are preventing natural conception from occurring? What’s true is that there are many, very different reasons: 30% of cases can be attributed to female factors, another 30% to male-related factors and 20% of cases are found to be a combination of both male and female factors. And what about that remaining 20%? This is where what we refer to as unexplained causes of infertility come into the picture.

What is unexplained infertility?

“If nothing is wrong with us, why can’t we get pregnant?” This is usually the very first question that females and couples with this problem ask each other. What generally happens is that they go to see a specialist and undergo all of the diagnostic testing, and when they return to the doctor to discuss their results … everything is normal. So now what? When this occurs we are dealing with a case of unexplained infertility.

The good news is that the prognosis is good in the majority of cases even though the couple will require help through assisted reproduction treatment. In patients with unexplained infertility, the prognosis will be highly dependent on their ages and the number of years they’ve been trying to conceive.

In fact, we need to keep in mind that this definition will be different for patients over the age of 38-40, as the determining factor in these cases is a low ovarian reserve, which sometimes goes hand in hand with poor egg quality. This means that in these cases we’re no longer talking about unexplained infertility seeing as the couple’s inability to conceive can be associated with specific causes.

What tests are performed on females in order to detect fertility issues?

As we were saying, before we are able to diagnose a couple with unexplained infertility there is testing which must be carried out on the female and on her partner. For females, we will perform a detailed interview regarding their medical history and also perform a physical, gynaecological exam including a transvaginal ultrasound in order to evaluate the uterus and the ovaries.

There is also complementary testing that we may request in order to study ovarian function (baseline hormones including FSH, LH, estradiol…, anti-müllerian hormone), a hysterosalpingogram (to study the permeability of the fallopian tubes), and a hysteroscopy (to evaluate the uterine cavity), for patients who have already had unsuccessful attempts in previous cycles.

What tests are performed on males in order to detect fertility issues?

For males, in addition to a rigorous interview regarding their medical history and a physical exam, if necessary, the most common diagnostic tool is to run a sperm analysis, a study which will help us to pinpoint a possible male-related factor.

Here you’ll find more information about what fertility testing is like for males.

Sources of infertility without a clear cause

Despite all the tests and studies, the truth is that it is sometimes complicated to determine the reasons why a couple hasn’t been able to conceive. Fortunately, in recent years with advances in reproductive medicine and generally after undergoing in vitro fertilisation, some of what could be the causes of unexplained infertility have been detected.

Among these causes we have found, first and foremost, chromosome abnormalities in the eggs: the older the female, the higher the likelihood of finding eggs with poor quality.

Genetic abnormalities in spermatozoids have also been identified. Abnormalities in the genetic make-up of sperm could lead to fertilisation failure or poor embryo development.

Finally, we must also talk about embryo abnormalities. When we are dealing with embryos whose cells are fragmented and/or asymmetrical, or embryos with several nuclei… we know that these embryos are more likely to stop developing and to cause the treatment to result in implantation failure or miscarriage.

What treatment options exist for unexplained infertility?

Treatment for these types of patients must be based on the individual characteristics of each person and each couple. This is why a special focus must be placed on the patients’ ages, as well as on a good physical and emotional preparation for treatment in order to help us confront the process that much more easily.

Treatment, in some cases, will also serve the purpose of allowing us to diagnose any underlying causes responsible for preventing natural conception, such as poor egg or poor embryo quality, which may in turn lead us to more complex procedures.

It is important to keep in mind that deciding the best way to proceed will always be left to the discretion of the specialist, while taking the couple’s opinions into consideration. Normally treatment is carried out in stages, starting with the most simple procedures first, such as artificial insemination;  if simple treatments are not successful then the patient will progress to more complex techniques such as in vitro fertilisation or, if necessary, egg donation.

What can be done to improve treatment conditions during a cycle?

In addition to everything we’ve discussed up until this point, we would also like to share some tips that might help you while undergoing assisted reproduction treatment. What you’ll read here is simple and straightforward advice, but these tips will have a bigger impact than you would think when it comes to trying to conceive with the help of fertility treatment.

Tip number one is to eat a healthy and balanced diet with a special focus on fruits and vegetables as they are rich in vitamins, minerals and antioxidants.

On a related note, it’s important to get physical activity to help maintain a good level of general health and to reduce the high stress and anxiety levels that often appear when trying to conceive. In addition, being overweight is an obstacle when it comes to trying to conceive , so regular exercise will help with this as well.

Finally, it is also essential to eliminate or reduce, to the extent possible, the intake of substances such as tobacco, alcohol and caffeine, as their consumption is considered to be one of the most detrimental habits to our fertility.

We hope we’ve been able to help you better understand what unexplained infertility is, what the possible causes are, the tests we run in order to rule out different pathologies and also what you can do to improve your fertility. As always, at URE Centro Gutenberg we’re here to help answer any questions you may have and to assist you with anything else you may need.

You can request an appointment with our assisted reproduction specialists by clicking here.