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Some people may fail to get pregnant. Infertility is defined as the failure to conceive after one year of regular intercourse without contraception or the inability of a woman to carry a pregnancy to a live birth. Infertility can affect either the male or the female and can result from several causes. About 1 in every ten couples are infertile, or somewhere between 10 and 15 percent of the population.

Normal fertility depends on the production of a sufficient number of healthy, motile sperm by the male, delivery of those cells into the vagina, successful passage of the sperm through the uterus and into the fallopian tubes, and penetration of a normal ovum (egg) by one of the sperm. A successful pregnancy also requires that the fertilized ovum become implanted in the lining of the female uterus. A problem at any one of these stages can result in a couple’s infertility.

The majority of couples experiencing problems with fertility can receive an explanation for their infertility. Still, when doctors cannot seem to find anything wrong with either the male or female after analysis of sperm and fallopian tubes or uterus, they have unexplained infertility.

UNEXPLAINED INFERTILITY:

Unexplained infertility, sometimes called idiopathic infertility, is when standard infertility testing has not found a cause for a couple’s or a woman’s inability to get pregnant. Some reproductive physicians hold that a diagnosis of unexplained infertility is a non-diagnosis.

According to the American Society for Reproductive Medicine (ASRM), up to 30 percent of couples struggling to conceive are diagnosed with unexplained infertility. Other experts say the diagnosis rate is closer to about 15 percent, and the variance in these numbers often relates to differences of opinion as to what constitutes “comprehensive testing.” That’s because no fertility test or combination of tests can accurately identify all abnormalities that can cause unexplained infertility.

TYPES OF UNEXPLAINED INFERTILITY:

1. Primary Unexplained Infertility: This occurs when a couple has never been able to conceive naturally despite regular, unprotected intercourse.

2. Secondary Unexplained Infertility: In this case, a couple has successfully conceived in the past but is now struggling to achieve a subsequent pregnancy.

CAUSES OF UNEXPLAINED INFERTILITY:

Testing for infertility can detect apparent causes, such as blocked fallopian tubes, abnormal sperm counts, and problems with ovulation. Still, it may not see more subtle ones like poor-quality eggs or complications with the development or implantation of embryos.

An unexplained infertility diagnosis may result from several causes that might cause infertility, low fertility, or delayed fertility, including.

Anomalies or disturbances in the luteal phase are associated with progesterone production in women and follow ovulation in the menstrual cycle.

Subtle irregularities in the ovaries or uterus.

Release of an egg before it's ready, making fertilization impossible.

The person or couple's ignorance of the significance of scheduling sexual activity around anticipated ovulation and engaging in sufficient sexual activity to raise the likelihood of becoming pregnant.

Infections like mycoplasma and chlamydia result in infertility; it is better to treat them first to maintain fertility

DIAGNOSIS OF UNEXPLAINED INFERTILITY:

Doctors diagnose unexplained infertility when a conventional infertility examination yields expected results.

Medical examination: A thorough examination of the medical records of patients.

Testing fertility: testing ovulation and semen analysis

Hysterosalpingography: This examination assesses the uterine and fallopian tube structures to detect obstructions and other related problems.

Hormone testing: This blood test determines testosterone, ovulatory, and pituitary hormone levels.

Genetic testing: This examines the potential for a genetic disorder to result in infertility.

Laparoscopy: In some circumstances, a laparoscopy may be necessary to examine the pelvic region visually and find hidden problems.

TREATMENT FOR UNEXPLAINED INFERTILITY:

The primary therapies for unexplained infertility are IVF, clomiphene citrate with intrauterine insemination (IUI), controlled ovarian hyperstimulation (COH) with IUI, and expectant monitoring with planned intercourse and adjustments to lifestyles.

1. Expectant monitoring and adjustments to lifestyles:

According to epidemiological research, smoking cigarettes, having an abnormal body mass index, and consuming large amounts of alcohol and caffeine can all lower a woman's ability to conceive. The female spouse should reach a normal BMI, reduce caffeine to 250 mg daily, and restrict alcohol consumption to 4 standard drinks per week to increase fertility. Without therapy, the chance of conception is less for unexplained infertile couples, although it is still more than zero. Research reveals a wide range of cumulative conception rates, with untreated groups exhibiting an average cycle fecundity ranging from 1.3% to 4.1%.

When it comes to expectant management, the age of the female spouse affects the pregnancy rate. Based on available data, it appears that determining the window of fertility prospectively works better than using calendar calculations or BBT to determine the best time to have intercourse. While expectant management is the least expensive option, cycle fecundity rates are the lowest, and it performs worse than readily accessible reproductive procedures.

2. Clomid and timed intercourse

A low-level infertility therapy such as clomid tablets can increase fertility up to two times over no treatment at all. Nonetheless, women over 35 or couples experiencing unexplained infertility

without insemination are usually not candidates for Clomid therapy, according to infertility specialists. It is doubtful that prescribing Clomid to a woman who already ovulates once a month and has regular periods will resolve her problem. For couples experiencing unexplained infertility, using Clomid without IUI is not advised.

3. Clomid- IUI treatment:

Fertility rates increase with treatment that combines IUI with Clomid pills. According to research, women under 35 who have unexplained infertility had monthly success rates of around 10% every cycle with Clomid with insemination. This pregnancy rate persists for about three attempts, after which the success rate declines significantly. Although the insemination component increases fertility more than the Clomid component, combining the two results in better success rates.

Another oral drug that is occasionally used to encourage the growth of numerous follicles during infertility therapy is letrozole, also known as Femara.

4. Injectable gonadotropins (shots of FSH hormone) - intrauterine insemination (IUI):

When injectable FSH was combined with IUI therapy, research found that pregnancy success rates were higher than when no treatment was given.

5. Injectable gonadotropins- intercourse

The study on the benefits of ovarian stimulation and insemination is limited, but they both likely increase fertility potential independently, with the IUI component providing more fertility benefits. The effects are not yet fully understood.

6. In vitro fertilisation (IVF):

In young women with unexplained infertility and regular ovarian reserve tests, in vitro fertilization (IVF) has a high success rate. If a woman under 40 years old is infertile, the majority of couples experiencing infertility will attempt three artificial inseminations before pursuing unproductive treatment (IVF).

CONCLUSION:

In conclusion, Unexplained infertility is when standard infertility testing has not found a cause for a couple’s or a woman’s inability to get pregnant. Some reproductive physicians hold that a diagnosis of unexplained infertility is a non-diagnosis. An unexplained infertility diagnosis may result from several causes that might cause infertility, low fertility, or delayed fertility. Still, it can be treated with IVF, clomiphene citrate with IUI, controlled ovarian hyperstimulation (COH) with IUI, and so on.

MMC IVF:

MMC IVF is a leading fertility clinic in Dubai, helping couples worldwide complete their family with world-class fertility specialists. We also offer medical concierge services, so we take care of everything from travel to stay to treatment. All you have to do is make an appointment at +971 56 404 5330 or email us at info@mmcivf.com. We will get back to you promptly. The best part is that you can stay home and talk to our specialists online before deciding. In addition, you can request a second opinion on the diagnosis and treatment you already are on. Contact MMC IVF and we will fix an appointment for it.