Explaining Unexplained Infertility

Diagnosing Unexplained Infertility

Unexplained infertility (also called idiopathic infertility) is a growing category of infertility whose diagnosis is actually reached via a very narrow set of standard infertility tests, leaving more and more couples in the 'unaccounted for' category of failure to conceive. The standard tests used to evaluate a couple's fertility are semen analysis, ovulation assessment, and fallopian tube/uterus assessment, and in some cases laparoscopy and ovarian reserve tests as well. While this the 'unexplained infertility' diagnosis thereby rules out a few potential causes of infertility, what is omitted are the myriads of other possible abnormalities that could account for a couple's difficulty to become pregnant.

Explaining Unexplained Infertility

In order to become pregnant and for a pregnancy to develop, many natural processes must take place in the male and the female reproductive tracts. Any aberration, weak link, or broken link in the system can contribute to infertility. This includes molecular and biochemical processes in the body, many of which are not examined at all in the standard set of fertility tests.

Key Fertility Factors

Many factors or combinations of factors can contribute to infertility. Stated another way, many things have to occur 'right' in order for a couple to conceive. Here are but a few of the many 'miracles' or key fertility factors that must occur in order to become pregnant.

- Pituitary glands must function properly to release hormones that stimulate egg development

- Eggs must be chromosomally normal, of sufficient quantity and quality, and must develop to maturity

- LH hormone must be released with sufficient surge to stimulate end stages of egg maturation

- Follicles must rupture properly to release the egg

- Sperm must successfully swim to the fallopian tubes to meet the egg

- Sperm must penetrate both the area surrounding the egg and the shell of the egg

- Sperm must release proper DNA into the egg

- Fertilized egg must divide properly

- Embryo must continue to develop normally

- Fallopian tubes must be unblocked to allow embryo to travel into the uterus

- Embryo must develop into a blastocyst, which in turn must hatch

- Uterine lining must be receptive for the implantation of the blastocyst

Age and Time Factors

Due to the increased likelihood of egg quantity and egg quality problems that naturally occur with age, a diagnosis of unexplained infertility is more likely in women aged 35 and over. In addition, the longer infertility goes on, the less likely it is that a couple will be able to conceive on their own or without fertility treatment.

Fortunately, many couples with 'explained' or with unexplained infertility do successfully become pregnant over time and with the aid of expectant management or assisted reproductive technologies.

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