The Infertility Misnomer

What is Unexplained Infertility?

The diagnosis 'unexplained infertility' is a bit of a misnomer since it conveys the notion that this condition can never be accounted for or helped. In fact, however, couples who have been assigned the diagnosis of 'unexplained infertility' very often do end up becoming pregnant with time and with the aid of various interventions. It is when standard infertility tests do not find the cause for the failure to conceive that doctors use the term 'unexplained infertility.' As a result, couples who do not fit into the standard category are lumped together in one 'unexplained' group, yet there may be many other contributing abnormalities in the process of becoming pregnant.

Explained Versus Unexplained Infertility

When a couple has been unable to conceive after one year of regular unprotected intercourse, an infertility evaluation it typically conducted. For women aged 35 and older (advanced female age), doctors might begin the evaluation earlier, i.e., after an inability to conceive for six months.

There is a systematic, standard evaluation process couples undergo, which consists of a few key tests. If any of the test results are problematic, they might be the cause of a couple's infertility and thus provide an explanation for the failure to conceive. However, it is when all test results return normal that a couple is assigned the label 'unexplained infertility.'

Standard Infertility Tests

The following are the standard tests used to evaluate cases of infertility:

- Semen analysis (SA)

- Ovulation Assessment

- Hysterosalpingogram (X-ray assessing the fallopian tubes and uterus)

- Occasional tests for ovarian reserve and laparoscopy.

If test results are normal, meaning that there are no apparent problems with semen, ovulation, or the fallopian tubes, the diagnosis of unexplained infertility is assigned. It is estimated that approximately 15% to 30% of couples experience unexplained infertility,

Getting Pregnant Despite Unexplained Infertility

Most couples with unexplained infertility eventually get pregnant. There are many possible causes of infertility and thus several treatment options that can help a couple, including a range of modern reproductive technology interventions. However some cases still remain beyond the reach of current medical knowledge.

Treatments for couples with unexplained infertility include expectant management with timed intercourse, lifestyle changes, operative laparoscopy, clomiphene citrate or gonadotropins with intrauterine insemination (IUI), controlled ovarian hyperstimulation with IUI, and in vitro fertilization (IVF) with or without ICSI.

The optimal treatment strategy differs from case to case and is dependent on factors such as patient age, treatment efficacy, cost considerations, and side effects (i.e. the possibility of multiple pregnancies). Usually insemination is the first planned course of intervention before the more aggressive and more expensive IVF treatment might be recommended.

Login to comment

Post a comment