Common Fertility Problems: Unexplained Infertility
For couples who are trying to conceive, any delay in the process can be a source of anxiety. However, when the reason for the delay is unknown, those feelings can become even more aggravated.
In the United States, anywhere between 10 and 20 percent of couples experiencing fertility problems will be diagnosed with what is called unexplained infertility. The good news is that while your diagnosis might be vague, there are still options available that can help increase your chances of getting pregnant.
What is Unexplained Infertility?
Unfortunately, the definition of what unexplained infertility is remains as ambiguous as you might assume; the term means that your fertility specialist or health care provider was unable to find a medical explanation as to why you are having difficulty getting pregnant. It may be that there is nothing physically preventing pregnancy from happening, or it could be that the doctors simply donï¿½t know what the reason preventing conception from occurring is.
What are the Causes of Unexplained Infertility?
Unexplained infertility wouldn't be named as such if there were a known cause. That being said, however, medical studies do suggest there may be certain factors at play when a couple is experiencing difficulty achieving pregnancy. Any one of the following may be a cause of unexplained infertility:
- Abnormal Fallopian Tubes. Even the most seemingly miniscule abnormality in your fallopian tubes can lead to unexplained infertility. That is because your fallopian tubes contain minute structures that help to sweep your eggs inside. The first are called fimbria; finger-like projections located at the ends of each fallopian tube. Their job is to get a hold of your ovaries, so as to coax your egg inside. Your fallopian tubes also contain tiny hairs called cilia that work to direct your egg down into your uterus. If there are problems with either the fimbria or cilia, that could prevent your eggs from being fertilised.
Abnormal Eggs. We often hear that our ovaries are equipped with thousands of eggs, making it hard to believe that not one of them would be suitable for fertilisation. Unfortunately, however, this is often the case, and there are several possible reasons why; it may be that the size or shape of your eggs, or the chromosomes they contain, are abnormal.
- Weak Sperm. Similarly, abnormal sperm can affect your pregnancy outcome. In order to become fertilised, sperm must be able to break through the outer shell of your egg. In certain cases, even seemingly healthy-looking sperm are not strong enough to break through the egg, and thus, cannot create an embryo.
- Luteinised Unruptured Follicle (LUF) Syndrome. During the maturation process, your eggs are stored inside a tiny membranes called a follicle. Supported by hormonal stimulation, this follicle will release an egg (this is ovulation). After that egg has moved into the fallopian tubes the membrane leftover is referred to as the corpus luteum. LUF is caused when the follicles become corpus luteum before releasing the egg ï¿½ in effect, trapping it inside. Consequently, ovulation is blocked.
- Abnormal Luteal Phase. Once the egg has been released from the ovaries, a new phase of the menstrual cycle begins the luteal phase. It is during this phase that the corpus luteum begins to produce progesterone, the hormone responsible for stimulating your uterus to prepare the endometrial lining for implantation. If, however, your progesterone levels rise too quickly or too slowly, or if the hormone was not produced for a long enough period, the endometrium will not be properly prepared for implantation.
- Immune System Problems. Although your immune system is designed to protect you from any invading organisms, it can sometimes become confused, and start to attack healthy cells. In some cases, a womanï¿½s immune systems can begin to attack her own eggs. The same thing could also be happening to the male partner, causing sperm to stick together, therefore making them unable to move.
- Emotional Factors. Our own psychological well-being can play a major role in both female and male infertility. When you think about it, your entire reproductive system is controlled by the brain. Therefore, any emotional distress could interfere with the brain's ability to properly regulate all its functions.
Getting a Diagnosis
A thorough medical examination is key to getting an accurate diagnosis, as unexplained infertility is essentially what is diagnosed once all other possible infertility causes have been ruled out, which, as you might imagine, can be a very lengthy process. However, there are certain criteria that are often in fact attributed to those with unexplained infertility. These include:
- Normal ovulation
- Open and healthy fallopian tubes
- No pelvic adhesions
- Lack of endometriosis
- Male partner has high sperm count and good sperm motility
- Positive postcoital test
Other factors that will be taken into consideration are the number of times you are having intercourse, as well as the duration of time that you have been trying to conceive.
Unexplained Infertility Treatment
Being diagnosed with unexplained infertility can be very frustrating for couples trying to conceive. However, it is important to remember there are infertility treatments available that can help you become pregnant. In fact, your chances of getting pregnant within three years are over 30%.
Some treatments that you may wish to consider are:
Fertility drugs can be a very effective way of addressing irregular ovulation, as they help to stimulate egg production, thereby greatly improving you chances of getting pregnant.
Intrauterine insemination (IUI)
Intrauterine insemination is one of the most popular forms of assisted reproductive technology. This procedure entails placing sperm from your partner in a catheter, thereby increasing the chances of sperm meeting with your egg. This sperm is then released into your uterus in hopes that it will fertilize one of your eggs.
In-vitro fertilisation (IVF)
In-vitro fertilisation is another popular and largely successful way to address unexplained infertility; in particular if there is problem with the fallopian tubes or ovaries. Eggs are removed from your ovaries and fertilised in a dish containing your partner's sperm. The difference between IVF and IUI is that instead of fertilization taking place inside the uterus, it takes place in the laboratory. Once the eggs have developed into embryos, they are then implanted into your uterus. Success of IVF for unexplained infertility has been very promising, with up to 75 percent of patients achieving a subsequent pregnancy. Success rates, however, do vary depending on the woman's age.
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