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What is unexplained infertility?
Research has shown that unexplained infertility affects one in seven couples. It occurs when the cause of infertility remains unknown, even after thorough fertility tests. While some individuals may eventually conceive naturally, many do not. Fortunately, various treatments, including in vitro fertilisation (IVF) and intrauterine insemination (IUI), can help, so there is still hope for those wishing to have a child of their own.
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Definition of unexplained infertility
Unexplained infertility is diagnosed when a couple cannot conceive after 12 months of trying without contraception, and fertility assessments show no clear cause for the fertility problems.
Although there is a possibility of conceiving naturally, couples often undergo fertility treatment to assist in their journey to parenthood.
Possible causes of unexplained infertility
While unexplained infertility does not have an obvious cause, several potential factors may contribute, including poor egg and sperm quality. Currently, there is no definitive way to assess egg quality, which can decline due to ageing or undetected medical conditions. For sperm, a semen analysis assesses motility, morphology and concentration; however, some issues may not be detected, which could potentially contribute to infertility.
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Additionally, for women, problems with the uterine lining can make it difficult for the embryo to implant, even when a healthy sperm and egg have formed an embryo. Cervical mucus also plays an essential role; if it’s too thick, the sperm may find it difficult to travel through the cervix to reach the uterus. There may also be traces of medical conditions such as endometriosis, which can influence infertility.
In some cases, there may be no identifiable causes, or the condition may be difficult to diagnose or treat. It’s also important to note that unexplained infertility may not have any specific signs or symptoms, other than the inability to conceive. If you have any concerns, contact your doctor or fertility clinic for guidance.
How is unexplained infertility diagnosed?
Unexplained infertility is diagnosed through a fertility assessment. For women, this includes an anti-mullerian hormone (AMH) blood test to evaluate the ovarian reserve, which is the amount of eggs remaining in the ovaries, and an antral follicle count (AFC), which are fluid-filled sacs in the ovaries that contain immature eggs.
For men, a semen analysis is conducted to assess various sperm parameters, including concentration, motility, morphology and DNA quality.
If all test results are normal and the couple has been trying to conceive for a year, then unexplained infertility is diagnosed.
How is unexplained infertility treated?
There are several treatment options for unexplained fertility, including medical techniques and lifestyle changes.
IVF – One of the most common fertility treatments, IVF involves collecting eggs from the ovaries, fertilising them with sperm in a laboratory, and then transferring the resulting embryos into the womb.
IUI – Intrauterine insemination (IUI) is a procedure that involves introducing sperm into the woman’s uterus around the time of ovulation, which can potentially increase the chances of fertilisation. IUI may be suitable for couples who have difficulty or are unable to engage in vaginal intercourse due to physical disability or psychosexual issues. Additionally, it may be recommended for individuals with certain conditions that require specific consideration regarding methods of conception.
Intracytoplasmic sperm injection (ICSI) – This treatment involves an embryologist selecting normal sperm and injecting it directly into an egg to facilitate fertilisation.
Lifestyle changes – Maintaining a healthy weight can positively impact fertility. This includes eating a healthy, balanced diet rich in fruits and vegetables, incorporating regular exercise into your routine, and limiting caffeine and alcohol intake. It is essential to seek advice from your doctor about lifestyle changes and how they may benefit your fertility health.
Reviewed by Dr Chun Ng, Fertility Consultant at TFP Boston Place.
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