What is Unexplained Infertility and Can You Still Get Pregnant After This Diagnosis?

In about a quarter of patients that are experiencing infertility, unexplained infertility is the cause, according to the European Society of Human Reproduction and Embryology (ESHRE). 

In this article, we’ll look at what unexplained infertility actually is and what your chances of getting pregnant are when you get diagnosed with it. Also, we will briefly introduce the available treatment options.

What is Unexplained Infertility?
Unexplained infertility can be diagnosed after other causes of infertility have been excluded and after 12 cycles of unprotected intercourse have not resulted in pregnancy in women younger than 35 years of age. In women older than 35, for whom the standard evaluations are normal, no pregnancy after six cycles of unprotected intercourse can be diagnosed with unexplained infertility

However, if minor abnormalities are found, unexplained infertility may also be diagnosed as long as the abnormalities are not severe enough to cause infertility. 

To rule out any causes of infertility, tests are required. 

Which Tests Are Required Before a Diagnosis of Unexplained Infertility is Made? 
Various tests will need to be performed and evaluated before unexplained infertility can be diagnosed. This is to ensure that there isn’t another reason for infertility that may need a different type of intervention. 

These tests include:

  • Semen analysis
  • Assessment of ovulation and the luteal phase of the menstrual cycle
  • Assessment of tubal patency through hysterosalpingogram or laparoscopy

Semen analysis 
Also called a “sperm count test”, this analysis examines the health and viability of a man’s sperm. Three main factors are tested during the analysis:

  • the number of sperm in the sample (a normal count is 15 million sperm per millilitre),
  • the shape of the sperm (making sure that the sperm cells are correctly formed), and
  • sperm motility (the movement of the sperm).

The analysis is usually repeated 2 or 3 times to ensure that the results are as accurate as possible.

Assessment of ovulation and the luteal phase of the menstrual cycle
The luteal phase of the menstrual cycle refers to “the period between ovulation and either the establishment of a pregnancy or the onset of menses 2 weeks later”.  This assessment will therefore assess whether or not ovulation is normal and whether or not the luteal phase progresses normally. 

The corpus luteum plays a vital part in fertility during the luteal phase. The role of this temporary organ is to maintain the uterine environment after a mature egg is released. Should fertilisation not take place within 14 days after ovulation, menstruation will start and the corpus luteum will degenerate. A new corpus luteum is formed with each ovulation. 

The hormone that is primarily produced by the corpus luteum is progesterone, although inhibin A and estradiol (a type of estrogen) are also produced. This plays a part in the decline in levels of luteinizing hormone (LH) after ovulation. You can clearly see the LH surge (the time when you are most fertile) and decline after ovulation with the Eveline ovulation prediction kit

Assessment of tubal patency by hysterosalpingogram or laparoscopy
The “assessment of tubal patency” tests whether or not the fallopian tubes are working normally. The hysterosalpingogram (HSG) evaluates the shape of the uterus as well as making sure that the fallopian tubes are open using an x-ray called a fluoroscopy and a contrast material.

What Are My Chances of Getting Pregnant After a Diagnosis of Unexplained Infertility?
Here we have some good news for you! Even after 12 months of unsuccessful attempts, 50% of couples will conceive in the following 12 months and another 12% in the year after without further medical treatment (this is referred to as “spontaneous conception). The rate of conception can reach some 80% in younger couples during the following 3 years of unprotected intercourse and without other medical intervention.

There are, however, medical interventions available for unexplained infertility. 

Medical Treatments for Unexplained Infertility
The options for medical treatment for couples or individuals with unexplained infertility include:

  • Intrauterine insemination (IUI) with either clomiphene or letrozole as medication
  • In-vitro fertilisation (IVF) for those couples who are unsuccessful in achieving a pregnancy with IUI.

Intrauterine insemination 
Intrauterine insemination is a type of artificial insemination. In this procedure, sperm that have been washed and concentrated are placed directly into the uterus around the time of ovulation. IUI can be coordinated with a normal menstrual cycle or with fertility medications. 

An ovulation kit like the Eveline digital ovulation kit – which measures when you’re at your most fertile – can be extremely helpful in these circumstances. 

In-vitro fertilisation
In-vitro fertilisation refers to a series of procedures that are done to help with fertility, prevent genetic problems, and assist with conception. IVF has been shown to be the most effective form of assisted reproductive technology (ART) for unexplained infertility. 

IVF works as follows:

  • Mature eggs are collected from the ovaries,
  • These eggs are then fertilised with sperm in a laboratory. 
  • The fertilised embryo (or embryos) are then transferred to the uterus. 

The IVF procedures can be completed in about three weeks. However, IVF procedures can also be split and done at different times, meaning the process could take longer.  

For the IVF procedures, a couple’s own eggs sperm can be used or eggs, sperm, or embryos from known or anonymous donors.

Summary
As you can see from this article, it is still possible to get pregnant after being diagnosed with unexplained infertility – and the chances of doing so are quite high as well. You may even be able to either spontaneously conceive within a year or a couple of years without a medical intervention like IUI or IVF. 

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This article is for informational purposes only and is not meant to offer medical advice.

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Photo by Anthony Tran on Unsplash

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