If you and your partner have been trying to conceive for a year or more without success, you may be wondering if you have unexplained infertility. This is a term used to describe couples who have not been able to conceive despite having any obvious explanation for why they are unable to do so. In this blog post, we will discuss the causes of unexplained infertility, as well as some of the treatment options available.

Definition of unexplained infertility

When a couple’s or a woman’s fertility is unexplained, it is referred to as unexplained infertility. Some gynecologists believe that an undiagnosed explanation for infertility is merely a non-diagnosis.

Estimates suggest that between 15 and 30 percent of couples struggling to conceive are referred for unexplained infertility. It is one of the most common causes of infertility.

The difference in the estimated proportion of unexplained infertility is due to the fact that doctors disagree on what constitutes “standard infertility testing.” Testing may differ based on the individual’s circumstances and their doctor’s testing standards.

These may be done in addition to a physical exam and medical and sexual history review.

Unresolved fertility difficulties may affect both partners. People who are infertile suffer from inexplicable infertility because they know they have an issue but do not know what is causing it. Unexplained infertility, like certain causes of infertility, might clear up with time.

There are many possible causes of unexplained infertility, including:

  • Problems with the woman’s ovaries or eggs
  • Problems with the woman’s uterus or cervix
  • Problems with the man’s sperm
  • Hormonal problems
  • Infections

Undiagnosed underlying condition

You could have an undiagnosed underlying (non-reproductive) medical problem. We don’t know yet how poor health affects fertility in more subtle, as-yet-unquantifiable ways. However, we are discovering new things all the time. Untreated Celiac disease, for example, has been shown to cause some cases of unexplained infertility in people who don’t have it.

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According to a 2016 reanalysis of past research, celiac disease may be diagnosed six times more frequently in women with unexplained infertility than the general public. However, the study authors pointed out that previous studies were limited, so it’s impossible to know how reliable those figures are. Furthermore, it appeared that ladies with any type of infertility were more likely to get celiac disease diagnosed.

Poor sperm quality

idiopathic infertility

Sperm quality varies, and some defects are obvious. Poor sperm form (morphology) can lead to reproductive issues, for example. Sperm mobility (motility) might also cause infertility. However, these are identifiable problems. During a semen analysis, they can be identified. There may be concerns about male fertility that aren’t visible during a semen analysis.

The sperm may be of lower quality. DNA errors develop as men get older, which is why children of older fathers are more prone to certain birth defects and mental health issues. Sperm quality might be determined during IVF treatment. If attractive sperm are unable to fertilize healthy-looking eggs, it may indicate a problem with egg or sperm quality.

Problems with a fertilized egg

Let’s assume we have a decent-looking egg and sperm, and they develop into an embryo. The cells inside the embryo then split and grow to become a fetus. This happens from time to time. Embryos are monitored for normal cell division during IVF treatment, which can help identify this as a possible problem.

The vaginal environment and sperm

assisted reproductive technologies

Sperm must leave the semen and enter the cervical mucus following ejaculation. Then, to reach the uterus, they must swim up from the vagina, across the cervix, and into the womb. Occasionally, there might be issues during this stage from sperm to cervical mucus and on up through the cervix. There may be antigens in cervical mucus or even semen that harm sperm.

Cervical mucus is harmful. How to correctly identify this condition isn’t clear, leaving cases like these frequently unexplained.

Poor egg quality

There are various tests that can tell us if you’re ovulating, as well as other tests to get a better understanding of whether there are enough eggs in the ovaries. However, there is no test to determine if the eggs are high-quality. Low-quality eggs might be caused by age, an underlying medical condition, or some yet unknown cause. Egg quality may be evaluated during IVF treatment with an IVF procedure called fertilization. After egg retrieval, eggs will be examined using a microscope.

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Mild endometriosis

unexplained infertility cases

Endometriosis is associated with severe infertility, which may be detected without laparoscopic surgery. Endometrial cysts, for example, might block ovulation or induce fallopian tube obstructions.

Mild endometriosis does not always prevent ovulation or the clearing of the egg. It may also have no visible symptoms. Endometriosis may be behind some cases of unexplained infertility. However, experts are divided over whether mild endometriosis can cause infertility and, if so, whether laparoscopic surgery for diagnosis and resection of endometrial deposits is worthwhile.

Problems with the endometrium

But if the mature resulting viable embryo is unable to impact into the endometrium, we have a problem. There’s a lot we don’t know about possible fertility issues with the endometrium.

A virus that has been discovered recently is more frequently found in women with infertility than in fertile ladies, according to one research published in 2016. But how to diagnose and treat this issue isn’t known. Luteal phase deficits are another possible problem with the endometrium, and they might be the solution for some people who experience unexplained infertility.

How to improve your chance of a pregnancy

iui intrauterine insemination

There are a few things you can do to improve your chance of getting pregnant, even if the cause of your infertility is unknown.

  • See a fertility specialist: A fertility specialist will be able to diagnose any problems and recommend treatment.
  • Track your ovulation: Use an ovulation predictor kit or tracking app to help you time intercourse.
  • Use fertility treatments: If you’re trying to get pregnant and have been unsuccessful for a year, it may be time to try fertility treatments like IVF.
  • Make healthy lifestyle changes: Quit smoking, drink alcohol in moderation, and maintain a healthy weight.
  • Take prenatal vitamins: Make sure you’re taking a prenatal vitamin with folic acid to help reduce the risk of birth defects.

Derivation

Sperm are made in the testes. The process of making sperm is called spermatogenesis, and it takes about 64 days. Sperm production can be affected by a number of things, including age, illness, injury, and lifestyle choices. Smoking, for example, can reduce sperm count and quality.

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The best time to collect semen for use in fertility treatment is two to three days after ejaculation. This is because it takes about that long for new sperm to be produced. However, if you’re trying to get pregnant naturally, having sex every day will give you the best chance of success.

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FAQ

What could cause unexplained infertility?

There are many possible causes of unexplained infertility, including problems with the egg, sperm, or uterus; hormone imbalances; and unknown factors.

Can IVF help if I have unexplained infertility?

IVF can be successful in cases of unexplained infertility if there is a known problem with the eggs or sperm. If the cause of infertility is unknown, IVF may not be successful.

What lifestyle changes can I make to improve my chance of getting pregnant?

Quitting smoking, drinking alcohol in moderation, and maintaining a healthy weight are all things you can do to improve your fertility. Taking prenatal vitamins is also recommended.

How do you fix unexplained infertility?

There is no one-size-fits-all answer to this question. Treatment for unexplained infertility will vary depending on the cause of the problem.

How long does it take to get pregnant with unexplained infertility?

It can take anywhere from a few months to a year to get pregnant with unexplained infertility. If you’re having trouble getting pregnant, see a fertility specialist for help.

  • Unexplained infertility is diagnosed when all other causes of infertility have been ruled out.
  • There are many possible causes of unexplained infertility, including problems with the egg, sperm, or uterus; hormone imbalances; and unknown factors.
  • IVF can be successful in cases of unexplained infertility if there is a known problem with the eggs or sperm. If the cause of infertility is unknown, IVF may not be successful.
  • Quitting smoking, drinking alcohol in moderation, and maintaining a healthy weight are all things you can do to improve your fertility. Taking prenatal vitamins is also recommended.
  • There is no one-size-fits-all answer to this question. Treatment for unexplained infertility will vary depending on the cause of the problem.
  • It can take anywhere from a few months to a year to get pregnant with unexplained infertility. If you’re having trouble getting pregnant, see a fertility specialist for help.

Michelle Griffin

Gynecologist who specializes in obstetrics and fertility

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