What is Unexplained Infertility?
Roughly speaking, we talk about unexplained infertility when the cause of infertility remains unknown. The cause of infertility for most couples is attributed either to male- or female-related factors. The man may experience sperm-related problems (sperm count and quality), while the woman may have ovulation problems. In a third scenario, there is no specific cause for infertility. After tests and medical examinations, the causes of infertility can remain “unexplained”.
Why does Unexplained Infertility Occur?
Unexplained infertility is thought to be due to a combination of multiple factors. These factors include mild endometriosis (presence of uterine-like tissue outside the uterus), mild ovulatory disorders, cervical factor (mucus production that prevents sperm from reaching the egg), or inability of the sperm to fertilise eggs despite normal appearance and motility.
How is Unexplained Infertility Treated?
Methods used in the treatment of unexplained infertility are as follows: waiting for natural pregnancy to occur, laparoscopy, IUI, and IVF.
According to the specific situation of the patient, the doctor decides on one of these treatments.
In the treatment of unexplained infertility, the couple might try for a natural pregnancy for one year by changing their lifestyle if the woman is young and her ovarian reserve is good. During this process, the couple should quit smoking-drinking (if applicable), exercise regularly, and eat healthy as part of their everyday lives. In case pregnancy is not achieved during this period, the woman can undergo ovulation induction for 3 months, then try IUI (Intra-Uterine Insemination). If these methods are unsuccessful, the couple can undergo an IVF treatment.
If the prospective mother is over 35 years old, or if her ovarian reserve is low, the couple can undergo IVF straight away. Unexplained infertility does not have a standard treatment; the treatment is planned in line with the specific situation of the patient.
Unexplained Infertility and Semen Analysis
Despite some explanatory factors in recent years, one in six couples suffers from unexplained infertility. Semen analysis holds essential importance at this point. Semen analysis is not a simple laboratory technique; knowledge and experience are very important as the sperm sample is assessed. Contrary to popular belief, sperm count alone is not the only factor impacting pregnancy. The motility of the sperm, and more importantly, sperm morphology (shape) affects the reproductive potential. The only way of measuring sperm morphology is to examine it directly under the microscope since it is not measurable any other way. According to research, different laboratories report very different results when examining the same sperm sample. Semen analysis performed by an expert will prevent the couple trying to conceive from wasting time or money on unnecessary treatments.
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