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Unexplained Infertility

What Is It?

The diagnosis of “Unexplained Infertility” is used when no cause for the infertility can be found in either partner.

How Common Is This “Condition?”

Up To 1 in 10 infertile couples.

What is “Normal?”

  • Sperm Count
  1. At least 20 x 10 per ml, 60% motile, 40% normal forms.
  2. If low, the test should be repeated.
  • Ovulation Tests

That ovulation has occurred can be diagnosed by a combination of tests.

  1. Temperature Chart: Ovulation can almost always be detected by analyzing the previous temperature charts.
  2. Blood Tests: By having several blood tests each week for a full cycle, checks can be made on the level of progesterone produced by the ovaries.
  3. Endometrial biopsy: This is done by taking a small sample from inside the womb to check whether the lining of the womb is “in phase” with the time of the menstrual            cycle. This test can be done without an anesthetic or as part of a full curette.
  • Fallopian Tube Test
  1. Hysterosalpingogram: This X-Ray of the tubes can determine whether the internal shape of the uterus is normal and if the tubes are blocked
  2. Laparoscopy: This investigation done under general anesthetic allows the doctor

to visualize the tubes, ovaries and other pelvic structures.

  • Hostility
  1. Post Coital Test: At time of ovulation, mucus is extracted from the cervix 4-12 hours after intercourse and the activity of the sperm is assessed.
  2. Indirect Immummo-Bead Test (IIBT): Mucus and sperm are collected and mixed with coated beads in the laboratory. If the sperm are not able to move properly and       bind to the beads sperm antibodies are present.

Has Anything Been Missed?

There are some rare conditions which have been associated with unexplained infertility. However these do not always cause infertility. The tests are also often time consuming and expensive.

  • Psychological Causes-(myth or reality?)
  • Minimal Endometriosis
  • Deficient Luteal Progesterone
  • Adhesions in the Uterus
  • Mycoplasma Infection
  • Motility defects of Sperm

How Can This Be Treated?

  1. Treat the cause
  2. Try several treatments in the hope that one may work, (i.e. “Shot-gun therapy”)
  3. IVF

What is the Chance of Getting Pregnant?

If this is the only abnormality found, your chance of getting pregnant without treatment after 3 years is about 1 in 3, if you have never been pregnant before.

With treatment your chances of getting pregnant may improve to 1 in 2 after 1 year.