Unexplained Infertility: Common Causes And Treatment Options

Unexplained Infertility

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Are you planning to add a cute little member to the family? Have you tried every conceivable way, but nothing seems to help? In your recent visit to your gynecologist, did he/she mention the term unexplained infertility? Do you wonder what the term means?

If you can relate to these questions, or you find yourself nodding along, consider reading our post. Scroll down and learn more about ‘unexplained infertility’ and what you can do about it, here.

What Is Unexplained Infertility?

Unexplained infertility, or UI, is one of the most common forms of infertility that women contract. Out of all the cases of infertility, unexplained infertility accounts for almost 30 percent cases. It is a type of infertility diagnosis in which there is no determinable cause for the source of infertility, even after standard infertility tests. Unexplained infertility or idiopathic infertility occurs when doctors or fertility experts can’t explain the reason for infertility or what to do about it (1).

Why Does Unexplained Infertility Occur?

There can be various reasons for unexplained infertility that a doctor may rule out. Sometimes, it is possible that there is no real reason for your infertility, but that it is a result of various small aberrations in the way your reproductive systems cooperate with each other.

Getting successful while trying to conceive is a complex process, and there can be various circumstances in which the fertility of the female and the male partner affect each other. In some cases, the way the male and female fertility parameters affect each other that they may enhance each other. On the other hand, there could be a reduction in the fertility potential of both the female and the male partner combined. In such a case, the results could point to infertility.

There are many research studies about trying to determine the reasons for infertility. Studies try to determine the best way to diagnose the reasons for infertility. Not being able to conceive is painful enough, but being told that the reasons for infertility is not determinable, can be traumatic.

The Causes Of Unexplained Infertility, Even Though It Is ‘Unexplained’:

According to the journal Reproductive BioMedicine Online, researchers from Queen’s University in Belfast concluded that in almost 80 percent of the couples who contracted unexplained infertility, the cause has been discovered.

As part of the research, the study team reported that about 50,000 couples in the UK and over a million couples in the world receive treatment for various stages of infertility every year. More than a third of these couples have unexplained infertility or idiopathic infertility. In all these cases, nothing is wrong with either partner, even after a close inspection of the sperm and the fallopian tubes or uterus.

The research concludes that there is, in fact, a cause for the unexplained infertility, and the cause is the high amount of damage that the DNA can suffer.

When you suffer from unexplained infertility, don’t think that all is over. In fact, many doctors still try to look at other possibilities that may lead to infertility. Once such causes can be confirmed and treated, there are chances of treating the ‘unexplained infertility’ easily.

Here are a few conditions that may lead to unexplained infertility:

1. Endometriosis:

Endometriosis is a condition in which the tissue that is found inside the uterus in a normal scenario is located in some other part of the body (2).

  • The tissue can attach itself to your ovaries, to your fallopian tubes, to your bowel or other parts in the interior or even to the outer portion of your uterus.
  • As you experience a change in your hormonal balance during your menstrual cycle each month, the tissues break down and can cause scar tissue or adhesions that are extremely painful.
  • According to estimates, more than 5.5 million women in America suffer from endometriosis.
  • In most cases, the inability to become pregnant is the only symptom of endometriosis, and many times it goes undiagnosed or misdiagnosed.

[ Read: Fertility Drugs For Men ]

2. Tubal Disease:

The Tubal disease is a kind of disorder in which your fallopian tubes are either damaged or are blocked (3).

  • In many cases, scar tissues can develop as a result of endometriosis or some gynecological or abdominal surgery. Certain surgeries such as cesarean surgery, bowel surgery or ruptured appendix surgery can result in the same.
  • The scar tissue can block the passage of the egg from the ovary to the fallopian tube where it can meet the sperm.
  • Your fallopian tube is full of tiny hairs or cilia that help in transporting the egg. Any form of infection, such as chlamydia, can sometimes damage the cilia, in which case the egg will not be able to meet the sperm.
  • Alternatively, if your cilia are damaged, an egg that does become fertilized will not be able to travel towards the uterus. Such a condition could lead to an ectopic pregnancy, which can lead to further health complications (4).

[ Read: Blocked Fallopian Tubes – Types, Causes And Solutions ]

3. Premature Ovarian Aging (POA):

Premature ovarian aging, also known as POA, is one of the biggest and often most overlooked reasons for infertility in females (5).

  • Premature ovarian aging refers to a condition in which you have a low or poor ovarian reserve than what you should normally have at that given age.
  • Ovarian reserve, or OR, refers to the capacity of your ovaries to produce eggs that are of high quality.
  • With age, the ovarian reserve goes down as part of a natural process, and it also reduces the number of the eggs that the ovaries produce as well as the quality of the eggs.
  • A low number of eggs and poor quality of eggs further reduces the chances of a female being able to conceive.
  • In most cases, the decline in OR starts affecting women once they reach their 40s, but around 10% women suffer from the decline in ovarian reserve much earlier. In such a case, the woman is diagnosed as suffering from premature ovarian aging or POA.

Getting Pregnant While Suffering From Unexplained Infertility:

Once you have been diagnosed with unexplained infertility, your chances of being able to get pregnant without the use of any medical treatment will depend on a lot of factors. One such factor that will play a major role is the amount of time that you have spent on trying to conceive and not being able to conceive. If you have tried and not been able to conceive for five years or more, or you suffer from unexplained infertility, your chances of getting pregnant without medical intervention fall to less than 10%.

Treatment For Unexplained Infertility:

Your diagnosis of unexplained fertility does not herald the end of your conception dreams. While unexplained infertility means that the cause of your infertility is not determinable, it does not mean that you can’t treat it. Your doctor will try look at more angles to find a cause for this unexplained infertility. To get to the root of the problem, your doctor will go for the following approaches that may help:

1. Ovarian Stimulation:

During your normal cycle of ovulation, one of your eggs reaches maturity every month.

  • Ovarian stimulation is a process to help as many eggs as possible mature every month. It will increase your chances of getting pregnant along with medical treatment.
  • For ovarian stimulation, medicine is injected for about 8 to 14 days that will help to stimulate your ovaries and make more eggs. The stimulation medications are derived from the FSH and LH hormones that are the natural hormones that are part of your monthly ovulation process.
  • In some procedures, only one of the above hormones is used, while in some other procedures doctors typically use a combination of both the hormones.

2. Intrauterine Insemination (IUI):

Intrauterine insemination or IUI is another type of artificial insemination that is used to help treat infertility.

  • For this procedure, sperms are washed and concentrated and are then placed directly inside your uterus. It is done approximately at the time when your ovaries release one or more eggs that can be fertilized with the help of the sperm.
  • In intrauterine insemination, the doctors try to make the sperm connect in such a way that it moves into your fallopian tubes and fertilizes the egg that your ovaries have released. If successful, the procedure can lead to a normal pregnancy.
  • Your doctor will check for all causes that could be the reason for your infertility and will decide the best approach to using intrauterine insemination. IUI for unexplained infertility typically occurs either as part of your regular monthly cycle or with the help of other fertility medicines.

[ Read: Symptoms Of IUI Pregnancy ]

3. Clomid Medication:

Clomid is a medicine that helps treat infertility in males and females.

  • It is a medicine that has been used in the medical world for more than 40 years, and the results of its use have almost always been positive and encouraging.
  • Clomid is also known as clomiphene citrate and is used to help women who suffer from irregular menstrual cycles, or those who do not have a regular monthly ovulating cycle.
  • It is a type of drug that blocks the hormone estrogen and sends signals to your hypothalamus and your pituitary gland that are located deep inside your brain. Once the signal is sent and received, various hormones that can stimulate the ovaries to produce eggs are released. The hormones that are produced as a result of the medication are GnRH or gonadotropin releasing hormone, FSH or follicle stimulating hormone and LH or luteinizing hormone.
  • Clomid can often also be used along with other procedures of assisted reproduction or artificial insemination. Doctors feel that using Clomid as an infertility drug for at least a period of three to six months can help to improve chances of fertility by almost two times as compared to not using it. In most cases, however, doctors will not refer the use of Clomid treatment to treat infertility if the woman is over 35 years of age.
  • Along the time that you will be put on a treatment using Clomid, your doctor may also suggest doing timed and regular intercourse to increase your chances of conception and supplement the treatment.

[ Read: Fertility Drugs For Women]

4. Injectable Gonadotropins:

Gonadotropin is the name given to the group of hormones that are secreted by the pituitary gland and that help to stimulate the reproductive organs into action. One of the treatment therapies for unexplained fertility is injecting Gonadotropin.

  • Gonadotropin is a substance that can be used to stimulate the ovaries in females who have a dysfunctional pituitary gland or who lack one. In case of the former, the gland fails to secrete enough gonadotropins and in the latter case, the body does not have its supply of gonadotropins.
  • They are also thought to be more effective as compared to fertility pills in their ability to stimulate the ovaries in women whose FSH and LH are not properly in balance.
  • In the most common scenario, gonadotropins are used to hyperstimulate and rouse the ovaries in those women who have regular ovulation cycles.
  • It also acts as a part of many of the advanced reproductive technologies, which also include intrauterine insemination (IUI) as well as in-vitro fertilization (IVF) (6).

[ Read: Ovarian Hyperstimulation Syndrome ]

A Look At What Happens During The Conception Stage:

For you to become pregnant, everything needs to be perfect. There are many steps involved and many situations that need to be fulfilled for you to become pregnant. Here is a step by step look at some of the procedures that take place inside your body once you and your partner start trying for a baby and till the time you get pregnant:

Your brain and your pituitary gland start releasing the hormones that will help to stimulate the formation and release of eggs. The same hormones will also make sure that the eggs are being released properly.

The egg that you produce each month has to be of good quality and should have a normal range of chromosomes.

  1. The egg that is released has first to reach its full maturity level.
  1. Next, your brain has to release a decent amount of the LH hormone so that it can stimulate the egg during its final stage of maturation.
  1. The eggs that are released develop in structures in your ovaries and are known as follicles. The follicle has to rupture to release the fluid of the follicle and the egg.
  1. Your tube has to pick up the egg.
  1. The sperm enters your vagina for a small amount of time and has to be strong enough to survive there. Next, the sperm has to enter the cervical mucus and swims to your fallopian tube from where it has to find the egg that you release.
  1. The sperm also has to manage to reach the cumulus shells around your egg properly and be able to bind the shell of the egg.
  1. The sperm then has to go through a biochemical reaction and then release its DNA properties (which are exactly 23 chromosomes) in your egg.
  1. Once that happens, the egg that has been fertilized thus should be able to divide itself.
  1. In the early stages, the embryo continues to divide and develop in a normal way.
  1. After three days that your egg has been fertilized with the help of the sperm, the tube should by now have transported the embryo below in your uterus.
  1. The embryo has to keep on developing and expand itself into a blastocyst (7)..
  1. As a next step, the blastocyst has to hatch out of the shell.
  1. Once that happens, the endometrial lining of your uterus has to be properly developed and has to be ready to receive the blastocyst as well.
  1. As part of the next step, the blastocyst that has hatched will have to attach itself to your endometrial lining and plant itself.

The steps mentioned above are just the beginning in the earliest stages of conception. Once you become pregnant, the changes will become more intense and more abrupt than earlier.

[ Read: Infertility Treatment – Gamete Intrafallopian Transfer (GIFT) ]

What Can Increase A Woman’s Chances Of Suffering From Infertility?

There are various factors that come into play when there is a risk of infertility. What affects you in a particular way, may not affect another person in a similar way. There are of course common factors that affect women and can increase your risk of contracting infertility. For your benefit, we list some common factors that can increase your risk of experiencing infertility:

1. Age:

If you are mature in age and have reached your late 30s or 40s, then your chances of becoming pregnant decrease significantly.

2. Smoking And Drinking:

Smoking and drinking can both considerably increase your chances of not being able to conceive. If you are a habitual smoker or if you regularly consume alcohol, it can put you at a higher risk of suffering from infertility than other women.

3. Stress:

Stress can also affect the way your body reacts and can create hormonal imbalances. The hormonal imbalance can have an adverse effect on your fertility. Being stressed can also lead to other health complications that can make it difficult for you to conceive.

4. Poor Diet:

Not having a good and balanced diet can often put you at risk for infertility. Eating healthy and eating the right food is extremely important when you are trying to conceive. Your body will need a mix of nutrients that will help your hormones and the different parts of your body do the job that they have to do for you to be able to conceive. Make sure you eat at least six small meals through the day and include all the main nutrition groups like proteins, fats, carbohydrates, iron, calcium, and so on.

Avoid eating processed or packaged foods or foods that are high in their sugar content, such as fizzy drinks and colas. Overeating packaged, or sugar-laden foods can also increase your chances of contracting other conditions like high blood pressure, heart disease, diabetes, a blockage in the arteries, and stroke.

5. Excess Weight Gain Or Obesity:

It is normal for you to gain weight during pregnancy. However, gaining too much weight while you are trying to conceive can have a negative impact on your body. Obesity is the harbinger of many dangerous conditions, and it can also reduce your chances of having a baby. A healthy body mass index (BMI) will significantly increase your chances of getting pregnant.

If you have been battling with weight issues for some time, try to find out ways in which you can reduce your weight. Make exercise a regular part of your routine, and you can start with something as simple as a daily walk and move on to more strenuous jogging and running schedules later. You can also reach out for more holistic ways of reducing weight and staying in shape by practising and learning yoga. Not only will it help you lose weight and stay in shape, but it will also help you to stay healthy.

When you are fighting with weight issues, it is important for you to keep a watch on what you eat. Ensure you eat homemade food whenever you can, and reduce your intake of fried food, oily food. Foods that are processed or come from packets are high in preservatives and chemicals than can lead to long-term problems. It is also important to limit your intake of sugar and salt. Most importantly, concentrate on maintaining a healthy mass index, and don’t be tempted to follow a fad diet, or a weight loss program.

There can be many reasons for your infertility, and even if the diagnosis says unexplained infertility, speak to your doctor about dealing with unexplained infertility, and follow the line of treatment she recommends.

Do you suffer from unexplained fertility, or do you know someone who does? What did the doctor recommend? What line of treatment did you follow? How did it help? Help ease your fellow parents’ anxieties here, leave a comment in the section below. We would love to hear from you.

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