What does a diagnosis of unexplained infertility mean?

Idiopathic infertility or unexplained infertility is when standard infertility testing has not determined a cause for the failure to get pregnant. Certainly standard diagnostic testing will identify the major reasons why a couple is experiencing infertility, but will not identify all the reasons. There are 20 to 30 percent of patients who are diagnosed with unexplained infertility. What this means is that, after a standard fertility evaluation, there appears to be nothing wrong with the male’s sperm or the female’s fallopian tubes, uterus, or ovaries.

What is a standard fertility evaluation?

In a standard fertility evaluation, the medical and sexual history of both partners are discussed. For the female, your doctor will first want to check to see whether you are ovulating. Ovulation can be determined and monitored through blood tests that detect hormones and by an ultrasound exam of the ovaries. If you are ovulating, your doctor may then take an x-ray of your fallopian tubes and uterus with a test called a hysterosalpingogram. In this test, a radiographic dye solution is placed in the uterine cavity.

If the fallopian tubes are open, the dye will flow through the tubes and be visible in the abdominal cavity. If the fallopian tubes are blocked, the dye will be retained in the uterus or fallopian tubes.
The male will undergo a semen analysis that will evaluate his sperm count and the sperm movement.

Understanding the diagnosis

In reality, there are many “causes” of infertility. Although diagnostic testing will reveal obvious factors of infertility, such as blocked fallopian tubes, abnormal sperm counts and ovulation problems, it may not address more subtle infertility factors such as inadequate egg quality, problems with embryo development or implantation issues.

It is helpful for any couple who suffers from infertility to understanding how the body works under normal conditions. In order for pregnancy to occur, a precise sequence of events must take place. A healthy, mature egg must be released from the ovary and met by one healthy sperm that has travelled through the female reproductive tract (vagina, cervix, uterus, and fallopian tubes) at the right time. Timing is frequently is a common obstacle to conception. Once the egg is released from the ovary, the sperm only have 12-24 hours to fertilize the egg. Once conception occurs, and an embryo is formed, it must make its way through the fallopian tube into the endometrial cavity (inside the lining of the uterus). Once in a normal endometrial cavity, the embryo implants and develops into a fetus. An interruption at any of these points can cause infertility.

If you are diagnosed with unexplained infertility, remember that it is better to find nothing wrong than to find out something is seriously wrong. Even though the cause of infertility is unexplained, that does not mean it is untreatable.

IVF is sometimes the best option.

In vitro fertilization (IVF) will sometimes reveal subtle infertility factors that other diagnostic processes miss, such as inadequate egg quality, poor embryo development or implantation issues. Sometimes women with excellent ovarian reserve can still have inadequate egg quality.

The success rate of IVF is very impressive. For women under the 35 years old, 47.7% of transfers resulted in live births. While that percentage does decrease with age, it’s still reasonably high for women between the ages of 38 and 40, with 28.5 % of transfers resulting in live births.

At The Fertility Institute, we will guide you through all of your treatment options and make sure you have the best chance possible for starting your family.