Unexplained infertility- is it really unexplained?

By  DR. OLAJUMOKE OGUNRO 

For convenience infertility is generally categorized into: Primary infertility, Secondary infertility and Unexplained infertility.

Primary infertility is when a woman who has never been pregnant before has been trying to conceive for a year or more.

Secondary infertility is when a woman who has been pregnant before(regardless of the outcome) has been trying to conceive for a year or more.

Unexplained infertility- when the cause of infertility cannot be determined by using the conventional methods.

The cause of infertility cannot be explained in about 10% of infertile couples when the conventional tests for infertility are carried out.

Conventional tests carried out for infertile couples include:

Semen Analysis – this is to check if the sperm parameters are within normal limits

Test to determine if the fallopian tubes are patent – usually a hysterosalpingogram(HSG) is done. Laparoscopy and dye test can also be done, this is complementary to HSG.

Hormone Profile – This is done to determine if ovulation has occurred, also the thyroid hormones are checked to ensure that the hormones are within normal limits.

So when the above tests are carried out and no abnormalities are revealed the diagnosis of unexplained infertility is made.

The question is: Is it really unexplained? The truth is if the cause of infertility cannot be explained with the conventional tests then more in depth evaluation of the couple is needed. I do know that for some couples the cause may not be found even with in depth evaluation. However, for others the cause may be found.

Infertility caused by endometriosis, advanced age of the female, abnormalities of the finger-like projections of the fallopian tubes, antibodies to the sperms or antibodies in the uterine lining that cause rejection of the embryos will not be picked by the usually conventional tests for infertility.

Many couples just sit by and relax once the diagnosis of unexplained infertility is made, thinking all is well. The lesson here is that when such diagnosis is made an in depth evaluation is needed to determine the cause of infertility.

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