Unexplained infertility

At Equipo Juana Crespo, we know that all infertility has a cause. We focus on diagnosing Unexplained Infertility

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    What is unexplained infertility?

    Unexplained infertility is generally a diagnosis given to couples when, after performing basic female and male fertility tests, the specialist has not found conclusive evidence of what is preventing pregnancy.

    Infertility can be defined as the inability of a couple to achieve pregnancy after more than one year of unprotected sexual intercourse. After this period, we recommend beginning a basic fertility study comprising examinations and diagnostic tests for both partners.

    Statistically, 30% of infertility is attributed to female causes, 30% to male causes, 20% to mixed causes and, when the couple does not fall into any of these categories, then it is diagnosed as unexplained infertility.

    All infertility has a cause.

    At Equipo Juana Crespo, we believe that all cases of unknown infertility have an underlying cause.  

    Therefore, couples experiencing this situation should know that their chances of pregnancy are not lower than those of a couple with infertility due to an already identified cause.

    The challenge in this case is to identify the cause that is preventing fertility to find the appropriate treatment. This is relative sterility, as the possibility of finding an adequate response depends to a large extent on how the diagnoses are made, the specialists involved, and the clinic where they are performed.

    Remember that the female and male reproductive apparatus is a system where all the organs and participants have specific functions, but they must also be perfectly synchronised for reproduction to take place.

    The most common reasons for unexplained infertility are related to multifactorial causes, i.e., causes where several organs are affected to a greater or lesser extent, and which are difficult to diagnose with conventional or basic fertility tests. Poor egg or sperm quality due to genetic causes, implantation problems due to poor endometrial receptivity, and structural problems in the uterine cavity are other potential causes.

    The most common causes for unexplained infertility are related to egg and sperm quality. Poor quality eggs and/or sperm with genetic alterations can lead to difficulties in fertilization and/or the formation of an abnormal or suboptimal quality embryo to result in a live new-born. Implantation problems due to poor endometrial receptivity or structural problems of the uterine cavity also account for a significant number of unexplained infertility cases.

    Unexplained infertility diagnostic procedures

    To establish an adequate treatment for unexplained infertility, a series of diagnostic tests must first be performed to detect the origin of the problem preventing pregnancy.

    The protocol for diagnosing unexplained infertility consists of performing different types of tests and analyses:

    When assessing the infertile couple, both partners must be examined.

    The fundamental supplementary test, in addition to the basic male study, is a semen analysis to examine the morphology, number and motility of sperm.

    The supplementary tests to the basic female study are: transvaginal ultrasound, tubal patency test, and a baseline hormone profile. It is important to complete the study with other hormones such as prolactin and those defining thyroid function, as these can be important in patients with ovulation problems.

    3D and 4D ultrasound produces high-resolution images to obtain a more complete study of reproductive system morphology, rule out pathologies that may compromise success, and reach a more accurate diagnosis. Ultrasound produces static three-dimensional images, while with 4D, three-dimensional moving images can be obtained.

    Hysterosalpingography is a diagnostic test performed by X-ray and contrast to visualise the morphology of the uterus and fallopian tubes. 

    It is performed in the X-ray or radiology room at centres specialised in diagnostic imaging, is for outpatients, and lasts about 15 minutes.

     

    During the examination, the radiologist observes the trajectory of the contrast through the tubes to determine if these are patent or if, on the contrary, there is something that prevents the contrast dye from circulating well during its journey to the abdomen. This would be a case of blocked tubes. 

    Tubal patency is essential to achieve a natural pregnancy.

    Pelvic MRI is one of the best diagnostic imaging tests to visualise all pelvis structures and therefore the entire reproductive system.

    This test’s major challenge lies in the ability and knowledge of the specialist to interpret the findings that sometimes are not obvious and require individualised study time and experience.

    MRI has been a basic fertility test since Equipo Juana Crespo first started out.

    MRIs allow us to study pathologies such as uterine fibroids, endometriosis, Müllerian anomalies, etc. with greater precision.

    The most specific technique for studying the cervical canal and uterine cavity. It affords a direct view of the anatomy of the space that first receives the embryo before implantation (the endometrium). It also helps to solve pathologies such as polyps, myomas and even highly complex cases that require remodelling of the entire cavity due to the presence of scar tissue that prevents proper embryo implantation.

    Treatments in cases of unexplained infertility

    Depending on the results obtained, different types of treatments will be considered to deal with unexplained infertility.

    Treatment aimed at the union of the egg and sperm in a laboratory to obtain embryos that will be introduced into the uterus to achieve gestation. IVF is not only a therapeutic method but also a diagnostic method that allows us to identify causes of infertility that cannot be identified with current diagnostic tests. This is the case, for example, in fertilization failures that can be easily diagnosed in a laboratory. 

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    An innovative procedure developed by Equipo Juana Crespo that revitalizes the uterus and ovaries, thus improving the functionality of both organs. Through this revitalization, the chances of embryo implantation and therefore pregnancy with own eggs are increased.

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    This technique involves in vitro fertilization with eggs from an anonymous donor. The technique enables the fertilization of the donated oocyte with the man’s sperm, with the goal of implanting the embryo obtained so that pregnancy can occur.

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    Frequently Asked Questions

    Can I still get pregnant despite this diagnosis?2023-01-04T10:57:47+01:00

    Yes. With an accurate diagnosis that provides favourable results for the right treatment and does not reveal that natural gestation is impossible, pregnancy is possible.

    What treatment is recommended for unexplained infertility.2023-01-04T10:58:36+01:00

    Each treatment must be personalised and the choice of one or another will depend on the results of the different diagnostic tests.

    Potential treatment options include In Vitro Fertilization, Revitalize or egg donation, depending on the results of the tests and considering the most advisable treatment in each case.

    How is an unexplained infertility diagnosis reached?2023-01-04T10:59:31+01:00

    Statistically speaking, it is established that 30% of infertility cases are due to male causes, 30% to female causes, and 20% to mixed causes.

    The other 20% are due to unknown causes that do not fall under common diagnoses. Such cases are unexplained infertility.

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