What Does It Mean to Have Unexplained Infertility?

unexplained infertility

What Does It Mean to Have Unexplained Infertility?

The frustrating news: After finding the right fertility center and undergoing all of that testing, the diagnosis is “unexplained infertility.” Ugh! You wanted concrete answers and solutions!

The good news: This is by no means the end of the road. Having unexplained infertility simply means the most typical causes of infertility, such as atypical ovulation, anatomical abnormalities, or low sperm count/motility have been ruled out. Now it’s time to get to the bottom of things.

Unexplained Infertility Means You’re Closer to Finding a Solution

For all of the information out there about infertility factors, unexplained infertility (UI) is fairly common, so you are not alone. About 25%, or one-in-four, couples will be told they have unexplained infertility after receiving “normal” results from routine diagnostic tests. This diagnosis is the beginning of Phase II, and fertility centers will take that information and begin to dig deeper.

Once we’ve ruled out the most likely causes of infertility, we work like detectives to find additional factors that contribute to infertility. Some of the most common are:

Underlying medical condition(s)

We are continuously learning more about how disease and overall health affects infertility. There is always a chance that a yet-to-be diagnosed medical condition is compromising your ability to conceive or carry a healthy, full-term baby.

Examples of health conditions that have played a role in infertility include:

  • Celiac disease (a 2016 metanalysis showed that women with a UI diagnosis were six-times more likely to have celiac disease, which is a gluten intolerance)
  • Autoimmune disorders such as lupus, fibromyalgia, or rheumatoid arthritis
  • Diabetes
  • Thyroid disorders
  • STDs or other infections
  • Cancers
  • Endocrine system disorders

The good news here is that your infertility may be a blessing in disguise, pointing the way to a potential medical condition that can be treated before it becomes more serious – while simultaneously leading the way to improved fertility chances.

Mild endometriosis

Endometriosis is one of the leading causes of infertility. People often assume serious endometriosis affects fertility more than mild endometriosis, and this is not always the case.

Some women with mild endometriosis have been able to get pregnant faster after treatment. That said, many women with mild, moderate, or more serious cases of endometriosis are able to get pregnant without any assistance whatsoever. We’re continually learning more about which symptoms or locations of misplaced endometrial tissue are most likely to prevent pregnancy.

Poor egg or sperm quality

While we routinely use hormone tests and imaging to verify egg quantity, there is still no way to test a woman’s egg quality. Sometimes, pre-genetic screening illuminates a chromosomal or genetic disorder that doesn’t affect the mother but is carried in her eggs. Still, there are other factors affecting egg quality that we simply cannot test for at this time. Similarly, male sperm may have compromised DNA, and there is no way to test for that either.

If we move forward with fertility treatments such as IUI or IVF and experience failed attempts leading us to suspect poor sperm or egg quality, we will discuss how donor sperm or donor eggs may help your fertility chances.

There is a problem with the endometrial lining

Sometimes a woman’s endometrial lining isn’t thick enough for the fertilized egg to implant, or for the implanted embryo to develop full-term. This is due to a shorter-than-normal luteal phase, sometimes a diagnosable cause of recurrent miscarriage, but not always. If we suspect inadequate endometrial lining is a factor, we can discuss a range of potential treatment options that may increase the thickness of the endometrium and go from there.

Your immune system is too active (or not active enough)

Reproductive immunology is an exciting frontier of reproductive medicine. There are all kinds of ways your body may be rejecting your partner’s sperm, a fertilized egg, or the embryo. Similarly, your partner’s sperm may potentially have a reaction inside your body that makes it unable to fertilize the egg. These immunological responses can occur from the minute the sperm enter the vagina, at any point during the sperm/egg journey, and after a fertilized egg has implanted and begun developing inside the uterus.

Immunotherapy to support fertility treatments have been successful for women around the world, and we will discuss the options that make the most sense depending on how infertility is showing up for you (not conceiving at all, recurrent miscarriage, etc.)

The Fertility Center of Dallas does not shy away from an unexplained fertility diagnosis. This is our call to double-down and work to find the underlying cause so we can create the best fertility treatment plan for you and your partner. Contact us when you’re ready to transform UI into a known infertility factor so we can get to the bottom of things.

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