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If you’ve tried for a long time to get pregnant, the first question which plagues you is - “ Why am I not getting pregnant? “ It’s natural for couples who are struggling with conceiving, to go through the complete diagnostic process- you will start reviewing your past, researching family history, and going to a doctor to get hormone tests and scans done – in short , you go through the whole shebang in order to find the answer to such a simple question ! And when at the end of it all, you find that you are no closer to finding out what the reason for your infertility is, it’s bound to leave you frustrated.

If the problem doesn’t lie with you and it doesn’t lie with him, that what is it that’s keeping you from conceiving? Unexplained infertility isn’t uncommon and about 10% of all couples face this particular dilemma. While some of these patients have come to me for the first time, others have come in for a second opinion. No matter how well-informed or clueless they are about infertility, they all are equally worried and frustrated.

The Big Question Mark

The only thing on their mind is that if its unexplained fertility, how is it going to be treated? This is where I calm them down and tell them that in many ways this diagnosis of unexplained infertility is actually a very good prognosis. From my viewpoint, the glass is always half full, never half empty.

Look at it this way- isn’t it much better to find that absolutely nothing is wrong with you,  rather than find that something is seriously wrong? Of course, it does mean that there will be many more question marks in your head and your doctor will have to catalyze his grey cells into thinking a little more about how to give you a baby, but it’s still a good  thing.

Some Facts

Here are some frustrating facts related to unexplained infertility and how best to cope with them:

#1. Almost 10-20% of infertility patients are told they have unexplained infertility

The diagnostic testing that is available is useful only in identifying the major reasons why any couple may be facing difficulties in getting pregnant; but it’s unable to identify every single reason. The truth is that there aren’t any specific tests for many subtle infertility factors which could affect fertilization ( for example, poor egg quality).

Coping- Since we don’t know what the root cause for this infertility is, it simply means that there will be various treatment options available to you; and the only  limiting factors are your determination and of course your available resources.

#2. Among fertile couples, the average chance of conceiving in any given cycle is 20%.

This particular statistic can disappoint even the most determined couples, and it may feel  like no one else understands your struggle. But the truth is that even many fertile couples can sometimes find  it difficult  to get pregnant.

Coping- Before you go all out and dive into various invasive treatments, it’s important that you start out with the ones that require minimal intervention. Unless you try, you will never be sure. Many patients with unexplained infertility get pregnant with medications alone.

#3. One of the most frustrating things you can hear from a doctor is “ Now you just need to wait it out”. Unfortunately, this particular approach doesn’t really help many women and most times, it doesn’t even end in having a baby. Regardless of whether your infertility is unexplained or not, you are infertile for a reason and just because your doctor can provide you with a diagnostic label, doesn’t change the fact that you may need help.

Coping- After a point, an “expectant management” approach is no longer good enough. You need to take active steps since you cannot afford to waste time. You need to have a plan of action in your head, and find a doctor who will implement this for you. Create a road map, and then work towards your goal. You will need to progressively escalate if simpler treatment options do not work. Taking treatment at a world-class clinic will maximize your chances of success and give you peace of mind you did your best !

IVF- The best recourse

Of course, at the end of it all, IVF is often the most effective treatment option for  couples who have unexplained infertility. The benefit of IVF is that at times, we are able to pick up certain subtle infertility factors which other diagnostic processes tend to miss; for example, poor egg quality, because IVF is the only method which actually allows us to study fertilization.

What’s even more heartening is the fact that IVF has a truly impressive success rate- this of course, varies from one clinic to the next.IVF remains the one big hope  for couples dealing with unexplained infertility, because it allows us to bypass all the natural hurdles infertile couples encounter in their bedroom.

Need more information? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you better!

Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.

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