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Unexplained infertility simply means we do not know why the couple is infertile - it is a confession of our medical ignorance. Yes, even in this day and age, there are lots of things about the human body we don't understand well !
Patients with unexplained infertility fall into two groups. One is the group who really have no infertility problem whatsoever, but are just plain "unlucky". The other is the group which do have a reason for their infertility - but the reason is so subtle, that with present-day medical technology, we cannot find it.
Infertility may be said to be 'unexplained' if the woman is ovulating regularly, has open fallopian tubes with no adhesions or endometriosis ; if the man has normal sperm production; and the postcoital test is positive. Intercourse must take place frequently, particularly around the time of ovulation, and the couple must have been trying to conceive for at least one year.
Using these criteria, about 10% of all infertile couples have unexplained infertility. However, the percentage of couples classified as having unexplained infertility will depend upon the thoroughness of testing; and the sophistication of medical technology.
The diagnosis is one of exclusion - that is, one which is made only after all the tests have been performed and their results found to be normal. This is why, the frequency of this diagnosis will depend upon how many tests are done by the clinic - the fewer the tests, the more frequent this diagnosis.
Previous tests should be carefully reviewed to ensure that the diagnosis is in fact "unexplained" - and that no test has been omitted or missed. It may sometimes be necessary to repeat certain investigations. Thus, if the blood tests have not been done from a reliable lab, it may be necessary to repeat them.
Remember, you still have a fairly good chance of getting pregnant on your own without needing any treatment at all! If no abnormality is found, your chance of getting pregnant without treatment within 3 years is about 1 in 3. Taking treatment helps to increase the chances of your conceiving - and also makes it likelier that you will get pregnant sooner.
The treatment of luteal phase defects is as controversial as their diagnosis. They can be treated by using clomiphene which may help by augmenting the secretion of FSH and thus improving the quality of the follicle (and therefore the corpus luteum which develops from it). Direct treatment with progesterone can also help luteal phase abnormalities. The progesterone can be given either as injections or vaginal suppositories.
Many patients are worried that if we are not able to find the cause of the infertility, we will not be able to treat them. Fortunately, this is not true - today, our technology for treating infertility is far superior than our technology for making a diagnosis ! Even though we are not very good at identifying problems, we are very good at bypassing them with the help of assisted reproductive technology ( ART) ! In any case, most infertile couples are not really interested in a diagnosis of what the problem is - they are much more interested in finding the solution to their problem - getting a baby !
Today, with assisted reproductive technology, the chance of treatment being successful is very good. Intrauterine insemination with superovulation is the simplest approach, and it helps because it increases the chances of the egg and sperm meeting; but some patients may also need IVF or ZIFT . IVF can be helpful, because it provides information about the sperm's fertilizing ability, and also allows the doctor to perform in the lab what is not happening in the bedroom ( whatever the reason for this ) ; ZIFT ( ZIFT Video ) , on the other hand, has a higher pregnancy rate, and is very useful in these patients, since they have normal fallopian tubes.