Unexplained infertility is Infertility cases in which the standard infertility testing has not found a cause for the failure to get pregnant. Unexplained infertility is also referred to as idiopathic infertility - meaning that its cause remains unknown even after an infertility work-up.
According to the report, around 50,000 couples in the UK, and 1 million couples worldwide, undergo fertility treatments every year. More than one third of them are told that they have unexplained or idiopathic infertility, meaning doctors cannot seem to find anything wrong with either the male or female.
The term "unexplained infertility" really reflects the present limitations of medical science. The fact is that current technology does not have the tools for revealing the cause of infertility. In unexplained infertility abnormalities are present but not detected by current methods. Means the physician failed to find the true cause of infertility. In other words, the diagnosis of unexplained infertility is reached by default; it is a negative diagnosis, suggesting that a clinical problem exists but that the probable cause for this problem has not been arrived at.
In reality, there are probably hundreds of "causes" of infertility. There are a lot of things that have to happen perfectly in order to get pregnant and have a baby.
- Semen should be normal – Male Factor
- Semen should be deposited at proper place in vagina – Coital Factor
- Cervix should be able to transfer the semen properly forward – Cervical Factor
- Uterus should be anatomically and functionally normal – Uterine Factor
- Fallopian tube should be functioning normally – Tubal Factor.
- Ovary should be secreting normal ova – Ovarian Factor
- Pituitary and other endocrine glands physiologically normal – Endocrine Factor
- Normal reproductive immunology - Immunological factor.
- Mind should be in sound psychological state – Psychological Factor.
A weak link anywhere in this chain will cause failure to conceive
The above list is oversimplified, but the point is made. There are literally hundreds of molecular and biochemical events that have to happen perfectly in order to have a pregnancy develop.
The standard tests for infertility really only looking for obvious factors, such as blocked tubes, abnormal sperm counts, ovulation problems, etc. These tests do not address the molecular issues at all.
Unexplained infertility and female age
The likelihood of a diagnosis of unexplained infertility is increased substantially in women of 35 and over - and greatly increased in women over 38. Most women over 40 who try to get pregnant will have difficulty, and fertility over age 44 is rare - even in women who are ovulating regularly every month. The point is that the older the female partner, the more likely that there is an egg related issue causing the fertility problem.
Even if significant advances have occurred in the diagnosis and, more importantly, in the treatment of reproductive disorders over the past decade, the overall incidence of infertility has remained stable and there is no improvement in diagnosis percentage of unexplained infertility.
Chance for getting pregnant on own - without fertility treatment - for couples with unexplained infertility diminishes as age advances. The longer the infertility, the less likely the couple is to conceive on their own. After 5 years of infertility, a couple with unexplained infertility has less than a 10% chance for success on their own.
These couples often invest a lot of time and money in fertility treatments and are unlikely to be successful. These couples should understand better treatment options, which will keep them from wasting their money, time, and emotions.
Conditions misdiagnosed as unexplained infertility
In cases of unexplained infertility following four conditions:
- Tubal disease
- Immunological infertility
requires carefully evaluation. These are Common conditions misdiagnosed as unexplained infertility.
Endometriosis is one of the great mimics in medicine. It may be present to a very mild degree and cause considerable symptoms, or affect a patient very severely without her even being aware that she has the condition. Diagnosis is further hampered by the fact that endometriosis often is only microscopic in nature which means that, even during laparoscopy, the by far most reliable diagnostic technique available; the condition can be overlooked and/or underestimated in severity. Endometriosis does and, even more importantly, affects fertility adversely in many different ways. Women with endometriosis have fewer positive outcome than other women of the same age without the disease. .
in them fallopian tubes may function abnormally, that ovarian function may be adversely affected and that endometriosis may release toxic substances which may harm embryos and/or their implantation capacity. Even in IVF these poor results are seen in practically all the aspects of the process, from having fewer eggs at time of retrieval, reduced quality of the eggs, and having lower implantation and pregnancy rates. Women labeled with a diagnosis of unexplained infertility, in reality suffer from endometriosis related infertility.
2. Tubal disease
Some cases of unexplained infertility represent the failure of proper diagnosis of tubal disease, especially distal tubal disease. The high rate of misdiagnosis of tubal disease has been well documented in the medical literature. Most of this misdiagnoses can be attributed to the limitations of hysterosalpingography (HSG), HSG is particularly poor in diagnosing correctly fimbrial tubal disease and peritubal adhesions. HSGs have only the ability to investigate the anatomic condition of the fallopian tubes. The functionality of the oviducts, cannot be evaluated by a HSG. In over 80% of cases elevated the laparoscopically confirmed presence of tubal problems, once again confirming that tubal disease is greatly under-diagnosed.
3. Premature ovarian aging (POA)
Women are born with approximately 300,000 follicles and that number declines by approximately one half every 10 years. In parallel female fertility also declines only to half until approximately age 37.5 years, when roughly 25,000 follicles are left over. From that point on, the decline in fertility accelerates in parallel with accelerated ovarian follicular loss. It can be assumed that in this age fertility also decline.
Women with Premature ovarian aging have the aging curve high at much younger age. These women will face a dramatic decline in their fertility potential prematurely. 11% of women encounter menopause early. Many women are expected to experience an accelerated fertility decline much before the usual age of 37.5 years. They do not exhibit any specific symptoms, they are frequently misdiagnosed with unexplained infertility.
A timely and correct diagnosis in these women is of crucial importance because their infertility treatment is then geared downward towards their ovarian age, rather than their chronological, age.
4. Immunological infertility
Abnormal immune function can affect female fertility. There is overwhelming evidence in support of the fact that (auto)immune mechanisms can reduce female fertility potential. Some cases, wrongly diagnosed as unexplained infertility, in reality suffer from immunological infertility. Women with classical auto-immune diseases, such as rheumatoid arthritis, systemic lupus erythematosus, scleroderma and others, long before they become clinically symptomatic and, are diagnosed with their diseases, already have a significant decline in fertility. This has been demonstrated in a large number of studies all over the world.
Why do so many doctors misdiagnose unexplained infertility?
The reasons why underlying problems is diagnosed vary for many reasons. One possibility is that there is no one obvious cause for a couple's infertility and that their problem may be the results of multiple minor defects of reproductive systems. Successful establishment of pregnancy is a highly complex process. Many a time male and female fertility, are affected to such a mild degree that standard diagnostic test results are considered within normal parameters. Yet, together, the reduction in the couple's combined fertility potential is very low and causes infertility.
The diagnosis of unexplained infertility is a diagnosis of exclusion.
So if more comprehensively and the more accurately the diagnostic work up is performed, the more likely will a true cause for a couple's infertility be detected and the less likely will they end up with a diagnosis of unexplained infertility. The poorer the medical care, the more likely a couple will end up with a diagnosis of unexplained infertility. Exactly the opposite is also true that good medical practice - good care better is the diagnostic accuracy.
Unexplained infertility will, therefore, greatly vary between practitioners, and what is considered unexplained infertility in one practice may have a very specific diagnosis in another.
First of all it is advised to all couple that if you receive a diagnosis of unexplained infertility, be sure to discuss all of your questions, concerns, and choices with your fertility specialist so that you can arrive at the right conception-options for you.
Experts in the field have explained that Alternative medicines – homeopathy - can find the cause of infertility for many of those couples having unexplained infertility and suitable treatments can be tailored for them which will direct them straight to the best treatment and increase their chances of having a baby. Further if these couples are assisted with recently developed treatment procedures options, they will have very high chances of having pregnancy. .
Unexplained infertility treatment
The first step in treating unexplained infertility is finding the right diagnosis. Carefully reevaluate diagnostic work-ups.
The treatment for unexplained infertility is therefore, by definition, empiric because it does not address a specific defect or functional impairment. This is like treating something without understanding it. The optimal treatment strategy needs to be based on individual patient characteristics such as age, treatment efficacy and cost considerations.
Treatment options for unexplained infertility
- Ovarian stimulation and/or intrauterine insemination, IUI
- Clomid and timed intercourse for unexplained infertility
- Clomid plus insemination, IUI for unexplained infertility
- Injectable gonadotropins plus intrauterine insemination, IUI
- Injectable gonadotropins plus intercourse
- Assisted reproductive technologies and IVF
Complementary therapies - HOMEOPATHY - for Unexplained Infertility
Complementary therapies can help much and encourage conception rate. Complementary therapy - HOMEOPATHY by bringing the body back into balance by normalizing body’s homeostasis. This allows reproductive functions to work at their.
'Helping the body to cope with the demands of modern life can do wonders to stimulate the reproductive organs into action.'
The idea is that, like small dose of vaccines, they 'kick-start' the body's defenses against the problem. Homeopathic remedies are highly diluted and they produce no side effects. The same hormone that is causing them the problem can aid fertility. The same hormonal remedy homeopathically corrects the imbalance of female sex hormones,'
Homeopathy can help women with a variety of fertility problems from blocked tubes and endometriosis to polycystic ovarian syndrome (PCOS).
Is it effective? There is a strong evidence to show that homeopathy aids fertility. A German clinical trial showed twice as many women taking daily doses of the drug - agnus castus - fell pregnant compared to those not taking the drug. In another German study more than half of women with fertility problems experienced improved ovulation and pregnancy after taking a homeopathic remedy. For women who are not ovulating regularly - folliculinum - an extract of ovarian follicle starts ovulating normally.