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Causes of unexplained infertility that you should be aware of, solutions for men and women

ByZarafshan Shiraz, Delhi
May 07, 2023 11:28 AM IST

The issue of unexplained infertility may create frustration among individuals and couples. Here are potential causes for unexplained infertility and solutions

When a couple is unable to conceive a child despite several attempts, chances are that one of the partners, or perhaps both, is infertile and irrespective of men or women, it is difficult for anyone to accept that they are undergoing fertility issues. Infertility is a sensitive issue that triggers numerous emotions among men and women as it causes a conflict in a couple’s relationship which deteriorates the physical, mental and emotional health of the affected couple.

There have been cases when couples or individuals have undergone all the necessary tests, yet the doctor is unable to pinpoint a specific cause and this is termed as unexplained infertility.

Unexplained infertility is a condition experienced by couples or individuals where they fail to conceive a child despite making several attempts. The issue of unexplained infertility is a common phenomenon among couples and individuals and even though this issue may create frustration among individuals and couples, it does not mean that it cannot be treated.

In an interview with HT Lifestyle, Dr Beena Muktesh, Fertility Specialist at Motherhood Hospitals in Gurugram, echoed that unexplained infertility is an umbrella medical term devised by healthcare providers to describe infertility without being able to specify a cause after running several tests and fertility evaluations. According to her, health specialists conclude unexplained infertility when the tests signify -

  • No uterine abnormalities or structural issues with a woman’s uterus.
  • The process of ovulation occurs at regular intervals.
  • When the fallopian tubes aren’t obstructed.
  • When the ovarian reserve or egg count is good.
  • When the brain produces normal or adequate levels of hormones required for the reproduction process.
  • When the man’s semen analysis is normal ranging from sperm count, amount, motility, and shape.

She revealed that the causes behind unexplained infertility are unknown however, following are the possible factors for unexplained infertility among men and women -

  • An undiagnosed underlying condition: Every person’s bodily functions differ from one another therefore causes behind unexplained fertility can be an underlying medical condition like diabetes or thyroid which may contribute to infertility.
  • Endometriosis: This condition usually affects the woman’s reproductive system where tissue similar to the lining of the uterus grows outside the uterus. Mild cases of endometriosis or endometriosis with no symptoms can create complications and may contribute to infertility.
  • Cervical mucus: This form of fluid produced and released from the cervix or the opening of the uterus helps the sperm swim to meet the egg during ovulation. If the cervical mucus has a thicker consistency or contains certain ingredients, then the sperm is unable to travel through the cervix and vagina to form an embryo.
  • Egg quality: When the quality of the egg deteriorates due to age or other factors, then the chances of infertility increase.
  • Sperm quality: Similar to the egg quality of a woman, a decrease in the quality, count, or mobility of a sperm contributes to unexplained infertility.
  • Uterine lining: the endometrium is the lining of the uterus where the embryo sticks to and grows during the pregnancy stages. When the fertilized egg is unable to implant itself on the uterine lining, it may result in a failed attempt in achieving pregnancy.
  • Poorly timed intercourse: The frequency or timing of sexual intercourse is unable to match up with the ovulation process.

Bringing her expertise to the same, Dr Suparna Bhattacharya, Fertility Consultant at Nova IVF Fertility East in Kolkata's Uttam Kumar Sarani, shared that unexplained infertility does not have a specific cause however, in men, a few reasons include -

  • Like egg quality, the quality of the sperm is essential for fertility.
  • When the timing of sexual intercourse doesn’t coincide with the ovulation process.
  • Childhood illnesses or testicular trauma which may result in vascular injuries that could damage the testicles.
  • History of testicular torsion where the testicle twists on its pedicle which causes difficulty in blood flow.
  • Previous surgical procedures like bladder operations or surgery for testicular cancer.
  • Exposure to heat which interferes with the sperm temperature that causes impairment during sperm production.
  • Alcohol consumption and smoking can be associated with infertility.
  • History of venereal diseases or medication can affect the reproductive system.

In terms of women, potential reasons for unexplained infertility include -

  • Endometriosis: A disorder among women where the tissues lining the uterus grow outside the uterus and can be found on the ovaries, fallopian tubes, or the intestines. Mild cases of endometriosis can contribute to infertility.
  • Cervical mucus: Cervical mucus helps the sperm swim through the fallopian tubes to meet the egg during ovulation. If the cervical mucus has issues, then the sperm is unable to travel through the cervix and vagina resulting in unsuccessful fertilization.
  • Egg quality: While achieving fertilization, the quality of the egg is important because if the egg quality isn’t up to par, the process of fertilization is difficult to achieve.
  • Uterine lining: When the endometrium- the lining of the uterus, is unable to prepare itself for a fertilized egg, it may result in infertility.

Unexplained infertility can be frustrating and confusing for couples or individuals however, with the advancement of technology, exploring alternative treatment measures can help couples or individuals achieve success in conceiving a child. Talking about solutions for unexplained infertility, Dr Suparna Bhattacharya said that despite infertility issues, couples can choose alternative procedures by using Assisted Reproductive Technology (ART), fertility treatment where the fertilization process takes place in a laboratory. Few ART treatments include -

  1. Intrauterine Insemination (IUI) or artificial insemination is when the sperm are washed, concentrated, and placed in the woman’s uterus during the ovulation period. During the IUI procedure, gonadotropins are injected which contain hormones that stimulate egg production in females and can also treat low sperm count in men helping cure unexplained infertility.
  2. In vitro fertilization (IVF) where sperm and eggs are fused to create embryos which are then placed in the uterus. IVF involves intracytoplasmic sperm injection (ICSI)- a procedure where the sperm is injected directly into the egg.

Besides these procedures, Dr Suparna Bhattacharya highlighted that modifying an individual’s lifestyle is crucial as it contributes to infertility hence, it is important to -

  • Maintain a healthy weight with a well-balanced diet.
  • Avoid consumption of alcohol, smoking cigarettes, and recreational drugs
  • Limit caffeine consumption
  • Engage in physical activities to remain fit
  • Reduce the risk for sexually transmitted infections (STIs) by using protection during intercourse.

Unexplained infertility does not mean that the cause cannot be detected or treated because, with such medical advancements, couples can consult a doctor about possible alternative treatments with an optimistic mindset throughout the process.

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