Unexplained infertility in men and women

Unexplained infertility is when no apparent cause of a fertility problem is found out after the required tests. It is a diagnosis of exclusion and can be much frustrating for the couple going through the ordeal. Around 10-30 per cent of couples dealing with infertility have this condition also referred to as idiopathic infertility.

Tests are done to check for ovulation (egg release), whether fallopian tubes are blocked or not and for semen analysis. If these are found to be normal, then a couple has unexplained infertility. Unexplained infertility most likely involves issues with poor egg or sperm quality, or problems with the uterus or fallopian tubes that aren’t identifiable during normal fertility testing.

What are some of the significant causes of unexplained infertility?
The root cause of unexplained infertility is difficult to explain as no tests can measure them. However, some possible causes can include the following:
Endocrinal disorders. Hormonal disorders like decreased or increased functioning of thyroid gland, adrenal disease or disorders of pituitary gland can lead to unexplained infertility in a couple.
Endometriosis: Endometriosis is a condition in which tissue that normally lines the inside of your uterus grows outside your uterus. It has been found that even mild cases of endometriosis can have an impact on a female’s ability to conceive.
Egg and sperm quality in a couple: The quality of the egg in the female and the quality of the sperm in the male can significantly impact the fertility cycle of a couple. However, not all tests can help to find the quality of the egg or the sperm, leading to a diagnosis of unexplained infertility.

Genetic abnormalities in male or female: these may cause abnormal embryo formation which will be rejected by uterus.
Immunological conditions- Autoimmune conditions in which antibodies are formed against our own cells and the body attacks itself can lead to unexplained infertility.
Naturally low fertility- Some couples may naturally have a low fertility potential.

What are the available fertility treatments?
Medications: Fertility drugs may be prescribed to improve egg and sperm quality, stimulate ovulation or increase sperm count and motility
Surgery: In some cases, surgical procedures like hysteroscopy and laparoscopy may be recommended to correct structural abnormalities, remove blockages or cysts, or repair damage to reproductive organs
Assisted reproductive technologies (ART): ART techniques, such as in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), and intrauterine insemination (IUI), these methods can help overcome fertility problems by facilitating conception outside the body or directly injecting sperm into the egg. Assessing the genetic constitution of embryo by PGT-A and of the uterus can also be done here.

Lifestyle modifications: Making changes to one’s diet, exercise routine, and habits such as quitting smoking, reducing alcohol intake, or maintaining a healthy weight can improve fertility
Donor gametes or surrogacy: In cases where infertility cannot be treated by other methods, using donor eggs, sperm, or embryos, or surrogacy can provide an opportunity for parenthood.

Dr. Rakhi Goyal, Centre Head, Birla Fertility & IVF