Living with a medically unexplained diagnosis can be both a relief and a cause of anxiety for patients. On one hand, your specialists have effectively ruled out several undesirable causes for your symptoms but on the other hand, you are still living with those symptoms. For couples who have been diagnosed with unexplained infertility, this can be particularly frustrating as it gives you no explanation as to why youre struggling to start a family.
Unexplained infertility is diagnosed when a couple has been unsuccessfully trying to conceive for 12 months or more. As well as the inability to fall pregnant, unexplained diagnoses have ruled out all other known explanations.
Fertility can be a complex and mysterious process, but even those with unexplained infertility have treatment pathways they can explore.
How Specialists Reach a Diagnosis of Unexplained Infertility
There are many causes and risk factors related to infertility and your fertility doctor will explore all of these pathways when making a diagnosis. In general, infertility can be defined as the inability to get pregnant, carry a pregnancy to term and deliver a baby.
Male Infertility Tests
For male infertility, specialists will look at factors that include:
- sperm size, shape, number and mobility
- the presence of varicoceles (enlarged veins in the scrotum)
- blockages of sperm-carrying ducts
- the presence of infections, cancer and STIs
- hormonal imbalances
- risk factors such as excessive weight, smoking, alcohol and drug abuse and a history of fertility disorders
To diagnose male infertility, your specialist may undertake semen analysis, prostate examinations, scrotal ultrasounds, testicular biopsies, anti-sperm antibody tests and other examinations.
Female Infertility Tests
To diagnose female infertility, your specialist may look for:
- polycystic ovarian syndrome
- premature ovarian failure
- blocked or damaged fallopian tubes
- the presence of polyps or fibroids in the uterus
- endometriosis
- an abnormally shaped uterus
- period irregularity and irregular menstrual cycle length
- weight gain, facial hair growth and lifestyle factors
To identify these symptoms, your specialist may undertake an x-ray or laparoscopic exam of the fallopian tubes, relevant biopsies, ovarian reserve testing (for egg quality) and other examinations.
Inconclusive Diagnosis Where to Next?
Unexplained infertility is essentially a process of elimination. If your diagnosis remains inconclusive after a full investigation, there are still several options you can explore.
Keep Trying Naturally
If you want to keep trying to conceive naturally, you should consult with your fertility specialist for advice. In some cases, your age and other factors may indicate that assisted reproduction is the best option to start a family.
IVF and Other Pathways
For many women, even those with unexplained diagnoses, IVF remains their best chance for pregnancy and starting a family. IVF can be successful even when the exact cause of your fertility problems is unclear because IVF substitutes many aspects of fertilisation.
Other Assisted Reproductive Technology may be considered alongside IVF or as an alternative to the treatment. Gamete Intrafallopian Transfer (GIFT), Zygote Intrafallopian Transfer (ZIFT) and Intracytoplasmic Sperm Injection (ICSI) may be options that assist you.
In many cases, IVF and other treatments may uncover the ultimate cause of your infertility, leading to answers and the opportunity of pregnancy.
Explore Your Options with Dr Alex Polyakov
Based in East Melbourne, Dr Alex Polyakov is a specialist in IVF treatments and fertility. Whether you have an unexplained fertility diagnosis or you are exploring your options for the first time, Dr Alex can guide you through testing and treatment, as well as your options for conception, pregnancy and delivery. For an appointment and advice, contact Dr Alex today.