Unexplainable infertility is affecting about 15% of couples who and its cause remains unidentified even after an infertility work-up as fertility specialist find no apparent cause for the failure of embryo implantation and pregnancy.
Basic tests to explain unexplained infertility
When patients fail to achieve pregnancy after having tried it for a year in a natural way, a proper functioning of the reproductive male and female organs must be checked:
- Ovulation disorders: when ovulation fails to occur or occurs on an infrequent or irregular basis, a pregnancy hardly can be achieved in an natural way. It is therefore important to check and correct it if necessary. A gynaecologist will be able to check patient’s cycle by performing an ultrasound and a blood test to determine the hormone levels.
- Tubal permeability: for the sperm to meet and fertilize the egg, the tubes must be permeable, which means they must leave a free passage for both gametes. The patency of the tubes can be explored by a hysterosalpingography.
- The uterine cavity must be ready to receive the embryo and do not have any obstacle, such as cysts, endometriosis, which could stunt the embryo from implanting and developing properly.
- The quality of the sperm: performance of a spermiogram is essential for a good diagnosis.
Advances in Assisted reproductive technology (ART) help to find answers
However, fertility specialists increasingly find answers to the causes of the unexplained infertility thanks to the advances in the field of ART. Cases of infertility are now better diagnosed, so that the patients know what to do in order to achieve a healthy pregnancy. New diagnosis methods make it possible to consider more factors for a more precise diagnosis.
Genetic reasons for infertility
Genetic tests can be very helpful in order to determine the causes of implantation failures and miscarriages.
It is therefore important to check whether one of the partners are carriers of chromosomal alterations and carry out a karyotype test or whether the created embryos are carriers of a malformation which can be determined by a Preimplantation genetic diagnosis. This is still a vast subject which is still being studied but which already improves considerably the results of assisted reproduction treatments.
The endometrium receptivity: misplaced in 28% of cases
It is often said: for an ART treatment to work, you need a beautiful embryo and a beautiful endometrium. The endometrium is usually checked by an ultrasound, but in some cases, further studies and testing of endometrial receptivity are required. This involves a biopsy of the uterus at a specific time to check whether it meets all the conditions for embryo implantation. This test ist called ER -MAP test of endometrial receptivity.
About 28% of women is receptive at a different point of the cycle as the rest of women. Thus, the ER-MAP help to figure out when a woman´s endometrial is the most receptive, so the embryo can be transferred exactly in this moment and increase significantly the implantation rate.
The thrombophilia study by implantation defects
This is also known as the “miscarriage protocol”. The thrombophilia examination is normally carried out in cases of repeated miscarriages but is also recommended for implantation defects. It determines whether a woman’s uterus is well supplied with blood, which is extremely important for the implantation of the embryo. Even if a woman has a normal coagulation value, she may have thrombophilia changes that cannot be detected in a basic analysis.
Psychology is important
Getting pregnant and carrying a child is often not easy, so that a psychological blockage can occur without any physical explanation. For this reason, highly professional care is very important for the success of a fertility treatment. A calming and caring environment reduces unpleasant feelings and increases the chances of treatment success.
IVF-Spain Madrid is specialized in complex cases and unexplained infertility. Our medical staff will be able to answer your questions and advise you on your individual case. Please contact us for further information at here.