Unexplained Infertility

Good morning , I am Dr Puneet K Kocchar. I am a consultant gynaecologist and fertility specialist.

Today I am explain about unexplained fertility. Now before going to unexplained fertility, I am going to tell you about what is infertility or sub-fertility.

If you have has unprotected regular intercourse for a period of one year or over one year and you have not been able to conceive, then you need to see a doctor. That is when you are suffering from sub fertility and you need to see a doctor. And for the women above the age of 35 years, if you have been trying reguarly to get pregnant over a period of 6 months and you are not pregnant. You might see a doctor and get some basic tests done.

Now coming to unexplained infertility. This is where when we are not able to find out the cause of infertility. Lets start from the basics. You need four basic things to get pregnant. I will show you here,

• First we need a sperm which should be normal and have good mortality present in the semen.
• When you have intercourse, the sperm is deposited in the vagina.
• Then you need eggs to be produced in the ovary and we need two fallopian tubes which should be patent and should be able to transfer the sperm to reach the egg.
• Then we have uterus which is normal and able to carry on the pregnancy.

Now unexpalined infertility is when all these factors are normal and still someone is not able to conceive. You will be suprised to know that unexplained infertility accounts for as much as  20-25% cases of infertility, that we see in our clinic daily.

The good news is that about 80% of the women are able to conceive. Most of them conceive on their own or some of them need help of a doctor. No extensive treatments are required in this case, mild treatment might help you conceive. Now the first kind of management is to provide oral medicines, such as follic acid, which help in the development of baby. If you are suffering from polycystic ovaries, we might give the medicines of ovugation induction to improve the quality of egg. These are the oral medications which help in the formation of the eggs. Sometimes we give injections to form highter number of eggs. There are some tablets which helps in improving the quality of few eggs.

On the other hand, there are extreme opposite case in which woman instead of having higher number of eggs, have low number of eggs. So these women might benefit from DHEA tablets, so we give them oral medications in order to improve the egg quality. After improving the egg quality and the serial ultrasounds we can see the egg is develpoing normally. And you have tried naturally, lets say about 3-6 months and you are still not pregnant, then the next step is for Intrauterine Insemination, also called IUI.

In IUI, once your egg is ready, we call the couple to the clinic. The husband has to give semen sample which is then processed. The good quality or the rapidly move sperm is put in the uterus. This might help in conception by increasing the chances of natural pregnancy by about 5%. In natural pregnancy, the chances of getting pregnant is about 15% and in IUI cycle, the chances increase to about 20%. If this fails for about 3-6 cycles, we have two more options;

We either perform the tests for the tubes again. So, we either do the laposcopy tests or we move towads IVF, which is called "In Vitro Fertilization". This is also called test tube baby treatment. It is not actually a painfull or extensive treatment, infact it is quite simple treatment which has a success rate of about 50-60% of conception for majority of couples, below the age of 35-36 years.

In the patients with unexplained infertility, the chances of conceiving without requiring IVF is very high. As I said, all you need is a good direction and not to give up hope and not to stop treatment for very long time. If you are suffering from any such problem, I would request you to call us and make an appointment and discuss the problems in personal.

You can contact me through lybrate or directly on my clinic.

Thank you.