A condition is termed as UNEXPLAINED INFERTILITY when the basic infertility workup doesn’t show any noticeable cause. In a male, the contributory factor for fertilization is the sperm, and its count, motility, and morphology all appear normal in a routine semen analysis test. Also, there are no issues found in female reproductive health, yet a couple cannot conceive.
• There might be some issues related to sperm quality that cannot be detected in a routine semen analysis test and poor-quality sperm may not be able to fertilize an egg.
• There might be some issues with the egg quality. Maternal age and the quality of the egg play a major role in pregnancy.
• There might be a mild ovulation problem.
• The egg and sperm cannot interact normally as they should.
• There might be some issues in the lining of the fallopian tube that is not detected in an HSG test and due to which the passage of egg, sperm, or the fertilized egg may be disturbed.
• There might be some defects that lead to implantation failure.
If a couple has been diagnosed with unexplained infertility, the first thing we doctors suggest is not to stress. If the couple is young, they can try naturally for a few cycles. But if the age of the female is 35 years or above it is best to visit an infertility specialist. The first choice of treatment should be IUI with a natural cycle or with controlled ovarian stimulation. Some oral medications or hormonal injections are used to stimulate the ovaries to produce and release an egg. But if 3 cycles of IUI have failed, then it is best to move on with IVF.
IVF also can give us clues as to the cause of infertility. For example, we may see low fertilization rates per egg, or we may see slow embryo development, excessive fragmentation of the embryos, abnormal eggs, and abnormal eggshells.