 |
 |
|
Unexplained infertility means that doctors cannot determine why the couple is infertile - it is a confession of medical ignorance. Patients with unexplained infertility fall into two groups. The first group consists of those who really have no infertility problem whatsoever, but are just plain "unlucky". The other group has members which do have a reason for their infertility --- but the reason is so elusive, that even with present-day medical technology, we cannot find it.
Infertility may be said to be "unexplained" in cases where the woman is ovulating regularly, has open fallopian tubes with no adhesions or endometriosis; the man has normal sperm production; and the postcoital test is positive. Intercourse must take place frequently, particularly around the time of ovulation, and the couple must have been trying to conceive for at least one year.
On the basis of these criteria, about 10% of all infertile couples have unexplained infertility. However, the percentage of couples classified as having unexplained infertility will depend upon the thoroughness of testing; and the sophistication of medical technology.
The diagnosis of unexplained infertility is one of exclusion, that is, one which is made only after all the tests have been performed and their results found to be normal. This is why, the frequency of this diagnosis will depend upon how many tests have been done by the clinic --- the fewer the tests, the more frequent this diagnosis.Possible causes of unexplained infertility are as follows:
It is possible that there may be a subtle defect in the mechanism by which the fimbria "pick up" the egg at ovulation; or also the cilia in the tube may not functioning properly.
A very small number of cases of unexplained infertility could be due to the persistent production of abnormal eggs. These eggs may have a deformed structure or chromosomal abnormalities.
In some cases it would appear that eggs are produced, and mature correctly within the follicle, which then goes on to become a corpus luteum without however, first bursting to release the egg. The egg is therefore effectively "trapped" inside the unbroken corpus luteum --- and this is called a luteinized unruptured follicle (LUF) syndrome.
© Dr. Aniruddha Malpani and Dr. Anjali Malpani www.drmalpani.com
Credits: How to Have a Baby: Overcoming Infertility
