Unexplained infertility is a condition that is diagnosed when a couple fails to conceive despite consistent efforts to achieve pregnancy. For most couples, the diagnosis can be confusing because there is no particular issue to identify and solve. However, unexplained infertility is a known medical condition globally and is a reflection of the limitations of existing technology rather than the absence of a real fertility problem.
Globally, unexplained infertility is a major cause of infertility. It is estimated that one in six people worldwide experience infertility at some stage in their lives, and unexplained infertility is a major contributor to this figure.
There is an increasing awareness and availability of fertility testing, and as a result, more couples are being diagnosed with infertility issues. However, the social norms surrounding procreation make it difficult for couples to communicate openly about unexplained infertility and their health concerns.
Unexplained infertility is only considered when the usual causes of infertility have been eliminated. These evaluations typically include both partners and are intended to assess the fundamental elements necessary for pregnancy to happen.
The following areas are typically evaluated for the diagnosis of unexplained infertility:
If these results do not suggest any underlying issues, and yet pregnancy has not been achieved, the infertility can be said to be unexplained. Patients might have to go for assisted reproductive techniques or fertility treatments to achieve parenthood.
Fertility is a biological process, and the testing procedures currently in place are not capable of capturing all the aspects of the fertility profile. There are some factors at the microscopic level, which are usually not detected.
The reasons for this could be subtle changes in hormonal levels, slight modifications in the quality of eggs or sperm, or the process of implantation, which are difficult to quantify. Age-related changes also affect fertility, even when results are normal.
Some physical or biological factors are difficult to detect in the standard testing. These may include:
These are some of the reasons why unexplained infertility is not due to absence of a cause, but rather a challenge in detection.
Reproduction is closely linked to matters of social identity, family responsibilities, and spousal and family relations. In some couples experiencing unexplained infertility, there may be distress, anxiety, or feelings of inadequacy because of not being able to conceive. Women, in particular, may be subjected to social pressure even if there is no medical reason for the infertility and pregnancy failure. The absence of a medical reason may also imply that the couple is subjected to repeated questioning by family members, which may be distressing and depressing at the same time.
Along with understanding the basics of unexplained infertility, getting well-versed with the common myths and misunderstandings is also paramount. They can help you make more informed choices during your pregnancy journey. Some of them are listed below:
The fact is that unexplained infertility is a real diagnosis and should be understood and sympathised with. A variety of factors can contribute to it, and medical guidance is necessary.
Although lifestyle changes cannot guarantee conception, overall well-being can be improved with improvements in an individual's lifestyle.
Useful areas of focus include:
These measures help ensure the overall physical and mental well-being of couples planning to conceive.
Medical guidance should be sought as soon as you start to observe minor symptoms of infertility. If you have been trying to conceive for over a year now, with unprotected intercourse for over a year, but with no successful outcomes, expert guidance becomes paramount. However, if pregnancy does not happen, it is essential to have continuous guidance and emotional support. This will enable the couple to be updated on the current health scenario.
Unexplained infertility can be emotionally challenging, especially in a culture where procreation is greatly cherished. It is essential to have a more informed awareness and understanding of the issue, which will help reduce stigma and avoid self-blame. Even though the diagnosis does not provide immediate solutions, it provides a platform for better decision-making, emotional support, and hope based on understanding.
Chief Infertility Specialist, MBBS(DU), FCPS(Obstetrics and Gynaecology), Fellowship in Assisted reproduction
Dr. Umme Ruman is a BMDC-registered infertility specialist based in Dhaka. She holds advanced qualifications in assisted reproductive techniques, sexual and reproductive medicine. Dr. Ruman serves as a Chief Consultant at Indira IVF Dhaka, helping patients with personalised fertility care based on her vast experience and expertise. Her knowledge and compassion will support couples navigating reproductive health challenges and guide them effectively towards their parenthood dreams.
IVF specialist, MBBS (SSMC), MS (Obstetrics and Gynaecology), Fellowship in Assisted reproduction
Dr. Rezwana Kabir is a BMDC-registered specialist in obstetrics and gynaecology, and now a part of Indira IVF’s team of fertility specialists in Bangladesh. She combines medical proficiency with a patient-centric approach, offering tailored solutions to couples seeking fertility assistance. She is committed to helping individuals confidently navigate the journey to parenthood through ethical, empathetic, and evidence-based care.
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