Unexplained infertility can often be a very frustrating diagnosis , for both patients and doctors. In one sense, it’s actually a non-diagnosis. We are effectively telling patients we don’t have a clue why they are not getting pregnant – and this can be very upsetting. Patients start believing that if we cannot even find out what their problem is, then how will we able to solve it ?
Typically, these patients have had an extensive battery of tests done, all of which come back as normal. All we can tell them is that the fact that you are not getting pregnant means that either your sperm are not fertilizing your eggs in your fallopian tubes ; or your embryos are not implanting in your uterus, and sperm are not meeting in your fallopian tubes when you are trying naturally, even though there does not seem be any abnormality in your test results.
In one sense, this is a limitation of our testing technology . Thus, while our tests for semen analysis allow us to check the sperm count and motility; and more advanced tests of sperm function allow us to check some aspects of how well the sperm are working , none of these tests can answer the key question – are the sperm functionally capable of fertilizing the egg ?
IVF provides invaluable diagnostic information for these couples, because it allows us to answer this crucial question. Of course, it can be quite a rude blow to the man when he finds out that even though his sperm count and motility are fine, for all practical purposes he is still shooting blanks, because his sperm cannot fertilise his wife’s eggs !
IVF is also very helpful for checking egg quality. Many women naively believe that just because they are ovulating; or that because they are growing good follicles when ultrasound scans are done during their IUI treatment, this means that their eggs are fine. Doctors also contribute to this confusion, because they often use the terms eggs and follicles interchangeably. However, a follicle is just a black bubble which the doctor can track on ultrasound scans. Eggs, on the other hand, are microscopic, and can only be seen in the IVF lab after egg retrieval, under a stereozoom microscope. Not all follicles will contain eggs – and not all these eggs are of good quality.
IVF is the only method by which we can prove that the eggs are of good quality ; and that the sperm are able to fertilise them. The proof of the pudding is in the eating !This is why IVF provides invaluable diagnostic information, which we can use to plan the treatment protocol, thus maximizing the patient’s chances of success.
In any case, I always remind patients that their question should NOT be “Why am I not getting
pregnant ? “Rather, it should be – What can I do in order to get pregnant ?” After all, no one cares about problems – we only care about results – about having a baby . IVF allows us to bypass all the problems, and allows us to take a cost effective shortcut to their goal of getting pregnant !
Frustrated with your diagnosis of unexplained infertility and worried that your doctor cannot help ?
Please send me your medical details by filling in the form at www.drmalpani.com/malpaniform.htm so that I can guide you better !