How Infertility Sometimes Drops its “Unexplained” Cloak During IVF

It can be extremely humbling when you put into perspective the fact that even with young fertile couples who aren’t facing any issues with getting pregnant, the chances of them achieving pregnancy in any particular month they attempt  to, are just 20%. Let’s switch the angle from which you look at this fact- 80% of the time, even fertile couples fail to get pregnant in a single month, even if they have sex every single day . Most will conceive within 1 year of trying, while others might take much longer or may not get pregnant at all.

It’s best that couples who haven’t gotten pregnant after a year of unprotected and well-timed intercourse should consult an IVF doctor without delay. In case of women who are above 35 years, this step should be taken within 6 months of unsuccessfully trying to have a baby.

Unexplained Infertility

When a couple comes to me, they are looking for answers. After understanding some basic things about their situation, we will get diagnostic testing done in order to identify what the primary causes of their infertility are, based on their specific medical history. In almost 10% of the cases, all the results are normal, and we tell them they have unexplained infertility. Needless to say, they are baffled by this term. What good is a doctor who cannot provide an explanation for their infertility ? And their biggest fear is that if the doctor cannot make the right diagnosis, how will he able to treat them ? Does this mean they will never be able to have a baby of their own ?

It’s very important that they understand the meaning of this test result, so let me explain this a little further.  The diagnostic tests only identify the main reasons why the couple might be facing a difficult time conceiving; however it can’t identify all the possible reasons. In case the woman’s fallopian tubes are blocked or if the man has no sperm, it goes without saying that these are obviously major blocks to getting pregnant. However, these tests can’t identify certain subtle infertility factors like fertilization failure or poor egg quality.

Cost-Effective Treatment

In patients who have unexplained infertility, we are very well aware that despite all the standard  diagnostic testing their chances of achieving pregnancy  in any given month they try (without any infertility treatment), is only about 5%, which is way below the normal 20%  chance that young, fertile couples have.

In many ways, this is also why most couples eventually opt for IVF to help them attain their goal of having a baby. As a matter of fact, if any of our patients are unsuccessful in getting pregnant post 3-cycles of Clomid (the medication which is used to stimulate ovulation) and IUI (intrauterine insemination); I recommend that they should move onto the IVF option without delay. They will have a much better chance of getting pregnant faster and will also end up spending far less money on their infertility treatment.
It’s distressing to see the number of patients who come to us after trying various treatments at different clinics. Some even try alternative treatments like herbal and ayurvedic medicines, all of which have zero impact on their fertility. They end up losing a lot of time and money, and are obviously frustrated and at the end of their patience.

How IVF is Diagnostic in Nature

In some instances, we are able to analyse subtle infertility factors during IVF; and this is why the treatment can also be diagnostic in nature:

• Many women who have excellent ovarian reserve may actually have poor quality eggs; our embryologist is able to study the eggs under his microscope, after the egg retrieval process
• Couples who have mature eggs &  very normal semen parameters may face the issue of  total fertilization failure after doing IVF. This means they have sperm dysfunction, even though their sperm report is normal.
• Some patients will have slow growing embryos, or embryos which arrest in vitro, which again suggests their egg quality is poor.

All these are diagnostic benefits of In vitro fertilization; and there is no other way to detect them. Once these have been identified, there are a number of options to treat and overcome these particular infertility factors using IVF treatment.

Definite Plusses

Of course, though IVF isn’t a wonder fix for all infertility factors, it’s undoubtedly the most successful and proven treatment option for most couples. There was a time when IVF was associated with multiple births, but at our clinic we control that by transferring only 1 or 2 blastocysts to the patient’s uterus.

This cuts the risk of multiple births, increases the pregnancy rate, and lowers the miscarriage rate. It’s also possible to preserve her fertility by creating surplus embryos that can be cryopreserved (embryo freezing) and used at a later stage when she wants to add another baby to her family.

Need more information? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you!