Unexplained infertility

Q. I My husband and I have “unexplained infertility”. Besides being very frustrated with the lack of understanding why we can get pregnant, we don’t know what to do next. Can you help explain the possible causes for someone like us?

A. Unexplained infertility is frustrating for both the couple and the physician. It is estimated that up to 10% of couples with infertility will have no explanation. Our group at Fertility Centers of the Carolinas has a special interest in this type of couple and has ongoing research that suggests implantation failure may be part of this scenario. When the male has normal sperm and the female has open tubes, ovulatory cycles, and normal hormone profile, we have to look beyond the usual causes. The good new for these couples, is often this represents a form of inflammation that can be diagnosed and treated effectively. We usually recommend that women with unexplained infertility have a careful evaluation for endometriosis. In an ongoing study of couples with unexplained infertility, we find that the vast majority have stage I or II (minimal or mild) stages of the disease. Once diagnosed, most of these couples conceive on their own without further treatment. Unfortunately, many couples do not get early diagnosis and therefore may have problems even during in-vitro fertilization (IVF). Our philosophy is to diagnose our patients first and then start treatment. We believe this has made big difference in our high success rates in couples with unexplained infertility.