Even as WHO categorises infertility as a disease, the inability of a sexually active and non-contraceptive couple to achieve pregnancy in one year is fairly common. While treatments ranging from daily injections at home or heavy hormonal therapies and even surgeries are available to help couples achieve a healthy pregnancy within a few months, the reason of infertility in some cases is not known which tampers the treatment process.

This does not mean that the problem has to be neglected or has no solution. In an interview with Hindustan Times, Dr.Shweta Goswami, Associate Director- Fertility, Cloudnine Group of Hospitals, Noida shared her insight on the causes and cure of unexplained fertility.

According to Goswami, unexplained infertility is majorly a result of any of the following:

1. Poor egg quality or lower ovarian reserve – This can be determined by performing AMH or anti-mullerian hormone test. AMH hormone is a hormone produced by the ovarian follicles and acts as a marker of the egg quantity. It is possible for a woman to be completely healthy, yet have a weaker result in AMH test. Even if the result is normal, the women may have alleviated egg quality. It is quite difficult to determine the same as there are only limited basic tests available.

2. Dysfunctional fallopian tubes – Although tests like sonosalpingography (SSG) and hysterosalpingography (HSG) help to detect any sort of blockage in the fallopian tubes, there is, by far, no such test that can help to determine whether the fallopian tubes are carrying their function normally. It is possible to have functional abnormalities despite having normal HSG and SSG reports. In this case, we do not know if the egg is able to enter the tube or not. This is something that an ultrasound or any other imaging modality might not be able to access.

3. Sperm defects – Though other sperm parameters like sperm quality, quantity and motility may be normal, the sperm may not be able to fertilize the egg well or there may be sperm DNA damage which is preventing normal fertilization. Here, we are not looking at poor sperm quality but rather poor fertilization.

Talking about the treatment behind unexplained infertility, Goswami said, “Since the exact cause is unknown, it can be a little difficult to deal with unexplained infertility. A series of tests and screenings may be recommended to evaluate and assess all the known factors and rule out the possibility of the same. Medications and therapies will be started to see if there are any improvements.”

She added with a note of hope, “However, if these fail to give any significant results, ART or assisted reproductive techniques like in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) and intrauterine insemination (IUI) are always there to help you initiate your journey towards parenthood.”

While 1 in 10 cases of infertility is that of unexplained infertility, , the problem resolves on its own within a year of the diagnosis in around 50 per cent of the cases and the couple is able to conceive naturally. Since the problem might even aggravate in some cases, it is important to seek immediate medical intervention and go for proper screening.

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