Unexplained infertility is the medical diagnosis your doctor will give if there is no identifiable cause to explain why you are unable to conceive despite a thorough fertility investigation done on both you and your partner. A possible explanation could be due to multiple factors or subtle abnormalities in the egg, sperm and lining of the uterus’s function which is not detected by conventional fertility assessment. Approximately 10% of couples with infertility will have unexplained infertility.
What are the options of treatment and the success rate for unexplained infertility?
Treatment options for couples in unexplained infertility must take into consideration the efficacy, cost, safety of the fertility treatment. Do not despair, there are still several options for you if you have unexplained infertility:
The couple is advised to have a healthy lifestyle e.g achieving the optimal body weight, avoidance of alcohol, caffeine and cigarette smoking, good diet and regular exercise. There is no active medical treatment given. Approximately,1-3 % of couples with unexplained infertility will conceive on their own with this approach.1 However, this management would be suitable only if the female partner is less than 32 years old.
- Ovulation induction with Clomiphene
The role of clomiphene only for unexplained infertility treatment is less clear.
IUI using clomid or gonadotrophin injection increases the chances of pregnancy. Up to 3 to 4 cycles of IUI could be performed.
IVF is the intervention that results in the highest pregnancy rate in the shortest time interval. However, it is expensive and there is an increased risk of multiple pregnancy.2
Treatment with bromocriptine or danazol for unexplained infertility is not effective.3,4
RECOMMENDED BOOKS:
REFERENCES:
1. Evers, JL Female subfertility. Lancet 2002; 360:151
2. Kansal-Kalra, S, Milad, MP, et al. In vitro fertilization (IVF) versus gonadotrophins followed by IVF as treatment for primary infertility: a cost-based decision analysis. Fertil Steril 2005; 84:600.
3. Hughes, E, Collins, K et al. Bromocriptine for unexplained subfertility in women. Cochrane Database Syst Rev 2000; CD000044.
4. Hughes, E, Tiffin, G et al. Danazol for unexplained infertility. Cochrane Database Syst Rev 2000; cd000069
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