Even healthy, young, fertile couples only have a 15% to 25% chance of getting pregnant each month. If you or your partner are older or have health issues, then that number goes down. And if you’re a woman who’s been trying to get pregnant for at least a year, and you’re under 35 — or you’ve been trying for six months and you’re over 35 — then it’s time to consult a fertility specialist.
So, you do that. You and your partner undergo a battery of tests to find out why you haven’t yet conceived. Then, the results come back as “normal,” and your doctor says you have “unexplained infertility.” What’s going on?
At Advanced Women’s Healthcare in Bloomington, Illinois, Dele Ogunleye, MD, FACOG, Lisa Emm, MD, FACOG, and the rest of our knowledgeable team understand how frustrating and unsatisfying a diagnosis of unexplained infertility can be. Up to 30% of couples who consult fertility specialists don’t find a cause for their infertility. Many times, test results are borderline or inconclusive, which is why our doctors encourage you to get a second opinion and to explore some of the less common reasons for infertility. Below, we explore some of these reasons.
Were you not tested thoroughly enough?
When you consult with us about unexplained infertility, we first ask to see your prior tests and results. Sometimes, however, you or your partner may not have been given all the tests that we deem essential. If you’re having trouble conceiving, you should be tested to determine that:
- Luteinizing hormone increases before ovulation
- Progesterone levels increase regularly to indicate ovulation
- Thyroid hormone levels are healthy
- Levels of prolactin aren’t too high
- Fallopian tubes are open (hysterosalpingogram)
- There are no abnormal growths on or inside the uterus or other organs (ultrasound)
In addition, your partner’s sperm should be tested for quantity and quality. You should also both undergo a thorough physical examination with urine and blood tests to determine if you have underlying medical conditions that impair fertility.
If the results of prior tests were inconclusive, or if these tests weren’t performed at all, we first make sure that you get the answers you need by ordering missing tests or re-testing in areas where required.
Do you have endometriosis?
Endometriosis is a condition in which your uterine lining (endometrium) grows outside your uterus. The endometrium may cover your fallopian tubes, ovaries, outside of your uterus, and even your bowels.
We check for endometriosis through hysteroscopy, which is a minimally invasive in-office procedure. If you have endometriosis, we may recommend medications or minimally invasive endometrial resection with da Vinci® robotic surgery system.
In some cases of mild endometriosis, the endometrial lesions are microscopic. If our OB/GYNs find that you’re suffering from mild endometriosis, they may recommend short-term hormonal therapy before you attempt to get pregnant again.
Is your cervical mucus too acidic?
Sperm use the egg-white-like mucus that covers your cervix when you’re fertile to propel themselves from the vagina into your uterus, where they can fertilize an egg. However, if your cervical mucus is acidic, it kills the sperm before they can reach the egg.
Non-medical treatments for acidic cervical mucus include using a sperm-friendly lubricant. We may also recommend antibiotics or short-term estrogen.
Are you or your partner sensitive to gluten?
Celiac disease — which is a sensitivity to the gluten protein in wheat and other grains — impairs fertility. Even if neither you nor your partner has celiac disease, you may have an undiagnosed sensitivity to gluten that’s causing inflammation in your body. We may recommend that you both eliminate gluten from your diet while trying to get pregnant.
Are your eggs healthy?
Even if you still ovulate regularly, your egg quality might be poor. Normally, a woman’s egg quality deteriorates with age. The only way to test for egg quality is by retrieving the eggs themselves, as is done for in vitro fertilization (IVF).
Do you just need more time?
It’s almost a stereotype, but sometimes the less you “try” to get pregnant, the more likely you are to be successful. Even without intervention, you may conceive on your own over the next two years. However, getting treatments and exploring options such as donor eggs and surrogacy can help you create your family now while also alleviating some of the stress of unexplained infertility.
To learn more about why you haven’t been able to get pregnant and discuss ways to increase your fertility or resolve your infertility, call our office today.