Today, unexplained infertility affects about 15% of all couples who use reproductive medicine to become parents. The cause of infertility sometimes remains unexplained even after thorough examinations.
Tests to find the causes of infertility
If patients have not managed to become pregnant naturally after one year, the male and female reproductive organs should be examined to find out if there are any problems:
ovulation disorders: If ovulation fails to occur or occurs only rarely or irregularly, it is almost impossible to achieve pregnancy naturally. It is therefore important to check the regularity of ovulation and correct it if necessary. A woman’s cycle is controlled by examinations, with ultrasound and blood tests to determine hormone levels.
Tubal patency: for the sperm to be able to reach the egg directly and fertilise it, the fallopian tubes must be permeable. For this to happen, there must be a free passage for both gametes. The permeability of the fallopian tubes can be examined by means of a hysterosalpingography.
The uterine cavity must be ready to receive the embryo and must not have any obstacles, such as cysts or endometriosis, which could prevent the embryo from implanting and developing properly.
Sperm quality: A spermiogram is essential for a good diagnosis.
Reproductive medicine solutions to fertility problems
However, thanks to advances in reproductive medicine, fertility specialists are increasingly finding answers to the causes of unexplained infertility. Cases of infertility are now better diagnosed, so that patients know exactly what options are available to achieve a healthy pregnancy. New methods of diagnosis allow more factors to be taken into account for a more precise diagnosis.
Genetic causes of infertility
Genetic examinations and tests can be very helpful in determining the causes of implantation errors and miscarriages.
It is therefore important to use karyotype tests to check whether one of the two partners is a carrier of a chromosomal change or whether some of the embryos produced have a malformation that can be examined by pre-implantation diagnostics. This is a very broad topic, which is nowadays better controlled, but it is still not completely exhausted. However, these genetic tests are already decisive for the results of fertility treatment.
Sensitivity of the endometrium: the implantation window
It is often said that for a successful fertility treatment, above all, a beautiful embryo and a beautiful uterine lining is needed. The lining of the uterus is examined using ultrasound, but in some cases further examinations and tests are necessary to check the susceptibility of the lining of the uterus. This includes, for example, a biopsy of the uterus at a certain time to check that all the conditions for implantation of the embryo are met. This test is called Er-Map (test of the susceptibility of the endometrium). A proportion of 28% of women are susceptible at a different time of the cycle than the rest of women. In this way, the Er-Map helps to find out when a woman’s endometrium is most receptive, so that the embryo can be transferred at exactly this moment and the implantation rate can be significantly increased.
Thrombophilia examination: Irrigation of the uterus
This is also known as the “miscarriage protocol“. The thrombophilia examination is normally performed after repeated miscarriages but is also recommended in cases of implantation errors. It determines whether a woman’s uterus is well supplied with blood, which is very important for the implantation of the embryo. Even if a woman has normal values, she may have changes in thrombophilia that are not detectable in a standard analysis.
Psychology: more important than you think
Highly professional care is secretly important for the success of a fertility treatment, because getting pregnant and carrying a child is often not easy. In some cases, a psychological blockage may occur for which there is no physical explanation. A calming and caring environment reduces unpleasant feelings and increases the chances of treatment success.
IVF-Spain specializes in difficult and complicated cases where the reason for infertility is often unclear. Our medical team will be happy to answer all your questions. For this purpose, we offer regular patient meetings where our experts will give you free and individual advice. You can contact us here.