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Unexplained Does Not Mean Untreatable. A Primer for Infertility Patients.

Posted by Corey Whelan on with 2 Comments

by Corey Whelan

Imagine sitting in a doctor’s office and hearing the words, “We can find nothing wrong.” If the doctor was a cardiologist or oncologist you would probably go weak in the knees with giddy relief.  But, if the doctor is a reproductive endocrinologist, and you are seeing him or her because of infertility, these words may bring you anything but relief.  Instead, you are likely to feel confused, angry and frustrated, without a linear path towards your goal of having a healthy baby.  Unfortunately, this scenario plays itself out in around 12% - 25% of all infertility related cases, and is called unexplained, or idiopathic, infertility.    

 When starting infertility treatment, your reproductive endocrinologist will perform a number of tests on both the male and female partners, if you are in a couple.  These tests will include:

  • Blood tests to determine hormone levels
  • Routine screenings of both partners for sexually transmitted infections (STI’s), HIV, and hepatitis
  • Medical histories for both partners will be taken.  Family histories will also be discussed, in order to determine if polycystic ovarian syndrome (PCOS), premature ovarian failure (POF), endometriosis, celiac disease, varicocele, and other disorders are evident in either male or female family members. 
  • Charting of menstrual history
  • Bacterial screening[A1] 
  • Ultrasound
  • Hysterosalpingogram (HSG), which if suspicious, may be followed by a Hysteroscopy and/or Laparoscopy.
  • Semen analysis (even if he’s fathered a child before)

 The challenge is this.  Even with state of the art, current medical advancements, there is still much that is simply unknown about the causes of infertility.  Subtle, biochemical or immune factors that can stop conception cold may not even show up through current testing protocols. In addition, multiple, simultaneous issues may be at play that individually, would not necessarily stop you from conceiving but when coupled together, lessen the chances that pregnancy will occur.  Sometimes, a single, significant obstacle for which there is no accurate testing may be at fault.  Simply put, some possible causes of infertility continue to baffle scientists and doctors alike, and may continue to remain, unexplained.

Want to learn more?  Click here to read The AFA's comprehensive fact sheet on unexplained infertility.

Click here to watch a short video, featuring Jason Griffith, M.D.

Comments

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Laura Barnard Oct 1, 2011 8:52pm

For 18 months, after scores of blood tests of both me and my husband, we kept hearing, "You're completely normal. There is nothing wrong with you." However, after visiting an endocrinologist, he performed a test that showed my eggs were "fair" and not "good," but still manageable. While this diagnosis did provide a level of relief, nearly one year ago, we're still trying to overcome our problems, and now my anxiety has moved from, "What's wrong with me?" to "Will this (treatment) really work?".

Everyone deals with this news differently, but I think it is important for the healthcare professionals to remember to thoroughly explain the pros and cons of each treatment option and test, and why they may or may not work or find a problem/solution. Patients need to come in with questions about their condition and not be afraid to ask if more tests or treatment options are available.

My hope is we'll eventually get lucky, but I wish there was some way my journey could help further the understanding of infertility and help make it less taboo in some communities. Great post.

Corey Whelan Oct 3, 2011 8:41am

It is a pet peeve of mine that doctors, particularly low tech gynecologists, hold onto their patients for far too long before pushing them to see an infertility specialist, such as a reproductive endocrinologist. Laura, I hope things work out for you. If there is any information that The AFA can provide, please write back and let me know.

Corey