(Fort Worth Fertility)

(Fertility)

(Fort Worth)

(817-348-8145)

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Unexplained Infertility

Often times after a thorough evaluation and treatment, we are unable to diagnose the exact reason for infertility. This may be frustrating for couples who have completed an infertility evaluation.

About 85% of patients will have at least one reason for their inability to conceive. For the remaining 15%, there may not be a clear answer. This is because we do not have an understanding of all reasons for infertility and do not have testing procedures appropriate for these potential reasons.

Unexplained infertility means that all other diagnoses have been eliminated. When an individual is diagnosed with unexplained infertility, a careful review is conducted of the entire infertility evaluation.

Empiric treatment is treatment based on observation and experience with other infertile couples rather than conclusive evidence of what is wrong. The justification for empiric treatment is that it frequently works. Through the use of assisted reproductive technologies, we combine hormonal therapy with artificial insemination or in vitro fertilization.

The two potential options of empiric treatment for unexplained infertility consist of:

  1. Two to three cycles of clomiphene citrate with or without inectable medications called gonadotropins (Gonal F, Follistim, Repronex, Menopur) or only gonadotropins combined with intrauterine insemination. starting on either day 3, 4, or 5. Transvaginal ultrasound is then performed. Generally, two or three mature follicles may be observed. When the largest follicle is between 18-20 mm in diameter, hCG is given as a single injection and intrauterine insemination with washed sperm is performed approximately 24-36 hours later. Using this method, ovulation and male factor are being enhanced and cervical factor is bypassed.
  2. Up to three cycles of in vitro fertilization. Gonadotropins are administered along with Lupron. Transvaginal ultrasound and estradiol measurements are done routinely with hCG being administered when a few follicles are mature. Transvaginal follicular aspiration is performed 36 hours later. Embryos are transferred to the uterus three to five days later. With IVF, further diagnostic information will be obtained and we would be able to observe fertilization efficiency of the sperm.