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Did you know that 30% of infertile couples (failing to conceive naturally after at least 12 months of regular, unprotected sex) experience infertility of unknown cause?
Dr. Lucia Luchian, obstetrics-gynecology primary doctor with superspecialization in in vitro fertilization (IVF), explains: “Infertility of unknown cause is actually a diagnosis of exclusion. We come to this conclusion only after the couple goes through a complete set of analyzes and all values are within normal limits.”
What should investigations include?
It should be noted that medical investigations must be carried out by both partners.
Dr. Lucia Luchian states that female investigations must include:
- Investigations to highlight normal ovarian function and ovulation (hormonal analyses, transvaginal ultrasound).
- Uterus of normal appearance, homogeneous myometrium, normal uterine cavity conformed in 3D transvaginal ultrasound (to exclude uterine malformations as a risk factor).
- Fallopian tubes in either HyCoSy (hysterosonography) or HSG (hysterosalpingography) testing and negative testing for Chlamydia trachomatis infections (col cultures and blood antibodies).
Male investigations consist of performing a spermogram (which must have normal values according to international criteria).
Dr. Lucia Luchian, obstetrics-gynecology primary doctor with superspecialization in in vitro fertilization (IVF): “Attention, the spermogram is recommended to be performed in an assisted human reproduction center. Semen antisperm antibody testing and sperm DNA fragmentation testing are not mandatory tests for diagnosis. Also, hormonal analyzes are not recommended if the spermogram values are within normal limits according to the criteria.”
Depending on the case, further investigations are recommended, including hysteroscopy, laparoscopy and thyroid tests. Dr. LuChIAnA point out: “Testing for thrombophilia is not recommended because it is not considered to be a cause of unknown infertility. If pelvic endometriosis, mild or moderate form, is diagnosed during laparoscopy, the diagnosis is no longer infertility of unknown cause.”
The role of lifestyle changes and psychological counseling
Lifestyle changes (weight loss, Mediterranean diet, quitting smoking and alcohol, introducing sports activities), stress reduction, vitamin and antioxidant therapies (for both women and men), psychological counseling may also be indicated. couple.
Dr. Lucia Luchianobstetrics-gynecology primary care doctor with overspecialization in in vitro fertilization (IVF): „If the patient’s age and ovarian reserve allow, another 6-month waiting period can be proposed, involving lifestyle modification, antioxidant therapies, ovulation monitoring and indications of the fertile period in which to have sexual contact. Also, a maximum of 3 insemination cycles can be proposed, with or without ovulation stimulation. Sometimes the in vitro fertilization procedure is recommended directly, because this is the assisted human reproduction procedure with the highest chance of success and because, during the procedure, the causes of the failure to achieve pregnancy naturally can be detected.”
Source: www.doctorulzilei.ro
