After a thorough infertility work-up, approximately
10% of couples will be diagnosed with unexplained infertility.
This is perhaps the most frustrating "diagnosis"
of all because it takes away a sense of control that
the couple seeking to have a baby so desperately wants.
There are some things that you can do to reduce those
feelings such as being informed, talking with others
who have this same diagnosis, and seeking out another
opinion, making sure that you have exhausted all tests
available to you.
If you have been given a diagnosis of unexplained
infertility, the following data might be useful to
you.
 When
seeking any serious medical treatment always get a
second opinion. Take your records, notes, lab data,
and x-ray films with you or request that they be sent
to the second doctor's office. Also take a complete
list of questions you have for the doctor.
Ovulation
cycles should normally be 28 days in duration. If
your cycles or longer or shorter or irregular, this
should be brought to the attention of your doctor.
Is
the luteal phase of your cycle normal and if not,
has this been treated and then reassessed with an
endometrial biopsy and/or progesterone blood serum
levels?
Blood
should be drawn on cycle day 3 to test your FSH level.
You should discuss your test results with your doctor.
If your FSH level is elevated, ask whether it should
be checked again in a future cycle.
Even
if your ovulation pattern is regular, discuss the
possibility of intrauterine insemination (IUI) with
washed sperm combined with gonadotropin therapy to
optimize your cycles.
Repeat
the semen analysis. A complete semen analysis and
a properly-timed post coital (PK) test should be repeated,
since many factors can influence this test and the
results might change over time.
Sperm
antibody screening should be done on the woman and
the man if the post coital test is abnormal.
You
should have a series of vaginal ultrasounds to document
that the follicle does rupture and release.
Discuss
the possibility that you may be having very early
miscarriages before you get your period with your
doctor. There are some blood tests available that
evaluate certain immune factors that may contribute
to this phenomena in a small number of women.
Your
progesterone should be checked each cycle.
A
hysterosalpingogram should be done to be sure that
your tubes are open, i.e., that the dye flows freely
and no kinks or evidence of a rough lining are present.
Tubes may sometimes look normal on laparoscopy, but
due to problems within the tube, the fertilized egg
may get stuck and not move normally to the uterine
cavity.
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