There
are three factors – the male factor (something is wrong
with the male), the female factor (a medical problem
with the female), and unexplained
infertility (where
the exact reason cannot be found). Infertile couples
with no abnormalities as revealed by standard
infertility evaluation in the West pray wholeheartedly
for a child while their Indian counterparts visit
temples seeking divine blessings.
And that is
because, unexplained infertility is still a diagnosis of
exclusion. However, the diagnosis of possible etiologies
of unexplained infertility deserves more sophisticated
approaches while in the absence of a plausible cause,
the therapy, as may be expected, is more or less
empirical in nature. In other words, when the cause
cannot even be diagnosed, how can the treatment be
suggested? However, conventional medications do not try
to find out the real cause behind the problem and
concentrate on assisted reproductive techniques to help
the couple have a baby. Here are some of the approaches
that are followed to solve the problem.
Ø
Intrauterine
Insemination
Ø
Expectant
Management
Ø
Controlled
ovarian hyper-stimulation
Ø
Combined
COH/IUI
Ø
In
vitro fertilization or IVF
Ø
Intra Cytoplasmic sperm injection or
ICSI
Although
the precise etiology of unexplained
infertility is still
unknown to medical science, there are several
probabilities that could be considered. These
include
ü
Minute changes in follicle development
, ovulation as also the
luteal phase.
ü
Male
partner’s semen analysis displaying sperm concentration
and motility at the lower end of the normal
range.
Unexplained
infertility - explained
Most
cases of unexplained
infertility are presumably caused due to the
presence of multiple factors like the female partner
aged 35 or more, the male partner with low normal semen
parameters, un-synchronized intercourse, etc., each of
which on its own may not significantly affect fertility
but can and most probably does reduce the chance of
pregnancy when combined together. When compared with the
tubal factor, it has been observed that couples with
unexplained infertility that are treated with In Vitro
Fertilization, demonstrate reduced oocyte
fertilization and embryo cleavage while those with tubal
factor infertility showed 52% on an average.
Furthermore, couples with unexplained infertility had a
higher rate of total fertilization failure when treated
with IVF than with tubal factor
infertility, suggesting that thy probably had subtle
functional abnormalities in oocyte and/or sperm
function. IVF is the chosen treatment in cases of the
female factor, and ICSI usually is the treatment for the
male factor. But with unexplained infertility, even the
medical team is confused as to what would be the best
approach.
However, there are still a few
suggestions such as (a) Lifestyle changes; (b) Tubal
flushing; (c) Intrauterine Insemination and (d)
Treatment with Gonadotropin injections + IUI or IVF.
So far as lifestyle changes are concerned, cigarette
smoking appears to head the list. Then there is abnormal
body mass index and excessive consumption of alcohol.
Both the partners are advised to reduce their body mass
index (if they are obese), to wear lose clothes, drink
less coffee and to reduce the stress from their lives as
much as possible. The couple is also advised to engage
in sex in particular days of the month when the chance
of fertilization is the highest.
Unexplained
infertility
(though very difficult to be treated with the
conventional approach), can be cured completely with
treatment following the lines of a holistic approach.
This method does not cure the symptoms but goes into the
root of the cause and cures the person both in body and
the soul. The holistic approach analyzes the person from
the inside and tries to find out what the real cause is,
and then it suggests Chinese medications, herbs, diet,
exercise, lifestyle changes and acupuncture to treat the
problem. Because of this, very often, holistic remedies
can cure infertility, even those cases where the cause
has been termed ‘unexplained’ by the conventional
system.
