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]
- 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.