There is no any detectable problem about their fertility in 15-20 percent of infertile couples which we called this condition as unexplained infertility.
There is no any detectable problem about their fertility in 15-20 percent of infertile couples which we called this condition as unexplained infertility.
The most common mistake in the management of these couples is the saying of ‘your values are normal, you can have pregnancy, therefore no need for treatment’. Years are passed with these wrong advices.
Whereas treatment is necessary in couples those are not have a pregnancy within one year despite the examination and tests are normal.
The choice of treatment in unexplained infertile couples are dependent to 2 factors; 1- Women age, 2- Duration of infertility.
If the age of women is over 35, or duration of infertility is more than 5 years (independent of women age) we offer IVF treatment since the advanced women age means the decreased oocye number and quality which is the most important parameter affected fertilization and implantation success. In addition, time is working against these couples. One year later, today’s ovarian reserve may not be left. Therefore, if the mother’s age is over 35, direct in vitro fertilization is the most suitable option.
If the expectant mother is younger than 35 and the infertility period is less than 5 years, timed sexual intercourse with ovulation induction or intrauterine insemination treatments can be tried instead of in vitro fertilization.
In the treatment of timed sexual intercourse, we stimulate the mother’s ovaries with pills or injections, induce the ovulation when the follicles are ready, and then offer sexual intercourse at certain times.
In intrauterine insemination treatment, after egg development and ovulation, we wash the sperm of the man and give the most motile sperm directly to the uterus. Thus, the distance the sperm have to travel to reach the egg is shortened.
We continue these treatments for a maximum of 6 months. If pregnancy is still not achieved at the end of this period, these couples should receive IVF treatment.
Even if they are young, the success of repeated insemination treatments after several failure, is low. In these cases, in vitro fertilization is the most suitable solution.
I wish you healthy days.
Prof. Dr. Yavuz Şimşek