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Unexplained Infertility
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 Frequently Asked Questions

Q: I am married and we have been trying to conceive for the past 4 years. I have no health problems and my husband's semen count is also normal (i.e. 85 millions sperms). I have undergone a tubal x-ray, PC test, thyroid, GTT, DNC everything is normal. I have also taken 12 Gonodotrophone injections. Why am I infertile?

Madhulika (Igatpuri, India)

A: Have you had a laparoscopy done? If the laparoscopy result is also normal, your working diagnosis is 'unexplained' infertility - which essentially means that we cannot find a reason for it, because of the limitations of our technology.

Dr. Malpani

Q: I have been married for five years, and it has been 18 months since we stopped using birth control. However, I have been unable to conceive. We have undergone semen analysis, antigen-antibody test, nuclear condensation test, hormonal tests, endometrial biopsy all the results were normal. D&C was carried out as per doctor's advice - normal. Postcoital test showed non-motile sperms. Infection is ruled out. Recently HSG was also done, which showed the tubal patency as normal too. What could be the reason for non-conception?

Khushi (Igatpuri, India)

A: I would suggest you do a laparoscopy to complete your workup (to confirm your do not have endomteriosis or peritubal adhesions). If this is normal as well, then your problem is 'unexplained infertility'. In this case, superovulation with IUI (intrauterine insemination) would be your next treatment option.

Dr. Malpani

Q: I had laparoscopy done last year. A few small cysts were found, nothing detrimental. I had a vaginal ultrasound done nine months later and it clearly showed enlarging egg prior to ovulation, afterwards the corpus luteum was left on ovaries, proving that I ovulated that cycle.

Shalini (Vancouver, Canada)

A: I think your diagnosis is most probably unexplained infertility, and your blood test results are probably incorrect. You may want to visit another Fertility Specialist and perhaps get your results re-examined.

Dr. Malpani

Q: I have unexplained infertility for 6 years. Some black hair started popping up last year. The doctor thought I might have PCOS. (Ran blood test on Testosterone, LH, FSH & Prolactin Testost was 45, LH <0.7, FSH 0.7, Prol. 15.8.) I have always had a 28-30 cycle. How can this test be correct on the LH & FSH levels? I kept basal charts for 5 years and except for once, I had a definite LH surge. I have had laproscopy, hysteroscopy and dye test done. Only small cysts on the ovaries were found, which were drained.

Jasmine (Vancouver, U.K)

A: Your increased hair growth is called hirsutism and PCOS is a common reason for this problem. I find it difficult to believe your lab reports. Such low levels mean you have hypogonadotropic hypogonadism, and if this were true, you would have no periods at all! Often, these tests are done at unreliable laboratories. I think you need to repeat them again from a reliable lab. What does your ultrasound scan show? Did it confirm that your ovaries are polycystic? In any case, you may want to consider treatment like super-ovulation with IUI (intrauterine insemination). 6 years is a long time.

Dr. Malpani

Q: I have recently had a Laproscopy and Hystoscopy. Everything is normal. What is the cause of my infertility? I have been trying Planned Relations for a year. Nothing seems to be working out. Help!

Malini (Vancouver, Dubai)

A: You have what we call 'unexplained' infertility. What this means is that we do not have the technology to pinpoint the exact problem. For example, even though your husband's sperm count may be normal, this does not mean that his sperm are capable of fertilizing your eggs. If super ovulation with IUI does not result in a pregnancy in 4 cycles, you should consider IVF as your next treatment option.

Dr. Malpani

Q: I have done HSG which shows tubal patency. I have consulted an infertility specialist. IU Insemination was carried out, but it didn't work out. Now we have decided to undergo a Laproscopy and if it is normal, then we will go in for an IUI again. What is the success rate of ISI?

Sheetal (Vancouver, India)

A: This is appropriate treatment. Chances of a pregnancy are 10% per cycle. If you don't get pregnant in 4 cycles of IUI, you need to go on to the next step of therapy - HMG for super ovulation, plus IUI.

Dr. Malpani

Q: I have been on Clomid for 4 cycles, but didn't get pregnant. My doctor says that we have unexplained infertility. I do not have any problem ovulating. When I was on Clomid, my periods were very light and brownish. Is this normal?

Menka (Atlanta, U.S.A.)

A: Have you complete your workup (laparoscopy, hormonal blood tests)? If it is unexplained infertility, then the next step is IUI (intrauterine insemination).

Dr. Malpani

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