Causes of infertility – idiopathic infertility
Statistical data show that as many as 28% of couples who reported at infertility treatment clinics after two years of fruitless efforts to conceive have correct results of all standard fertility tests. The lack of a recognized cause of difficulties in getting pregnant is referred to as idiopathic infertility.
Complete diagnostics in couples with an idiopathic factor shows normal hormonal profile in a woman, regular ovulatory cycle with ovulation, good ovarian reserve, the patency of both fallopian tubes in Sono HSG examination, normal uterine morphology and the endometrium of proper thickness (only good ultrasound, HSC and histopathological examination results) as well as normal cervical mucus assessed during PCT test after the intercourse. The patient has no microbiological, genetic or immunological factors (in the basic scope) and her partner has semen of good quality (confirmed by semen testing and extended HBA, MSOME and SCD tests) with no genetic factors.
How to treat idiopathic infertility?
In this situation, it is recommended that a woman should undergo diagnostic laparoscopy, which in about 10% of patients detects endometriosis in its initial stage or peritubal adhesions (after their removal, about 10% of women become pregnant within the first six months after the procedure).
The treatment of idiopathic infertility depends, among others, on the patient’s age. If a woman is under 34 years of age, physicians often recommend that she should refrain from taking the treatment and continue her efforts to conceive in the natural way - after one year, about 16% of couples get pregnant without medical support.
Then the patients can undergo cycle stimulation (no more than six stimulated cycles) and insemination (maximum four procedures). The cumulative percentage of pregnancies obtained in this way reaches 19-22%. If the treatment has not been successful, the couple may opt for in vitro fertilization using ICSI (injection of a selected sperm cell into an egg cell).
The use of the in vitro procedure results in the detection of abnormalities at the stage of egg cell fertilization or embryo development, resulting from defects of the sperm cell or the egg cell at the level of biophysical or biochemical structure of gametes in about 32% of couples. Due to such abnormalities, the chances of pregnancy in patients in this group range 10-12%. In the remaining couples, the percentage of post-in vitro pregnancies is higher and similar to the average effectiveness of this procedure (at InviMed it is 46%).
Approximately 8% of couples affected by idiopathic infertility, who have had unsuccessful in vitro fertilization attempts, manage to get pregnant naturally within two years after the in vitro procedure. In 3% of them, the conception of a child occurs in the first four ovulation cycles of a woman.