Unexplained infertility: A growing concern for couples

Infertility is a complex medical condition affecting couples who struggle to conceive. Statistics indicate that primary infertility rates vary by age, with 7.3-9.1% of women aged 15-34, 25% of women aged 35-39, and 30% of women aged 40-44 experiencing infertility.

In some cases, the cause remains unexplained, affecting approximately 20% of couples facing infertility. Factors such as sperm function issues, immune system problems, uterine abnormalities, and fallopian tube blockages may contribute to this condition.

Sperm function issues, such as problems with motility, morphology, or DNA integrity, can hinder fertilisation. Advanced tests like sperm DNA fragmentation analysis can sometimes reveal these issues. Additionally, the body’s immune response might play a role in preventing conception or implantation, with autoimmune disorders or an overactive immune system creating a non-conducive environment for sperm, eggs, or embryos.

Uterine abnormalities, such as polyps or fibroids, can also impact fertility, while tiny blockages in the fallopian tubes may prevent egg and sperm meeting. These issues might not be detected through routine imaging tests.

Unexplained infertility is not just a medical condition but also a profound emotional journey that requires compassion, understanding, and support. Treatment options include surgery, ovarian stimulation, intrauterine insemination (IUI), and in vitro fertilization (IVF). However, despite these options, many couples struggle to conceive and have a live birth.

Reproductive immunology, a rapidly evolving field of science, offers new insights into the treatment of reproductive failures such as unexplained infertility and multiple IVF failures. Some infertile women have abnormalities in their immune system, leading to ovulation or fertilisation problems, and immune testing can help identify those with an overactive immune system.

Immune therapy, including medications can be tailored to individual patients to modulate their immune system and improve fertility outcomes. By raising awareness about available medical treatments, and lifestyle changes, we can create a more supportive environment for those affected by infertility.

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