Unexplained Infertility: How Common, Tests, Treatment
This article is sponsored by ReceptivaDx.
What You Need to Know About Unexplained Infertility
Ask an Expert addresses reader questions. Today we share part one of our expert series with Dr. Bruce Lessey of Wake Forest, who will answer some questions related to unexplained infertility. Dr. Lessey is an internationally recognized leader in uterine receptivity research and the identification of markers associated with unexplained infertility.
How common is unexplained infertility?
It’s estimated that “unexplained” infertility accounts for 40% to 50% of all cases of infertility. This includes bogus explanations that people put credence in for unexplained infertility that probably don’t count such as immune causes. Unless there is good data supporting it, it’s difficult to support the hypothesis. Most reproductive endocrinologist categorize a patient as unexplained infertility after checking for normal sperm count and motility, the patient tubes, and her consistency in ovulation. There are other tests that are also run but at that point, if a woman is not successful getting pregnant, we start wondering what’s going on. That’s where the test for BCL6 can help us identify women who have yet to be diagnosed with endometriosis or other causes of inflammation.
How many people with unexplained infertility actually have no underlying cause for their infertility?
I have a saying in my clinic that there is no such thing as unexplained infertility. I have seen only one patient in 2019 who had no identifiable reason for not being able to get pregnant. And that’s out of hundreds of patients that I see each year. So, it’s a very rare event. I think with the help of tests like ReceptivaDx we should be able to narrow that number down to one hand.
What tests do you recommend for someone with unexplained infertility?
The standard tests for the infertility work up includes a sperm count, and a hysterosalpingogram. We often do a sonohysterogram to evaluate the endometrial cavity and then check for other problems including hyperprolactinemia, hyperthyroidism and ovarian reserve. But once those tests all come back normal and the patient is ovulatory with normal tubes then I think the ReceptivaDx testing is an essential component to address the 40-50% of patients that may otherwise fall through the cracks.
Should someone with unexplained infertility jump to IVF, or are there other treatments more suitable?
Patients in our own clinic who have good insurance coverage who want to do IVF are encouraged to do IVF. We have very good success rate near 80%. On the other hand, there are many options that don’t include IVF including those who have to pay out of pocket or don’t want to do it for ethical reasons. I think getting a work-up to understand if there are underlying causes that can be addressed including suspected endometriosis is a cost-effective approach before turning to IVF. For instance, if a patient is found to have endometriosis and is treated surgically (laparoscopy) or through hormone suppression, and then resumes trying naturally, that is a very cost-effective option.
ReceptivaDxTM is a first of its kind test for the detection of inflammation of the uterine lining most commonly associated with endometriosis, a leading cause of infertility and implantation failure. Women testing positive for ReceptivaDx are 5 times less likely to succeed in IVF than women testing negative. ReceptivaDxTM (BCL6 Test) Predicts Chances for a Successful Transfer and Successful Pregnancy. 75% of women with unexplained infertility will test positive for BCL6. Learn more here!
Dr. Bruce Lessey of Wake Forest University. Dr. Lessey is an internationally recognized leader in uterine receptivity research and the identification of markers associated with unexplained infertility. He is the founder of the research on BCL6, the test you can order as ReceptivaDx through our website. He has served on multiple editorial boards for major journals and published over 150 peer reviewed articles, with a focus on infertility, endometriosis and the role of the endometrium in embryo implantation. Just as important, Dr. Lessey still sees patients regularly at his Wake Forest location. He has more than 30 years' experience in IVF.
Medical Disclaimer:
The information provided in this blog is intended for general informational purposes only and should not be considered as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your healthcare provider or qualified medical professional with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this blog.
