Infertility, or sterility, refers to the inability to conceive despite regular unprotected sexual intercourse for one year in women under the age of 35 and for six months in women over the age of 35. At the end of this period, when all medical tests and evaluations show no medical reason preventing pregnancy, it is called unexplained infertility.
This situation can lead to significant disappointment for couples and can be psychologically challenging. The inability to identify any issues through medical tests can make it difficult for couples to understand why they cannot conceive.
Factors contributing to unexplained infertility include negative lifestyle factors and genetic factors. Risk of infertility can increase due to negative lifestyle factors such as smoking, excessive alcohol consumption, and obesity. Additionally, it is believed that underlying endometriosis in women can lead to abdominal adhesions, disrupting the function of the fallopian tubes and thus causing unexplained infertility. In some cases, anatomical issues contributing to unexplained infertility may require surgical intervention. When these issues are corrected, the chance of pregnancy may increase.
There are differences in international reproductive medicine guidelines for the treatment of unexplained infertility. While some country guidelines recommend direct IVF after a two-year waiting period, others initially apply insemination treatment before moving on to IVF. What do we do in our country? We apply individualized treatment considering the duration of the couple’s marriage, the duration of infertility, and the woman’s age.
Negative Lifestyle Factors
Smoking, excessive alcohol consumption, obesity, and negative lifestyle factors can increase the risk of infertility.
Smoking is a habit with many harmful effects. Smoking can negatively affect reproductive health in both men and women and can lead to infertility. Cigarette smoke can reduce sperm motility and sperm count in men. Women who smoke may have fewer healthy eggs in their ovaries, reducing the chance of pregnancy and increasing the risk of infertility.
Smoking causes DNA damage in sperm and eggs in both men and women, affecting the quality of sperm and eggs. This affects the sperm’s ability to fertilize the egg, the number of eggs obtained in IVF treatments, the number of mature eggs, and fertilization. After fertilization, embryo development may also be negatively affected. In summary, smoking can reduce the response rate to treatment and decrease the chance of pregnancy in smoking couples. Therefore, smoking is a significant obstacle for couples with infertility issues, and quitting smoking is important to contribute to treatment.
Excessive alcohol consumption can adversely affect sperm count, motility, and morphology (shape abnormalities) in men, which can reduce the chance of pregnancy. Excessive alcohol consumption can affect hormone levels in women, such as estrogen and progesterone. Imbalances in these hormones can negatively affect regular ovulation and, consequently, pregnancy. In summary, excessive alcohol consumption is a factor with negative effects on reproductive health in both men and women. Therefore, it is recommended that couples planning pregnancy limit alcohol consumption or ideally quit altogether. Along with factors such as a healthy lifestyle, regular exercise, and balanced nutrition, reducing alcohol consumption is important to preserve reproductive health and reduce the risk of infertility.
Obesity is another negative lifestyle factor that increases the risk of infertility. Obesity disrupts hormone balance and can affect regular ovulation. Additionally, obesity can negatively affect sperm quality. Excess fat tissue in the body can affect hormone production and impair sperm production.
Genetic Factors
In cases of unexplained infertility, genetic factors are known to play a role. Some couples may have genetic abnormalities that can have adverse effects on the reproductive system. These abnormalities can affect the quality of sperm or eggs and cause problems during fertilization or embryo development.
Some examples of genetic factors that may contribute to infertility include:
In cases where genetic factors may contribute to unexplained infertility, medical tests and genetic counseling may be recommended. This way, the genetic status of couples can be evaluated, and appropriate treatment options can be determined.
Treatment Options
There are various options for treating unexplained infertility. These options include assisted reproductive techniques such as insemination and IVF, as well as surgical options for anatomical problems.
Insemination
Insemination involves the direct delivery of low-volume concentrated sperm into the uterus during ovulation. With insemination, the access of more motile sperm to the egg is facilitated by bypassing the uterine canal. It can be applied with the recommendation of a physician to selected patient groups due to being less invasive and having a lower cost compared to the IVF method. The success of insemination depends on factors such as selecting the correct patient group, young female age, infertility duration of less than two years, normal sperm analysis, and sperm morphology.
In Vitro Fertilization (IVF)
IVF is a commonly preferred method in the treatment of unexplained infertility. In this method, eggs taken from the ovaries of couples are fertilized with the partner’s sperm in a laboratory setting, and embryos are formed. Later, the embryos are transferred to the uterus at a planned time to increase the chance of pregnancy. While IVF treatment offers the chance of pregnancy to couples, success rates may vary. Since every couple’s situation is different, the treatment process and outcomes are individualized. This treatment option can be a ray of hope for couples with unexplained infertility as it has a higher success rate compared to insemination.
Surgical Options
In some cases, anatomical problems causing unexplained infertility may require surgical intervention. When these problems are corrected, the chance of pregnancy may increase.
Anatomical problems can be factors causing couples to be unable to conceive. These problems are usually due to structural abnormalities in the reproductive organs. For example, problems such as abnormal uterine structure or hydrosalpinx (fluid-filled swollen and blocked tubes) in women can lead to infertility. Surgical options can be used to correct these anatomical problems. Such surgical interventions will increase the chances of pregnancy for couples. For example, in a woman with hydrosalpinx, the chance of pregnancy increases with surgical intervention, and the risk of miscarriage decreases. In women with hydrosalpinx, the toxic fluid in the tubes flows backward, preventing the embryo from implanting in the uterus. If implantation does occur, it can lead to the mechanical expulsion of the embryo, resulting in a miscarriage.
Surgical interventions are performed by a gynecologist who is also a fertility specialist. Minimal invasive techniques such as laparoscopy can be used for these procedures. This can speed up the recovery process and reduce the risk of complications due to being a less invasive approach. If the diseased tube is removed laparoscopically (salpingectomy) or if the tube cannot be removed outside due to adhesions, the connection between the tube and the uterus is cut, i.e., the tube is ligated (proximal tubal occlusion) surgery is performed. Thus, the hydrosalpinx fluid cannot flow backward into the uterus, and the microenvironment of the uterus is not disrupted. This will increase the chances of couples getting pregnant.
Unexplained infertility refers to the situation where couples are unable to conceive despite the absence of any medical reproductive problems.
Infertility is the inability to conceive despite regular unprotected sexual intercourse for one year in women under the age of 35 and for six months in women over the age of 35.
Negative lifestyle factors include smoking, excessive alcohol consumption, obesity, and other factors.
Yes, smoking can cause infertility by damaging reproductive cells in both men and women through DNA damage, leading to infertility.
Yes, excessive alcohol consumption can increase the risk of infertility by reducing sperm quality in men and causing hormonal imbalances in women.
By filling out the form, you can make an appointment with Gynecology and Obstetrics Specialist Prof. Dr. Ebru Çöğendez.
IVF treatment prices usually include factors such as tests, medications, laboratory procedures, doctor examinations, etc. during the treatment process.
IVF treatment is applied to couples who are determined by taking certain factors into consideration.
Factors such as age, health status, choice of treatment center and treatment process can affect success rates.
The stages of IVF treatment usually consist of four main stages. The first stage is the preparation stage.
As with any medical intervention, IVF treatment has potential risks and possible complications.
