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Causes of Unexplained Infertility

Causes of Unexplained Infertility

Causes of unexplained infertility

  1. Anatomical abnormalities :- It used to be thought that a retroverted uterus was a cause of infertility, but this is no longer taken to be the case. The sperm cannot reach to the cervix due to the position of cervix is abnormal. It is also possible that there may be failures in the mechanism in the mouth of the fallopian tubes which allows them to pick up the egg. Abnormal levels of hormones called prostaglandins, which are responsible for making the muscles contract, may interfere with the passage of the egg in the tube. High prostaglandin levels are usually associated with endometriosis, and this condition is likely to be detected. Large multiple fibroids can interfere with the process of reproduction by making the womb unreceptive to a fertilized egg. Scar tissue can also result in damage to the fallopian tubes.

Diagnosis of the cause of infertility, investigations should include vaginal ultrasound scans and also hysteroscopy.  Vaginal ultrasound will pick up abnormalities within the womb and abnormalities with the ovaries, which would otherwise be missed by a laparoscopy. Hysteroscopy should be performed at the same time as a laparoscopy so that any problems within the womb, which could cause infertility, may be detected.

1.Abnormal development of the follicle and of ovulation

In few women the egg may be released from the follicle in which it develops before it is properly mature or it may not be released at all formed to cyst.

2.Abnormal eggs

It would appear that a very small number of cases of unexplained infertility are due to the persistent production of abnormal eggs. These may have a deformed structure or chromosomal abnormalities.

  1. Trapped eggs :- In some cases it would appear that eggs are produced, and mature correctly within the follicle. This goes on to become a “corpus luteum” but without first bursting to releasing the egg. The egg is therefore effectively “trapped” inside the unbroken “corpus luteum”.

 Luteal phase abnormalities - The most important of all causes of “unexplained” infertility. This is where the part of the cycle that follows after the egg has been released from the ovary, is abnormal in some way.

After releasing the egg, the follicle which contained it in the ovary goes on to become the “corpus luteum”. The corpus luteum produces the hormone called progesterone. Progesterone is essential for preparing the lining of the womb to implant the fertilized egg in uterus, and for continue the pregnancy for several weeks.

Several things can go wrong with progesterone production. The rise in output can be too slow, the level can be too low, or the length of time over which it is produced can be too short. Problems during this phase of the cycle are known as “Luteal phase defects”, and can be investigated either by carefully examining samples from the lining of the womb which is called endometrial biopsy or by monitoring the progesterone output by taking a number of blood samples on different days after ovulation so that the progesterone level in them can be measured. Problems in the luteal phase may also occur as a result of abnormal levels of the hormone prolactin.