Society places so much emphasis on preventing unwanted pregnancy that it has little time to address the desperately-wanted pregnancy and the heartbreak that occurs month after month when it doesn't happen. Once a couple decides to conceive and discontinues birth control methods, most automatically think that next month will be the month. After all, isn't it terribly difficult not to get pregnant? So a month goes by, then another and then another, and eventually they begin to wonder what's wrong. They find themselves questioning "Is it me? Is it him? Is it her?" Research shows, however, that the average couple in their 20s only has a 15 - 25% chance of conceiving in any one month. After reaching age 30, that percentage continues to decline. Unexplained infertility, therefore, might simply be explained by the odds and bad timing. After six months of not conceiving, a doctor will seriously discuss infertility issues with you, but you may not be diagnosed with infertility until you have been attempting to conceive for one year.
There are a series of tests that doctors perform to determine if there may be a problem. One of the first tests is a sperm count and motility test. It is one of the simpler, more inexpensive tests to perform and is almost always used exclusively to rule out male-factor infertility. A man may not have a low sperm count, but his sperm may be sluggish and slower than the norm, which will affect their ability to fertilize an egg.
If the male is ruled out, however, several months of testing may be in the works for the female. On her way home from the doctor, she may find one of her first stops is the drugstore to pick up an ovulation predictor test or a basal body temperature thermometer or maybe both. Monitoring the female cycle for ovulation is one way to improve the odds. A woman's wakening body temperature will rise immediately after ovulation, so it may take a few months of charting the basal body temperature to determine if a woman is ovulating regularly, sporadically or not at all. If a woman is ovulating regularly, a couple of months of charting will determine when she is most fertile, which will be 2 to 3 days prior to the temperature spike on her chart. In conjunction with the body temperature charting, a doctor may order blood tests to check thyroid and other hormone levels in her body to see if a hormonal imbalance may be creating the problem.
If a woman is ovulating regularly and conception does not occur after predicting her cycles, then more invasive procedures may be performed. A hysterosalpingogram may be performed by infusing dye through a woman's tubes while monitoring its motion with X-ray. The goal is to make sure the dye spills out of the tubes appropriately to prove no blockages. Often this test may be inconclusive and a doctor may order a diagnostic laparoscopy, which is outpatient surgery under general anesthesia to check the ovaries and tubes more closely. If those tests show no problems with the female, then the doctor may anticipate that the problem lies with the reaction of the two reproductive systems together and order a post-coital test. This test involves a doctor visit shortly after intercourse to examine the way a woman's bodily fluids are reacting to the sperm deposit. Is something in her body chemistry killing the sperm, or to paraphrase, are the soldiers being picked off before they ever get to the gate? As you can see, there are numerous tests that may be performed to determine what may be preventing pregnancy, but once a doctor has exhausted all resources with no conclusion, a diagnosis of "unexplained infertility" will be given. At some point, the doctor will stop the myriad of tests looking for a problem and begin concentrating on conception, which was, of course, the original objective. Statistics show that in many unexplained infertility cases, conception will occur when science runs interference against nature.
Fertility drugs, including orally administered Clomid and other injectable gonadatrophins, may be used to increase chances of conception. The female will be monitored closely while taking these drugs, especially the injectable varieties as they can on rare occasions send the ovaries into overdrive creating a health risk. Imitating the body's natural processes through science can be a very meticulous process, with timing of fertility injections being extremely important. During this time, most doctors will also monitor the ovaries via ultrasound to attempt to prevent a woman's conceiving too many children at once. To further increase chances of conception during this process, the collected sperm will be put through a sperm-washing procedure to separate them from the seminal fluid for direct injection through the cervix and toward the waiting egg(s).
There's no mistaking the result of curing unexplained infertility. It's all in the sound of a baby's cry.