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Fertility Education
Diagnose With Unexplained Infertility, Now What? | Listed Some Common Factors & Treatment Options
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Hello and welcome. I'm Manali Hirani, your host and creator of fertility education, shortly named as Fertility Ed. I launched this podcast with a mission which is to educate people and share my knowledge about the subject of fertility. And by doing this, I believe that it will empower women to make an informed decision of their sex life and future family planning. And I'm pretty excited to bring you my next episode of podcast, just to introduce myself again. I am a certified embryologist, hypnotherapist, natural family planning practitioner, and your fertility advisor. And I have had my presence in this field for over 10 years now, and I am using this platform to share my knowledge, experience and empower you on your next step regarding fertility. I will be covering a range of topics through my podcast episode which will educate you further to understand your own body and this broad field. And if you are one of those who are suffering from infertility, I want to tell you that you are not alone in this journey. And as a fertility advisor, I will try my best to educate you so you can keep your fertility health up to the mark. So let's learn, empower and inspire. Right then, here we go. Hello and welcome to Fertilityed Podcast. This is your host, Manali Hirani. Today we are going to talk about unexplained infertility. Well, trying to get pregnant can be an exciting time, but it can also be disappointing and frustrating if things don't go according to the plan. And while it's probably unreasonable to expect to get knocked up, your very first go though, many people are lucky. But it's a different scenario when you have been trying for months on end with no result. For many couples, the next logical step is to speak to a professional to double check. Is everything okay? So, but what if you both get a clean bill of health and you think we are doing everything right? All reports are normal. Doctor says that there is no issue with you. Then why still no luck? Well, unexplained infertility in many cases is not that there is nothing wrong, but simply we are unable to determine what may be causing the infertility. And to help specify the best treatment option for you, there must be a thorough investigation into the both partners first. The first thing to say is unexplained infertility traditionally has been defined as couples who have been trying for a year, for one year, and all conventional tests have come back as normal and. And yet they are not able to conceive. But you have to make sure that it is really is unexplained. In fertility because sometimes the history can be so simple as like sexual issues or timing issues and, you know, such kind of things. But there are also some other issues which are there new but which are beyond the realm of test. So in many cases, unexplained infertility is a result of not one, but many minor issues. When you have multiple small issues, each decreasing the chances of pregnancy together, it translates into a delayed time 2 pregnancy and sometimes an increased risk of miscarriage. So to put simply over here, unexplained infertility refers to cases in which infertility testing has been unable to identify the cause for the failure to get pregnant. So it is also termed as sometimes idiopathic infertility. Now I believe that term infertility can actually be misleading as it suggests that individual cannot fall pregnant without treatment. In fact, most couple struggling to conceive are sub fertile, meaning that they are multiple mild issues rather than one single big factor to not being able to get pregnant. Now, for the average couple, the chances of falling pregnant during any given cycle is approximately 20%. But for couples with unexplained infertility is closer to say, 1 to 4% chance without treatment. Now that said, the good news is that couples with unexplained infertility have still 50% chance of getting pregnant naturally within the 12 months following their diagnosis, because there's nothing to do if we don't know what's the problem. And the chances of conceiving naturally, however, are reduced if a woman Is, say, over 30 or if they have been trying for more than three years, or they have never ever previously, you know, fallen pregnant and have miscarriage or something. So there's a couple of situations where I would say the chances of course decreases to conceive naturally, though it's not impossible. It is possible, but just the chances are decreased. Now additionally, couples with unexplained infertility have 50% chance of getting pregnant, as I said, naturally within a year following diagnosis. But on the other hand, even without a definite diagnosis, reproductive technologies can help over here. So assisted reproductive technology have helped many people or many couples with unexplained infertility, and they have got really good results. So sometimes Dr. Just want to come up with a fertility treatment in the hope that you will fall pregnant and not addressing any targeted issues because we don't know any. Now generally when we go for the test, there's evaluation. The test basically focuses on four things. One is your hormonal blood reports, a normal semen analysis, adequate ovulation and tubal potency and normal uterus. So when we talk about test, most tests, most conventional tests are focuses only on these four parameters. And that's the reason if these all comes normal, mostly conventional doctor will tell you that, okay, you don't have any issue. This is probably unexplained infertility. However, unexplained infertility may reflect small effects from multiple factors. In other words, it's like one or both partners may have optimal fertility, but this does not show up negatively as a part of the fertility workup. And since the conventional workup results come out to be normal, the doctors fail to understand that what exactly is a problem, though? There's one thing to understand, that unexplained infertility is not only a one big factor, just one single factor. It could be due to small, small factors that is actually delaying the cause of pregnancy. However, today I'm going to put up some common factors which are increasing the risk of unexplained infertility. Starting with, it could be due to thin uterine lining. Now, many women believe that their uterine lining thickness is fine, especially because there was no issue during their previous IVF or iui. However, there is a false belief because medications given during these assisted reproductive treatments increases the lining thickness. And ultrasounds done throughout the initial diagnosis don't necessarily evaluate for the thickness of uterine lining. So the best way to know is to have transvaginal ultrasound done in the middle of cycle, which is a few days after ovulation, to assess the thickness. A common sign that you may have thin lining is that you may notice that you have a very light period, usually less than, say three to four days of medium to heavy flow that may be considered light and may signal that there is a thin uterine lining issue. So this is one of the factors to look into. The another could be which is also really common. One is low progesterone. So if your luteal phase is 12 days or less or you notice significant spotting during your luteal phase, you may have low progesterone. Blood tests are not quite accurate when it comes to measuring the level of progesterone. This is because the progesterone in the blood can change up to five times in the matter of just couple of hours. So blood levels fluctuate constantly and are not an accurate estimate for progesterone level in the uterine lining and the reproductive organs. So if you're going for fertility treatment, Dr. Will give you progesterone, extra supplements if required. But if not, and if you are diagnosed with unexplained infertility and if you're trying naturally, you should look into the low progesterone. Now I have done an entire episode about low progesterone and how to boost it naturally. You can refer to that episode and you can put all those tips in your trying to conceive journey. The another factor could be is low egg quality. The patient that are above the age of 35 or have say elevated FSH or decreased age AMH and decreased AFC which is ENTRA follicle count, they might have this low ovarian reserve. So hand in hand with low ovarian reserve is a condition called low equality. It means the integrity of the follicle is low. So it is less likely to fertilize, less likely to implant and less likely to lead to healthy pregnancy. It might occur into miscarriage. Well again this could be rectified, not exactly rectified, but you can do something about it. How you can improve equality. Now there is an entire episode on this as well that how can you improve equality? There are chances that if you follow a preconception health plan for say three months, that we work with patients to improve the equality and boost your chances of getting pregnant. So low ovarian reserve, which could be one of the factor of low egg quality can also be an issue. So you might be getting pregnant, but it could have been lead to early miscarriage and you probably not have noticed and that you might be thinking it's just my periods are back. So it's very common to, you know, to miss the miscarriage. It's like because it's so early miscarriage that you probably not even notice that you were actually pregnant. But just because there's a lower quality or there is a thin utrine lining, that's the reason the egg wasn't able to implant. And even if it was implanted, it was not able to sustain to the healthy pregnancy. Okay, now the another factor which is one of the classic one is elevated stress. And I have done previous episodes on stress. High stress level, especially when it becomes chronic, elevates the hormone cortisol in the blood. Now the increase in stress and the cortisol level shifts the blood flow to focus on on the vital organs such as brain, liver, skeletal muscles. So research has shown that elevated stress actually decreases the quality of the uterine lining and making implantation less likely. So I know it's easier to say than do it, but it's really important to keep your Stress level in check. Again, I have done the entire episode and you can see how, what are the ways you can, what are the ways you can incorporate in your life to keep your stress level down? So this was all about what happens in women. Now what about men? Because there is a high risk, high infertility risk factor in men as well. Again on this, I have done an episode called what Men do Wrong in TTC Journey. It's really interesting once you do go and listen to them. So what about men? Now we know the 50% of genetic material comes from men. So even the sperm analysis test come back to normal. There is something called sub optimal sperm health. So when it comes to fertility, it is important to understand the value of male fertility. Just because a male partner meets the minimum requirement does not mean that he has no role with the infertility. Sub optimal level are not flat during the sperm analysis so it will go unnoticed. And you may think there is actually no issue with me, oh, there is no issue with my partner. If sperm health is improved the optimal range, it can significantly support a shorter time to pregnancy. So when it comes to the sperm health, the sky is limited. And when it comes to improving the numbers, trust me, the best thing they can do is just follow really simple guidelines, this really simple preconception health plan and the numbers can shoot up. But let me tell you what are the couple of factors that might affect the sperm health. Starting with physical factors. Now this may include hypothermia, which is increased temperature near the scrotum area. It could be due to radiation or electromagnetic fields or just as simple as keeping a laptop on the lap all the time. The another could be chemical cause. Now chemical causes may include cigarettes smoking or excessive alcohol consumption or marijuana or cocaine use and excessive caffeine intake. So make sure that you don't, even if you just give up all these for three months, the numbers are going to show a significant result. The other one could be occupational hazards. Now occupational hazards such as some pesticides or industrial toxins like dioxin or PCBs and the exposure to heavy metals may also be linked to infertility. And lastly, my favorite lifestyle factor, just as simple as stress and nutrition can also play a major role when it comes to improving the sperm health and shooting up the numbers. So this was all about what men can do to improve their sperm health. So and with women, the common factors could you have to think about is low progesterone, thin uterine lining or elevated stress level and low egg quality. And lastly, I would Want to say is go for genetic testing. Though it's not very common that people go for it. Most couple goes for genetic testing, you know when they have been on their fertility journey for too long with no results. But if you and if you go in the start there's no harm. So go for genetic testing because you know lastly getting the genetic testing done is again, you know, you can reveal it can reveal so many things. So if we start talking about gene sky is the limit. So speak to your consultant and ask for thorough genetic testing for both the partners. So this was all the common factors that I want you all to look into it. If you are suffering from unexplained infertility. Now what if everything still is normal and you don't know what to do? Well, there are couple of treatment options for unexplained infertility and they have shown great results and they are really simple starting with fertility acupuncture. Well, I personally am not an acupuncturist so I don't know but I have spoke to lot many acupuncturists. I have also spoke, I have also done one Instagram live with one of the famous acupuncturists in usa probably he's in New York. His name is Mike Berkeley. You can also listen to that IGTV and you will understand that how acupuncture can do wonders when it comes to unexplained fertility. So fertility acupuncture helps to improve the blood flow to the uterus and ovaries. And acupuncture with specific protocols based on the latest research trial have being shown to improve egg quality, improve hormone balance, reduce stress, support healthy ovulations and progesterone productions. All that we want is done by acupuncture. And for males it has been shown to increase the production of sperm cells and can support a healthy sperm concentration. So if you are believer in acupuncture and even if you are not, there's no harm in giving a shot because I have heard really good results by people going for fertility and gunture. Okay, the other one could be is go and look for clinical nutritional supplements. Now the treatment of unexplained infertility can help to address a combination of factors to help increase the chances of pregnancy. Particularly the use of micronutrients may help to improve the quality of follicles and eggs by reducing the damage to them. So support sperm health by increasing the motility and normal sperm morphology. The antioxidants in high therapeutic concentrations helps to Reduce the damage to the sperm and egg cells and support improved overall functions. And when it comes to egg, there are couple of supplements that could really help with increasing the good egg quality. So people who have low Benin reserve and who have already less follicle left, less egg left for fertilization, they actually should be going for this three months of nutritional supplement plan and then go for the fertility treatment. The other thing I could think of is hormonal replacement with progesterone. Now the use of bioidentical progesterone therapy can help to support healthy implantation, now support a healthy pregnancy and may even reduce the risk of miscarriage, especially in the first trimester. So this treatment option is especially important for the patient with the history or the symptoms of low progesterone or who have a short cycle or who have early miscarriages. Now the other one I could say is IV therapies. Now the use of intravenous, there's something called intravenous glutathione, the most important antioxidant in the body can help to support the healthy sperm and egg cells. The, the antioxidant reduces the potential harm to the eggs and follicles by reducing the oxidative stress, a harmful type of chemical stress which significantly reduce say egg and sperm health. Can, you know, it can combine with intravenous vitamin C and other important nutrients and help you deliver a therapeutic concentration that are not possible to achieve with supplements or diet alone. In fact, they literally, you know, release in your blood so you don't have to do anything. As far as I see from here, IV therapies are future with respect to your skin health, your immune system's health. You know, this supplements in near future are soon going to convert into IV therapies, as I can see. Yes, this is one of the options if you have somebody doing IV therapies, you can actually go for that. And there are a couple of clinics are doing nowadays and the last I could think of is diet and lifestyle. So what is generally considered a healthy diet and lifestyle does not always translate in an optimal changes for fertility specifically. Okay, so diet and lifestyle counseling specific for sperm health and female fertility are crucial to the treatment of unexplained infertility. Sometimes the most basic treatments are most valuable to the improvement of our health. And fertility is no exception to this. So I know it sounds simple, but you never know. You know, probably just removing gluten from your diet or just removing dairy from your diet can do the wonders which the IVF treatments couldn't do. So you just need to have faith. Look closely, what are you doing and what should be done and what is your body telling you Never know anything can happen. It's all about miracle. Yes, this was all for today. We spoke about the common factors for increased risk of unexplained infertility and we talked about some simple treatment options for unexplained infertility. So if you think you have learned something new today, if you think it has been useful, or if you think any of your friends might be useful by this episode, do share with them. Meanwhile, don't forget to rate, review and subscribe this podcast. I am so happy to read them. And yes if you're there on the Instagram don't forget to follow us because there are more information on instagrams and we keep sharing post every day and there is an IG lives and stories. There's lot many things going on. So if you're there on the Instagram do follow us. So this is all I have for you today. Hope you enjoy it. Take home a fair bit of knowledge and thank you so much for listening. I would highly appreciate if you can please leave your reviews, feedback, suggestions and questions. If you have any. I would love to hear from you so you can drop us an email on infoertilityed.com you can also follow me on Instagram, Facebook and YouTube on the name of Fertilityed. I would urge you to share this knowledge among your friends and relatives. Be it girls or boys, it doesn't matter. Just spread the word and awareness and yay. Don't forget to subscribe. See you next time. Until then, stay fertile, stay healthy. Bye bye.