Unexplained Infertility

[H1974]

Hi,

I wondered if anyone might be able to offer any advice for me please.

I am 35 years old, my partner is 28 years old, we have been trying to conceive for 15 months with no success. Both me and my partner have had all the tests which have come back fine and we are now sat under the category 'unexplained infertility'. I was relieved to find that there was nothing wrong with either us but frustrated that nothing has happened yet.

I have been prescribed clomid which I have to take on the 2nd day of my next period for 5 days and I have also been referred to a fertility specialist for IUI. I have searched the internet for the success rates of both these but there seems to be a 50/50 opinion of both these.

I was also wondering if after an HSG if your periods are as regular as they were before the HSG. I only ask because I had the procedure last month and I am due on any day now and as always I am anxious not to come on.

Sorry for all the questions, but hoping that someone may be able to put my mind at ease.

Many, many thanks
H

[Clure]

hi,
I understand your anxieties. I too am ttc (#2) Its frustrating being told "unexplained", it may be you need further tests or repeat tests. I had HSG done first time around when I conceived my DD, I didn;t notice a change in my periods but then I;ve alway been irregular. I took clomid for one cycle before falling for my DD, I was 36 and had been ttc for 2 years. Clomid helped to balance my hormones. Sadly this time its not doing it for us. I will link you to a thread where there are lots of lovely ladies in the same boat as you, lots of good advice and support. here x

[AttilaTheMeerkat]

What tests have been done on both of you to date and when were these carried out?. If a test result is over six months old it should be discounted.

My guess is that some tests have been missed out (I can give you a list of missed tests).

Unexplained subfertility is infact no diagnosis at all; all it means is that the docs have failed to find out what is wrong. Sometimes it is a "diagnosis" given to such patients primarily because they have not been investigated properly or thoroughly enough.

Clomid is usually prescribed if ovulation problems are suspected; is this the case with yourself?. If not why were you given this drug treatment?. It is important that both of you are fully conversant with how and why such treatments are done.

A HSG should not affected regularity of periods at all. Did this show anything unusual?.

[AttilaTheMeerkat]

The following tend to be omitted in the course of fertility investigations:-

Adequate x-rays of the uterus which may show abnormalities not seen at laparoscopy in either the tubes or uterine cavity.

Hysteroscopy - telescope inspection of the inside of the uterus which may occasionally show abnormalities not otherwise seen.

Carefully timed post coital testing to see if sperms are surviving in the cervix

Repeated sperm counts over several weeks and months to make certain there is no subtle abnormality

Testing the sperm in special media - such as swim tests or velocity testing. When this is done it can sometimes uncover a hidden cause for the supposed "unexplained" problem.

Thorough hormone tests to detect abnormalities of male hormone or early falls in progesterone.

Scanning of the ovaries to see if follicles really are developing and there is no sign of polycystic ovaries.

You will need to be persistant in order to get answers.

[H1974]

Hi,

Thank you for help Clure and AttilaTheMeerkat.

The tests I have done are as follows:

Day 21 Ovulation test - came back fine
Day 3 test - came back fine
Chlamydia / gonorrhea test - negative
HSG - Both fallopian tubes open and uterus fine
Test for polycystic ovaries and endometriosis - negative
My partners sperm count (1 sample been given) - motility and count both fine

My gynae advised me to use clomid so that my ovaries would produce more than 1 egg each month which would hopefully increase my chances of conception

I will take your advice and be persistant and hopefully get a positive outcome.

Many thanks
H

[AttilaTheMeerkat]

And you've been led to believe that you've had all the tests done. The above list I posted would show otherwise. You have both been poorly served to date because they have not investigated the two of you thoroughly enough.

You need repeated semen analysis - one sample in not enough to prove or disprove either way there is no male factor problem.

You have not had enough blood tests done etiher; these often have to be repeated. Where are the internal ultrasound scans?.

Endometriosis is usually only diagnosed through a laparoscopy (keyhole surgery) so am wondering what test they actually did for that. I would seriously like to know as I have endometriosis myself.

Is this what you were told re clomid; clomid's main and only job is to work the ovaries harder. If there is definitive proof you are ovulating regularly clomid can actually have the reverse effect!.

I would return to your GP and ask to be re-referred to another unit; this one is not at all good and you are both being mucked around. It is certainly fair to say that some units are far better than others.