  
In approximately
15% of all infertile couples, a careful properly conducted infertility
evaluation will not reveal the precise cause of a couple's infertility.
For patients who fall into this category, it proves to be very frustrating,
causing much more emotional distress than if a precise cause can be
identified. However, research has clearly shown that applying specific
"treatment protocols" for this group of patients will yield
a substantial success rate. The basis for this success likely related
to the fact that our ability to precisely identify "subtle"
male problems or "occult" disorders of ovulation is limited.
Therefore, treatment protocols which "overdrive" the ovulation
process resulting in high hormone levels, increased numbers of eggs
and thickened uterine lining will allow successful pregnancies. Similarly
treatment protocols which pay strict attention to timing and prepare
sperm so as to maximize the number of motile sperm with access to
the egg will result in a substantial number of pregnancies.
When simple
office treatments fail to correct "unexplained" infertility,
in-vitro fertilization is often the answer. This technique allows
for pregnancy in the context of possible occult male problems, undiagnosed
ovulation deficiencies, and undiagnosed or unrecognizable problems
with fallopian tube anatomy or function. For these reasons, in-vitro
fertilization remains a very powerful tool in the approach to management
of "unexplained fertility". |
