Fertility Topics Explained from the Experts at SFS
Neither sex contributes more heavily than the other to infertility problems. Roughly one‑third of all infertile couples can trace their infertility to the woman, one‑third to the man, and one‑third to both partners. In practice this means that in >50% of cases there is both a male and a female factor involved. Understanding this reality before embarking on a strategic plan of treatment is in my opinion essential to optimizing outcome.
For about 10% of all infertile couples, the cause of the infertility cannot be readily determined by conventional diagnostic procedures. Such cases are referred to as "unexplained infertility." Modern IVF technology is making great strides in helping to identify some of the causes of so called unexplained infertility. Improved testing techniques have made infertility easier to diagnose, and the majority of cases can now be diagnosed and generally are treatable. For example, recent research has demonstrated that many women with unexplained infertility ultimately are subsequently found to have pelvic endometriosis that cannot yet be detected by direct vision during laparoscopy or surgery. For example, a condition called non-pigmented endometriosis, in which the endometrium may be growing inside the pelvic cavity with many of the same deleterious effects as overt endometriosis, cannot be detected by direct vision because no visible bleeding has occurred in these lesions. The fertility of these patients may be every bit as much compromised by these conditions as if they had detectable endometriosis. Sometimes infertility is due to non-receptivity of the uterine lining (endometrium) to the embryo (fertilized and divided egg). This can be due be the lining being too thin to accommodate the implanting root system of the embryo, scarring of the lining, infection or immunologic factors. The latter is fast becoming an important consideration, especially in cases of unexplained failure following the use of fertility drugs.
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