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How to conceive with unexplained infertility? – VnExpress


With unexplained infertility, the treatment plan is often based on clinical experience and some guesswork.

Treatment usually starts with recommendations for lifestyle changes and continues with trying to conceive naturally for 6 months to a year.

If unsuccessful, the patient can be given some fertility drugs and undergo intrauterine insemination (IUI) or in vitro fertilization (IVF) for 3-6 cycles. Finally, third-party assisted IVF treatments, such as using an egg donor or surrogate, are used.

Lifestyle change

When infertility has no known cause, it’s important to improve your overall health. The most common lifestyle change recommendations to improve fertility naturally are: limiting alcohol intake, cutting back on caffeinated beverages, quitting smoking, losing weight (if overweight) and exercising. exercise, reduce stress.

No research has shown that making these changes can actually help with conception. However, these factors are associated with decreased fertility in both sexes.

Try to conceive naturally

Doctors will recommend couples to continue trying for a natural pregnancy if they have had tests to confirm unexplained infertility, ovarian reserve testing (FSH, AMH, and follicle count). have a good result, are less than 35 years old and have been trying to conceive for less than 2 years.

A randomized clinical trial was performed to compare trying to conceive naturally in couples with a good prognosis and those receiving IUI plus fertility drugs. The study took place over a period of 6 months.

Results showed that 32% of women who did not receive IUI became pregnant spontaneously. 27% of pregnancies at the end of the study.

So, IUI plus fertility drugs for those with a good prognosis does not improve the chances of a successful pregnancy. Couples who continued to try on their own were just as likely to conceive as those who received treatment. Due to the high cost of treatment, the risks of fertility drugs, and the increased risk of multiple pregnancies, couples should try to conceive spontaneously for a certain period of time.

Couples under the age of 35 and with confirmed unexplained infertility should try to conceive naturally for 6 months to a year. Image: Shutterstock

IUI and fertility drugs

For those with unexplained infertility, IUI or fertility drugs have been shown to only slightly increase pregnancy rates. However, due to the high cost of IVF and more intensive intervention, the application of IUI and fertility drugs are options to try.

For unexplained infertility, Clomid with an IUI is often preferred over IUI with gonadotropins. Both Clomid and gonadotropin are commonly used to induce ovulation, treat infertility in women, and possibly to increase sperm count in men.

Gonadotropins are more expensive and more likely to lead to ovarian hyperstimulation syndrome (OHSS) and multiple pregnancies. How many IUI cycles to try depends on your age and personal preference to pursue IVF treatment if IUI fails. For those desiring to do IVF, 3 cycles of IUI with Clomid may be a good enough trial before switching to IVF.

IVF

When it comes to treating unexplained infertility, IVF has the best chance of a successful pregnancy. Pregnancy rate with IVF treatment is 3 times higher than with IUI with Clomid. The pregnancy rate for Clomid by IUI is 7.6%, the pregnancy rate per cycle for IVF is 30.7%. However, this percentage will vary with age.

Not only is the IVF success rate higher, the cause of “unknown” infertility is sometimes discovered during treatment. Only during IVF can the egg quality, fertilization and embryo development be closely observed. The downside of IVF is that it is invasive and expensive.

Most couples should try IUI with Clomid before going straight to IVF. However, going straight to IVF and skipping IUI may be the best option for couples aged 38 and over.

Other methods of assisted reproduction

If IVF fails, there are still other options for people with unexplained infertility.

Some people believe that unexplained infertility can be caused by mild endometriosis. In this case, endometrium deposits may not cause pain or directly affect ovulation or fallopian tubes, but their presence may increase systemic “stimulation”. reproductive.

According to this theory, this could be the cause of repeated IVF failures. Some doctors will recommend laparoscopy to diagnose and remove mild endometriosis before performing IVF or after repeated IVF failures. Whether this treatment can improve birth rates remains unclear.

Gamete donation

If egg, sperm, or embryo quality problems are detected during IVF, your doctor may recommend using a gamete or embryo donor for your next IVF cycle. Egg donation is the most expensive option, followed by embryo donation, and sperm donation. The success rate of egg donors is generally quite high.

The rate of embryo donation will depend on the source of the embryo, for example many donor embryos come from extra embryos created for IVF treatment of another infertile couple.

Surrogacy

If IVF treatment repeatedly fails after embryo transfer, surrogacy may be the next step. Surrogacy is extremely expensive and illegal in many countries. For those who can afford and access surrogacy services, this could be their path to parenthood.

Mr. Ngoc (Follow Very Well Family)

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