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Unexplained Infertility

It is where the cause remains unknown even after a complete infertility work up including semen analysis in the man and assessment of ovulation and tubal patency in the woman.
Prevalence :Accounts for about 10% of causes of infertility, globally.
Possible Causes : Abnormalities are likely to be present but are not currently detected by commonly performed investigations.

These may include:

Poor egg quality
Increased DNA fragmentation in the sperm
Failure of sperm to fertilize the egg
Mild endometriosis etc

Management:

Lifestyle modification
Ovulation induction for 3 to 6 cycles
Ovulation induction with IUI for 3 to 6 cycles
IVF treatment

Uterine Malformation

Uterine malformations are congenital defects of a woman’s uterus occurring in about 5% of women

Types of Malformation:

Arcuate:

Uterus appears normal from the outside but has a very small indentation protruding from the inner wall of the cavity. This is generally unproblematic.

Bicornuate:

The uterus appears heart shape with a deep indentation starting at the top of the uterus.

Septate:

The uterus appears normal from outside but contains an internal wall or septum that divides the uterine cavity into two.

Didelphys :

Double uterus where the two halves of the uterus remain completely separate

Unicornuate :

Only one half of the uterus is well developed.

Diagnosis :

Mostly discovered during investigation for infertility as they are usually asymptomatic
3D ultra sound
HSG
MRI
Diagnostic hysteroscopy

Treatment:

Medical Management:

Not Applicable

Surgical Management:

Only septate uterus needs to be treated the usual procedure performed being hysteroscopic septal resection.

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