Tubal Factor Behind Unexplained Infertility
So-called “unexplained infertility” is sometimes a result of subtle problems with the fallopian tubes. Even experienced radiologists sometimes miss these subtle tubal issues. Dr. David H. Barad from New York fertility center, the Center for Human Reproduction, discusses diagnosis and solutions.
So there are many factors behind diagnosing of unexplained infertility. They break down into the same three general topics, that everybody does as part of the fertility workup. For instance, a lot of people come and say they have a normal hysterosalpingogram history, but it is very common for us to repeat the hysterosalpingogram or review the images that people bring to us of their hysterosalpingogram and see that there is actually a problem.
This is because many radiologists – while they are very good radiologists – aren’t that used to dealing with fertility patients. If they see dye go into the uterus and come out the tubes they say it’s normal. We look a little bit more carefully, try to see if there is distention of the tube at all, if there is a jet-like stream of dye coming from the end of the tube, is the dye accumulating in pockets around the outside of the tube. These are all little hints, that you can see, that help to understand whether the tubal anatomy is normal or not. Any abnormality of the tube that keeps it from being freely open to pick up an egg or to move around to be able to pick up the egg could interfere with the fertility process.
It’s very interesting when we do a hysterosalpingogram, often many couples will conceive in the month or so after we’ve done the procedure. This is very common, suggesting that even when the study appears to be normal, you’ve actually flushed some small blockage out of the tube by the physical act of pushing the contrast media through the tubes. So, that is one general area having to do with tubal problems.