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Problem Solving Infertility

Problem-solving unexplained infertility involves a step-by-step walk-through of the steps needed to get pregnant and highlighting things that can prevent that from happening at each step. Once the steps are checked, most of the potential problems can be excluded, and it’s possible to have a more focused approach. 

Steps to pregnancy Possible problems
Sperm arrive in the vagina
Sperm enter the womb
  • It’s not the fertile phase of the woman’s cycle
  • An abnormal microbiome in the vagina or womb kills sperm
  • A lack of fertile mucus prevents sperm from entering the womb
  • The woman has anti-sperm antibodies that stop many of the sperm
Sperm cross the womb
Sperm survive in the Fallopian tubes, ready to fertilise an egg
An egg is ovulated and fertilised by a sperm
  • There’s no ovulation
  • Endometriosis physically obstructs ovulation
  • Inflammation in the pelvis creates a raised immune response that kills the sperm
  • There aren’t enough sperm to break down the shell of the egg and fertilise it
  • The sperm aren’t able to fertilise eggs
  • More than one sperm fertilises an egg
  • There are DNA incompatibility issues between the egg and sperm
The embryo reaches the womb in the “window of implantation”
  • The Fallopian tubes are blocked, or the cilia cannot transport the growing embryo to the womb
  • The peg cells in the Fallopian tubes don’t provide enough nourishment to the embryo
  • The embryo doesn’t arrive in the womb in the “window of implantation”
  • The embryo implants in the Fallopian tube and creates an ectopic pregnancy
The embryo implants and pregnancy begins
  • The lining of the womb isn’t thick enough to support implantation
  • Physical structures in the womb (fibroids or polyps) prevent implantation
  • The womb lining isn’t receptive to implantation; it may be that some old lining wasn’t shed during the period
  • There’s an aggressive immune response that prevents implantation
  • There’s a lack of immune response that prevents implantation
  • The luteal phase is too short, and a new cycle starts before the embryo fully implants

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