Unexplained infertility is a clinical diagnosis made when standard fertility tests show normal results, but pregnancy has not occurred. A ReceptivaDx test can provide additional insights to help guide personalized treatment decisions and determine the next steps in care. Here is more information on the details of unexplained infertility:
Understanding Unexplained Infertility
Unexplained infertility involves a diagnosis when a woman has been trying to conceive for 12 months without success; it may also apply to a woman age 35 or older who has been trying for six months, and no specific cause has been identified through standard testing. Testing provides an assessment of ovarian reserve, fallopian tube patency, and sperm analysis. When all of these results come back within normal ranges, the diagnosis of unexplained infertility applies.
The limitation of this diagnosis reflects what has been tested, not necessarily what has been ruled out. Routine fertility evaluations do not assess inflammation of the uterine lining. This means certain underlying conditions, such as those affecting implantation, may go undetected.
Identifying Endometrial Inflammation
Inflammation of the uterine lining can interfere with a fertilized egg’s ability to implant. Women with unexplained infertility, recurrent implantation failure, or recurrent pregnancy loss should explore endometrial inflammatory conditions. A ReceptivaDx test helps determine whether endometrial inflammation may be an underlying cause.
Endometriosis causes tissue similar to the uterine lining to grow outside the uterus. This includes the ovaries, fallopian tubes, and the outer wall of the uterus. It can also involve the intestines or other abdominal organs.
Silent endometriosis is another condition that presents without symptoms, including no pelvic pain, painful periods, or painful intercourse. The only apparent sign may be the inability to conceive or carry a pregnancy. Because there are no symptoms to prompt further investigation, silent endometriosis is a primary contributor to unexplained infertility diagnoses.
Learning About Standard Testing
An ultrasound and MRI scan may appear entirely normal in the presence of endometriosis. This is not a failure of imaging technology; rather, it reflects that endometriosis in its early stages exists primarily as uterine lining inflammation and does not always produce visible lesions. Laparoscopic surgery provides an option to confirm an endometriosis diagnosis.
Chronic endometritis, a bacterial infection of the uterine lining, is another condition that can cause infertility and recurrent pregnancy loss. It often remains undetected through standard evaluations. Plasma cells help indicate chronic inflammation, and their presence signals an underlying infection that can impair implantation. Like silent endometriosis, chronic endometritis frequently goes undiagnosed because it does not reliably produce symptoms that would prompt further testing. Both conditions directly affect the endometrium, and neither is captured by conventional fertility workups that focus on ovarian function, hormone levels, and anatomical structure.
Getting ReceptivaDx Testing
For women with an unexplained infertility diagnosis, the next step involves identifying what the standard workup did not evaluate. An endometrial biopsy helps assess the uterine lining for biomarkers associated with inflammation and endometriosis. A ReceptivaDx test detects BCL6, a protein marker of uterine lining inflammation associated with endometriosis. A biopsy also includes a full histologic analysis, which provides information on endometrial dating, cycle phase confirmation, and identification of any abnormal cellular changes. The test involves a routine office visit using a thin catheter to collect cells from the uterine lining. The biopsy must be timed appropriately, such as being performed seven to ten days after ovulation in a natural cycle. Results are returned to the ordering provider within seven to ten business days. CD138, a marker for chronic endometritis, can be added to the same biopsy sample for patients who also have a bacterial infection contributing to their infertility.
Start Treatment Today
An unexplained infertility diagnosis helps identify potential areas for further evaluation. Women who have not conceived after months of trying, have experienced one or more failed IVF cycles, or want to better understand their uterine environment before pursuing IVF may find that they need additional endometrial evaluation. Contact our team today to learn more about the ReceptivaDx test.
