Posted by: Zagreb

Dear doctor,

I have the following problem: I am 30 and we have been trying to get pregnant for fifteen months with no success. My husband’s sperm analysis tests are fine. I have done the ultrasound, Pap smear, bacteria tests and tubal patency test. All came back negative. My cycle is a 30-day regular one, feeling no pain and I am ovulating regularly as well, on the 16th day of the cycle (tested, including basal temperature tests and I almost always feel slight pain in those days). I am physically healthy with no disease history and I have never used any contraception. I have not yet done the hormone tests because my gynecologist says that since both my cycle and my ovulation are regular it is only a matter of time until we succeed, but I am not sure of it anymore. Can you please advise on any other tests we can do to establish the problem? Also, considering the tests results I have mentioned, what could be the reasons for my infertility?

Answer by: Martina Bračun, MD

Dear Zagreb,

Considering you have been unsuccessfully trying to get pregnant for over a year and have used no protection whatsoever I would suggest you do the hormone tests (Day 2 – 5 of the cycle blood tests). Should the hormone tests be satisfactory, your diagnosis is idiopathic infertility. 10 to 25 percent of all infertile couples have idiopathic infertility, which is defined as inability of getting pregnant during one year of unprotected sex, without any apparent cause for infertility. Between 40 and 65 percent of couples suffering from idiopathic infertility do manage to get pregnant within three years of trying. Causes of the inability to get pregnant can be found in unidentified sperm or egg dysfunctions, or fertilization issues. Those can only be diagnosed through an IVF procedures, which is why such couples are suitable for immediate IVF, especially if woman is over 35 years of age. The beginning of treatment in couples suffering from idiopathic infertility depends primarily on the woman’s age. Since you are still under 35, for several more months you can keep trying on your own.