Struggling to Conceive? Ultrasound Misses Hidden Causes

Many couples appear perfectly healthy, regular menstrual cycles, normal weight, balanced hormones, yet still find themselves wanting to get pregnant but can’t. This situation, often described as “healthy body but not conceiving,” can be deeply frustrating. In most cases, these infertile couples face hidden biological factors that standard health check‑ups or ultrasounds cannot detect. Conditions like microinflammation, immune imbalance, or oxidative stress can silently interfere with embryo implantation. Understanding and identifying these unseen causes through a fertility test for couples is the key to turning unexplained infertility into a successful pregnancy.

Even when the body appears healthy, menstrual cycles are regular, and there are no chronic illnesses or visible physical problems, many couples still face the challenge of wanting to get pregnant but can’t. For an infertile couple, the cause is often unclear. To identify the real reason, doctors may look deeper at micro-level mechanisms invisible to standard ultrasounds or basic blood tests. These hidden factors can interfere with embryo implantation, creating obstacles to conception.

Key Factors That Affect Pregnancy Even When Health Seems Normal

In some cases, a couple struggling-to-conceive cannot find answers through standard infertility testing. That’s because certain underlying issues cannot be detected by routine scans or lab work.

Microinflammation

Microinflammation is a subtle, low-grade inflammation invisible to ultrasound. It can affect how the endometrium (uterine lining) responds, preventing the embryo from implanting properly. Since this inflammation occurs at the cellular level, specialized testing is essential for identifying it as a hidden cause of infertility.

Immune Dysregulation

Immune system abnormalities, such as overactive NK cells (Natural Killer cells) or imbalances in Th1/Th2 responses, can disrupt embryo acceptance. In some cases, the immune system mistakenly identifies the embryo as foreign and attacks it, preventing implantation.

Oxidative Stress

Oxidative stress, which results from cellular imbalances, can reduce the quality of both eggs and embryos. This stress disrupts implantation and can also cause recurrent miscarriages. It cannot usually be detected through routine blood tests, making specialized testing important.

Advanced Diagnostic Approaches at the Cellular Level

High-precision diagnostic tests at the cellular level can reveal underlying causes of infertility and guide targeted treatment. Examples include:

• ERA Test (Endometrial Receptivity Analysis): Assesses whether the uterine lining is ready for embryo implantation, ensuring embryo transfer happens at the optimal time for infertile couples.

• NK Cell Assay and Cytokine Profiling: Measures immune activity that may disrupt implantation and checks the balance of immune responses. Detecting abnormalities helps doctors develop tailored immunotherapy.

• Hysteroscopy Diagnosis: A minimally invasive procedure using a small camera to directly examine the uterus. This can identify structural issues, such as uterine adhesions or polyps, that ultrasound may miss.

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Treatment Options for a Healthy Body but Not Conceiving

ICSI (Intracytoplasmic Sperm Injection) is an advanced form of in vitro fertilization (IVF) where a single sperm is directly injected into an egg. This method typically offers higher success rates and is particularly useful for couples where standard ultrasounds don’t reveal a clear cause of infertility.

By combining ICSI with advanced cellular diagnostics such as NK Cell Assays, Cytokine Profiling, and hysteroscopy, pregnancy outcomes are significantly improved, especially in cases of recurrent miscarriage or unexplained infertility.

• NK Cell Assay and Cytokine Profiling help assess the immune system balance in the uterine lining, detecting abnormalities that may cause the immune system to reject the embryo. This information allows doctors to develop an appropriate immune treatment plan.
• Hysteroscopy helps assess the uterine cavity for abnormalities such as adhesions or inflammation that could interfere with embryo implantation. Treating these issues increases the chances of a successful pregnancy.

Why ICSI is Ideal for Those with a “Healthy Body but Not Conceiving“

• ICSI can help resolve complex infertility issues at the cellular and immune levels. The fertilization process occurs in the lab, bypassing any uterine barriers that may hinder conception.
• This method is ideal for cases where embryo implantation is difficult or when there are abnormalities that cannot be detected by standard tests, especially at the cellular level. Issues like microinflammation or immune dysregulation may prevent successful embryo implantation.
• ICSI also increases the chances of fertilization success in cases of poor sperm quality by selecting the healthiest sperm and injecting them directly into the egg to improve fertilization outcomes.
• When combined with in-depth diagnostics, such as ERA Test, NK Cell Assay, Cytokine Profiling, and Hysteroscopy, doctors can gain a deeper understanding of issues at the cellular and immune levels. This approach significantly improves the chances of a successful pregnancy.

For couples struggling to conceive despite good health, a fertility test for couples can make all the difference. Consulting with a fertility team experienced in advanced diagnostics and ICSI is crucial to understanding the underlying causes.

At VFC Center (V Fertility Center), we provide personalized treatment strategies that analyze fertility factors at the cellular, hormonal, immune, and uterine environment levels. Our multidisciplinary fertility specialists are dedicated to helping every couple achieve their dream of parenthood.

 

Article by Dr. Nannapat Parosiyanont

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