A real clinical case from Dr. Galindo: endometrial infection
Unexplained infertility is one of the most challenging diagnoses in reproductive medicine. What happens when a couple undergoes multiple fertility treatments to have a baby, all conventional tests come back normal, but pregnancy still doesn’t happen?
Clinical experience and the ongoing search for answers can make the difference between failure and success. This is the clinical case of a patient treated by Dr. Galindo at Gravida, which perfectly illustrates why going beyond the basic tests can be decisive.
Patient with unexplained primary infertility
Failed intrauterine inseminations with all tests normal
A 35-year-old patient with primary infertility of unknown origin came to Gravida after undergoing three failed intrauterine inseminations at another clinic in Barcelona.
All conventional diagnostic tests were completely normal:
- Hysterosalpingography: no abnormalities
- Ovarian reserve: normal
- Semen analysis: no abnormalities
- Karyotype of both partners normal
So why wasn’t she getting pregnant?
The clinical decision: IVF (In Vitro Fertilization)
Dr. Galindo decided to move forward with an In Vitro Fertilization (IVF) cycle. The initial results were promising:
- 12 eggs retrieved during the ovarian puncture
- 4 viable embryos after IVF
At this point, the decision was made not to perform Preimplantation Genetic Testing (PGT), based on the patient’s age and the clinical data available.
The first pregnancy and the anguish of miscarriage
After the first embryo transfer, the patient achieved the expected pregnancy. However, at 18 weeks of gestation, a premature rupture of the amniotic sac caused the loss of the pregnancy.
This was a devastating moment for the couple. Despite all their efforts and having achieved the pregnancy, the gestation was interrupted. All conventional post-miscarriage tests were performed, but no apparent cause was identified. The pain and uncertainty were immense.
Even so, the couple decided not to give up. After processing their grief, they returned determined to try again.
The turning point: going beyond conventional fertility testing
The clinical experience that made the difference
Dr. Galindo proposed a different strategy based on her clinical experience: not settling for the usual tests and investigating further. Her proposal was to perform a diagnostic hysteroscopy, which came back normal, and an endometrial microbiome biopsy, an additional test that goes beyond basic fertility analyses.
Experience shows that certain pathogens inside the uterus can go undetected on conventional tests. In cases of recurrent implantation failure or pregnancy loss, with normal conventional studies, it’s reasonable to consider additional investigations.
The key finding: Ureaplasma Parvum
The results were revealing: the microbiome biopsy detected the presence of Ureaplasma parvum, a bacterium that can compromise implantation and the normal development of pregnancy. At this point it was considered that Ureaplasma might not fully explain the couple’s fertility problems, but it could be a crucial factor in the early rupture of membranes that caused the loss of the first pregnancy.
Treatment and confirmation of pregnancy
Specific antibiotics to eliminate the bacterium
The finding was good news: Ureaplasma parvum is treatable with specific antibiotics. After completing the treatment, Dr. Galindo wanted to confirm its effectiveness before attempting a new cycle. A second microbiome analysis was performed to verify the elimination of the bacterium. The result was satisfactory: there was no trace of the pathogen.
The desired outcome: successful pregnancy and a healthy baby girl
With the infection treated and its elimination confirmed, the couple proceeded with a new embryo transfer.
The result was a resounding success:
- Pregnancy confirmed
- Completely normal gestation
- A perfectly healthy baby girl is born
Second cycle: consolidating the protocol for a second pregnancy
When the patients returned to Gravida seeking a second child, Dr. Galindo applied the protocol that had worked before once again:
- Repeat the microbiome analysis to rule out any reinfection
- Confirm that no pathogens are present
- Safely proceed with the new transfer cycle
Once again, the result was a success: a second pregnancy without complications.
Conclusions: what can we learn from this case of unexplained infertility?
This clinical case illustrates several fundamental concepts in modern reproductive medicine:
- The importance of not settling: when standard test results don’t explain repeated failure, we should consider investigating further.
- The uterine microbiome as a reproductive factor: silent infections caused by pathogens like Ureaplasma parvum can compromise fertility without presenting classic symptoms.
- Clinical experience: an expert doctor recognizes patterns and knows when additional protocols are needed.
- Persistence: the couple didn’t give up after the first failure. Resilience and emotional support are just as important as medicine.
- Individualized treatment: there’s no single protocol that works for everyone. Each case requires a personalized approach.
Cases of unexplained infertility
If you have a history of:
- Recurrent implantation failure
- Spontaneous miscarriages with no apparent cause
- Primary or secondary infertility of unknown origin
- Previous IVF failures despite normal test results
It may be decisive to investigate beyond conventional testing.
Frequently Asked Questions
Contact our Assisted Reproduction specialists
At Gravida, our team supports you throughout the entire process. We have highly experienced Assisted Reproduction professionals dedicated to solving the most complex cases of infertility. If you’ve experienced failures in your fertility treatments, don’t hesitate to contact us for a personalized evaluation.
📞 Phone: +34 932 066 489
📧 Email: internacional@gravidabcn.com
🌐 Contact form
📍 Gravida
You’ll find us at Hospital de Barcelona (16th Floor)
Av. Diagonal 660, 08034 Barcelona
