{"id":33822,"date":"2025-06-04T08:00:00","date_gmt":"2025-06-04T06:00:00","guid":{"rendered":"https:\/\/www.dexeus.com\/fertility\/blog-fiv\/per-que-no-em-quedo-embarassada\/"},"modified":"2026-03-23T11:36:37","modified_gmt":"2026-03-23T10:36:37","slug":"infertilitat-de-causa-desconeguda","status":"publish","type":"post","link":"https:\/\/www.dexeus.com\/fertility\/ca\/blog-fiv\/infertilitat-de-causa-desconeguda\/","title":{"rendered":"Per qu\u00e8 no em quedo embarassada?"},"content":{"rendered":"

Tret que hi hagi antecedents familiars, poques persones creuen que poden tenir problemes de fertilitat. Per\u00f2 si fa un any que intentes quedar-te embarassada sense \u00e8xit, hauries de consultar a un especialista. I si tens m\u00e9s de 35 anys, s’aconsella anar-hi abans, al cap de 6 mesos. La ra\u00f3 \u00e9s que a partir d’aquesta edat la fertilitat femenina descendeix de manera progressiva. Per aix\u00f2, si existeix algun problema \u00e9s important detectar-lo al m\u00e9s aviat possible per no allargar l’espera de manera indefinida i perdre temps.<\/p>\n

\u00c9s cert que demanar visita costa. I acceptar que podem tenir un problema de fertilitat tamb\u00e9. Per\u00f2 el que ning\u00fa s’espera \u00e9s que despr\u00e9s de fer-se les proves habituals, els resultats indiquin que \u201ctot \u00e9s normal\u201d i no hi hagi una explicaci\u00f3. Aquesta situaci\u00f3 s’anomena t\u00e8cnicament esterilitat d’origen desconegut (EOD)<\/strong> o idiop\u00e0tica<\/strong>, i per a molts experts continua sent un tema controvertit, ja que la falta d’un diagn\u00f2stic fa dif\u00edcil decidir quina pot ser l’estrat\u00e8gia que cal seguir.<\/p>\n

No obstant aix\u00f2, alguns especialistes afirmen que aquest concepte tal vegada no hauria d’utilitzar-se, ja que hi ha problemes que no es poden detectar en un diagn\u00f2stic rutinari<\/strong>. \u201cPer aix\u00f2, \u00e9s molt important establir quines proves diagn\u00f2stiques<\/strong> es requereixen abans d’arribar a la conclusi\u00f3 que estem davant una EOD\u201d, explica el Dr. Josep Gonzalo<\/a><\/strong>, especialista en reproducci\u00f3 assistida i director del centre Dexeus Dona de Reus<\/strong>. A continuaci\u00f3, responem a alguns dubtes sobre aquest tema:<\/p>\n

Es tracta d’un problema freq\u00fcent?<\/strong>
S\u00ed. La infertilitat d’origen desconegut (EOD per les seves sigles en espanyol) representa aproximadament un 30% dels casos d’infertilitat, encara que aquest percentatge pot variar entre el 8% i el 37% segons el grau d’exhaustivitat de l’estudi diagn\u00f2stic realitzat.
Hi ha un perfil tipus<\/em> de pacient?<\/strong>
No hi ha un perfil \u00fanic. No obstant aix\u00f2, moltes vegades afecta dones joves amb funci\u00f3 ov\u00e0rica normal, trompes permeables i sense alteracions estructurals uterines. Aix\u00ed i tot, la casu\u00edstica \u00e9s bastant diversa i dep\u00e8n tamb\u00e9 del context cl\u00ednic i geogr\u00e0fic.
Quin tipus de proves inclouen els tests de fertilitat b\u00e0sics?<\/strong>
Les proves b\u00e0siques inclouen: hist\u00f2ria cl\u00ednica, sexual i reproductiva detallada, avaluaci\u00f3 sangu\u00ednia amb avaluaci\u00f3 hormonal, estudis tub\u00e0rics (histerosalpingografia (HSG) o HyCoSy) i ecografia transvaginal (idealment 3D) per descartar anomalies uterines. En cas de tenir parella masculina, tamb\u00e9 una an\u00e0lisi de semen segons criteris OMS.
Quines condicions d’infertilitat poden quedar-se fora d’aquestes proves inicials?<\/strong>
Endometriosi lleu, alteracions immunol\u00f2giques, defectes d’implantaci\u00f3 endometrial, anomalies gen\u00e8tiques o epigen\u00e8tiques. Aquestes condicions requereixen estudis m\u00e9s espec\u00edfics o invasius per a ser detectades.
Quina estrat\u00e8gia o protocol d’actuaci\u00f3 se segueix davant una EOD?<\/strong>
El protocol suggerit inclou: confirmar el diagn\u00f2stic per exclusi\u00f3 i calcular el pron\u00f2stic de concepci\u00f3 natural (\u00e9s una estimaci\u00f3 de gestaci\u00f3 que fa l’especialista en funci\u00f3 de cada cas). A partir d’aqu\u00ed, segons el pron\u00f2stic, es decideix si esperar uns mesos o iniciar algun tractament de reproducci\u00f3<\/a>.
Quines altres proves se solen demanar en aquests casos per a ampliar la informaci\u00f3?<\/strong>
Estudis de receptivitat endometrial; proves immunol\u00f2giques; estudis gen\u00f2mics i laparosc\u00f2pia diagn\u00f2stica (nom\u00e9s si hi ha sospita d’endometriosi o una altra patologia). Cal destacar que poques d’aquestes proves tenen alta qualitat d’evid\u00e8ncia, i el seu \u00fas es limita o es recomana nom\u00e9s en el context de recerca.
Quan pot estar indicat fer un estudi d’immunologia?<\/strong>
Nom\u00e9s en casos seleccionats amb antecedents cl\u00ednics rellevants, com a p\u00e8rdues gestacionals recurrents, malalties autoimmunes conegudes o fallades repetides d’implantaci\u00f3. No es recomana de manera sistem\u00e0tica en tots els casos de EOD.
\u00c9s convenient allargar una mica m\u00e9s els intents d’embar\u00e0s de manera natural abans d’optar per la reproducci\u00f3 assistida?<\/strong>
S\u00ed, si el pron\u00f2stic de concepci\u00f3 natural \u00e9s alt. Segons els models predictius, parelles amb probabilitat >30% en 12 mesos poden esperar entre 6 i 12 mesos abans d’iniciar tractaments, la qual cosa evita intervencions innecess\u00e0ries. Cal tenir en compte que canviar d’h\u00e0bits tamb\u00e9 pot millorar la fertilitat, em refereixo a deixar de fumar, no beure alcohol, mantenir un pes saludable, fer exercici almenys 30 minuts al dia, limitar la cafe\u00efna, reduir l’estr\u00e8s i dormir b\u00e9.
En el cas d’iniciar un tractament de reproducci\u00f3, quin s’aconsella?<\/strong>
La primera l\u00ednia de tractament recomanada \u00e9s la inseminaci\u00f3 intrauterina<\/a> (IUI) amb estimulaci\u00f3 ov\u00e0rica lleu, generalment durant 3 a 6 cicles. Si no hi ha \u00e8xit, es pot considerar la FIV<\/a>. L’\u00fas de ICSI nom\u00e9s s’indica si hi ha un factor mascul\u00ed identificat.
Quins resultats ofereixen les diferents t\u00e8cniques de reproducci\u00f3 assistida en aquesta mena de pacients?<\/strong>
En pacients amb mal pron\u00f2stic natural, la IUI amb estimulaci\u00f3 ov\u00e0rica ha mostrat millores en taxes d’embar\u00e0s que la gestaci\u00f3 expectant. La FIV no ha mostrat beneficis clars sobre IUI en aquest grup. I la ICSI no millora resultats respecte a la FIV convencional si no hi ha un factor mascul\u00ed. En resum: la FIV no aporta millors taxes d’\u00e8xit que la IUI en pacients amb EOD i bon pron\u00f2stic, la qual cosa refor\u00e7a un enfocament progressiu en el tractament.
Per acabar: hi ha esperan\u00e7a?<\/strong>
S\u00ed. Malgrat la incertesa que envolta a la infertilitat inexplicada, moltes parelles aconsegueixen concebre, sigui de manera natural o amb tractament. Gr\u00e0cies als aven\u00e7os en la medicina reproductiva i a l’\u00fas de models pron\u00f2stics, avui \u00e9s possible personalitzar les estrat\u00e8gies, reduir intervencions innecess\u00e0ries i millorar els resultats.<\/p>\n","protected":false},"excerpt":{"rendered":"

Tret que hi hagi antecedents familiars, poques persones creuen que poden tenir problemes de fertilitat. Per\u00f2 si fa un any que intentes quedar-te embarassada sense \u00e8xit, hauries de consultar a un especialista. I si tens m\u00e9s de 35 anys, s’aconsella anar-hi abans, al cap de 6 mesos. La ra\u00f3 \u00e9s que a partir d’aquesta edat […]<\/p>\n","protected":false},"author":1,"featured_media":33823,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[64],"tags":[],"class_list":["post-33822","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized-ca"],"yoast_head":"\nPer qu\u00e8 no em quedo embarassada? | Dexeus Fertility<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.dexeus.com\/fertility\/ca\/blog-fiv\/infertilitat-de-causa-desconeguda\/\" \/>\n<meta property=\"og:locale\" content=\"ca_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Per qu\u00e8 no em quedo embarassada? | Dexeus Fertility\" \/>\n<meta property=\"og:description\" content=\"Tret que hi hagi antecedents familiars, poques persones creuen que poden tenir problemes de fertilitat. 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