When a couple cannot conceive after one year of unprotected sex (or six months when the woman is age 35 or older) but no cause can be identified for these fertility issues, they are said to be experiencing unexplained infertility.
Unexplained infertility diagnosis
The frustrating diagnosis of unexplained infertility is given after basic diagnostic testing fails to reveal a cause for infertility. Many available diagnostic tests are designed to identify major causes of infertility, but some conditions that interfere with conception, such as poor egg quality, have no diagnostic test to pinpoint the cause. Problems with tubal function and sperm function can also be challenging to diagnose and treat.
When testing of both partners reveals no correctable abnormalities, fertility specialists may determine a couple suffers from unexplained infertility.
Treatment of unexplained infertility
Even when no definitive cause has been identified, unexplained infertility can still be treated. Treatment is highly individualized and many reproductive endocrinologists first opt for simple approaches before turning to more costly or complex therapies. Treatment options including the following:
- Intrauterine insemination (IUI) – artificial insemination performed by placing prepared sperm into the uterus. Before an IUI is performed, a woman may be treated with either pills (e.g. Clomid) or injectable fertility drugs to stimulate the ovaries to produce eggs.
- Assisted reproductive technology (ART) – any fertility treatment in which the eggs and sperm are both handled outside the body. The eggs are surgically removed from the ovaries, combined with sperm in a laboratory setting and placed inside the woman’s uterus
In vitro fertilization (IVF) is often the most effective form of ART for the treatment of unexplained infertility, but, even so, many fertility specialists recommend starting with a lesser treatment.
Some couples with unexplained fertility go on to conceive without undergoing active treatment, but the pregnancy rate for these couples is less than that of fertile couples.