Much higher than 10% of couples have only minor abnormalities that are not severe enough to cause infertility. It is referred to as unexplained infertility in these situations. Undiagnosed and/or difficult to treat problems with egg quality, tubal function, or sperm function may occur in couples with unexplained infertility. (1)
What is unexplained infertility?
Unexplained infertility refers to infertility that continues despite medical professionals’ greatest attempts to determine its obvious cause through testing. Only after both partners have undergone thorough reproductive evaluations do providers make the diagnosis of unexplained infertility. These tests frequently show:
- Your uterus is normal and there are no structural problems.
- Regular intervals are observed for ovulation.
- Your fallopian tubes are open and there are no obstructions.
- Your egg count is healthy (ovarian reserve).
- Hormone levels in your brain that are required for reproduction are normal.
- The semen analysis of your partner is healthy (number, amount, motility, and shape).
Couples can have a baby with the help of assisted reproductive technologies (ART), such as IUI (intrauterine insemination), IVF (in vitro fertilization), and other fertility procedures. (2)
Couples with unexplained infertility have utilized fertility medications and IUI with varying degrees of success. IVF may be suggested if pregnancy does not develop after three to six treatment cycles. (3)
How is unexplained infertility diagnosed?
The methods used for testing are not always accurate, and there is no one fertility test that can identify all anomalies that lead to infertility. For instance, these tests could miss mild abnormalities. Fertility tests, according to the American Society for Reproductive Medicine (ASRM), should include:
- A complete medical and sexual history
- Physical exam
- Blood tests to look at hormone levels
- Semen analysis
- Evaluation of the uterus, fallopian tubes, and other reproductive organs. This could involve an ultrasound exam or more sophisticated imaging procedures like a hysterosalpingogram or laparoscopy.
- Ovarian reserve test
- Ovulation check
If after comprehensive testing the cause is still unidentified, a fertility doctor or obstetrician might make the diagnosis of unexplained infertility. Keep in mind that the fertility testing protocol may differ depending on the provider. (4)
How is a woman’s fertility tested?
It is recommended to schedule a fertility test as early as possible since it may take some time, and female fertility decreases with age. The GP can conduct an initial evaluation to determine the potential causes of fertility problems and provide guidance on the next steps. It is advisable for both partners to attend the GP visit since fertility problems may impact one or both partners.
As trying to conceive can be emotionally taxing, mutual support is essential. It is worth noting that stress is one of the factors that can impact fertility.
The GP will inquire about the woman’s obstetric history, including any prior births, miscarriages, and pregnancy-related issues. The selection of tests will vary based on the individual woman’s medical background and physical assessment, such as ovulation tracking, blood tests, imaging tests, ovarian reserve testing, and laparoscopy.
Your doctor will ask you to weigh yourself to see if you have a healthy body mass index (BMI). Also, your doctor will examine your pelvic area to check for infection, swelling, or tenderness, which could be a sign of fibroids, ovarian tumors, endometriosis, or pelvic inflammatory disease (PID).
What are the treatments for unexplained infertility?
Your healthcare professional will probably suggest treatment based on your fertility test findings and experience with similar couples or people because there is no one cause of infertility. Your age and your desire for an intensive course of therapy are further considerations.
Following are some categories for the most common treatments:
- Assisted Reproductive Technology (ART) including intrauterine insemination (IUI), in vitro fertilization (IVF), and IVF with intracytoplasmic sperm injection (ICSI).
- Lifestyle changes, including avoiding smoking and drinking, maintaining a healthy weight, exercising, and limiting caffeine.
How can I prevent unexplained infertility?
While there are things you can do to increase your chances of conceiving, some infertility factors are out of your control. Some of the factors within your control are:
- Weight: Maintaining a weight that is healthy for you is essential.
- Smoking and drinking alcohol: You should avoid smoking and drinking too much alcohol.
- Sexual history: It’s healthy to reduce your risk of sexually transmitted infections (STIs) by wearing a condom.
It’s helpful to talk to your healthcare provider about your fertility concerns so they can recommend the next steps for your care.
Can I get pregnant with unexplained infertility?
If you have been given an unexplained infertility diagnosis, it is still possible to become pregnant. According to a National Institutes of Health (NIH) study, 92% of couples receiving reproductive treatment for unexplained infertility ended up becoming parents. A diagnosis of unexplained infertility doesn’t require you to give up on having a baby dream.
Moghissi, K. S., & Wallach, E. E. (1983). Unexplained infertility. Fertility and sterility, 39(1), 5-21.