In some couples, no obvious cause for their infertility is found. This is called unexplained infertility
This diagnosis occurs in 15-20% percent of couples after the work-up and evaluation are completed. Unexplained infertility simply means that we do not know why the couple is not fertile. People with unexplained infertility do have a cause for their infertility, but due to limitations of our current testing, we cannot determine the reason.
The diagnosis is one of exclusion-that is, one that is made only after all the tests have been performed and their results found to be normal. Infertility may be labeled as “unexplained” when:
- the woman is ovulating regularly, has open fallopian tubes with no evidence of adhesions or endometriosis;
- the woman has normal AMH levels;
- the man has normal sperm production;
- sexual intercourse takes place frequently, particularly around the time of ovulation; and,
- the couple has been trying to conceive for at least one year.
Here are some possible explanations for unexplained infertility:
- an undiagnosed underlying (non-reproductive) medical problem, such as thyroid disorders, diabetes or an autoimmune illness;
- mild endometriosis;
- the sperm has adverse reactions to the vaginal environment;
- poor egg quality caused by age, an underlying medical condition, or some yet unknown cause;
- poor sperm quality, such as problems with DNA;
- problems with the lining of the uterus that impacts an embryo’s ability to implant; or
- something causing your infertility that is completely unknown to medical professionals at this time.
Reproductive specialists treat unexplained infertility by optimizing your chances
Because unexplained infertility carries no specific diagnosis, the treatment recommended by fertility specialists is empiric. This means that the treatment is done to optimize a couple’s chance of successful conception but is not used to treat or overcome a specific problem. Sometimes the diagnosis is simply not as straightforward or easy to diagnose. Instead of spending valuable time on testing, it is more efficient to treat subtle defects of ovulation or sperm function with medication combined with artificial inseminations.
In some instances, couples with unexplained infertility will conceive over time with no treatment. In fact, 50% of couples diagnosed with unexplained infertility, who have never had a child before, will conceive within five-and-a-half years. For those couples wishing to expedite this process and not simply wait, there are proven methods to increase the chance of pregnancy even when no specific diagnosis can be made. In vitro fertilization is a good option for couples diagnosed with unexplained infertility who wish to move ahead with proven treatment with good success rates.