UNEXPLAINED INFERTILITY
What is Unexplained Infertility?
Unexplained infertility is diagnosed when standard fertility tests and comprehensive evaluations of both partners fail to identify a specific cause for the inability to conceive. This condition can be particularly challenging and frustrating for couples, as it accounts for approximately 10% to 30% of infertility cases. Although no clear cause is found, subtle issues such as minor ovulation problems, poor egg or sperm quality, or minor reproductive tract abnormalities might be contributing factors. The diagnosis of unexplained infertility implies that while all visible indicators of reproductive health appear normal, a hidden barrier to conception exists.
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Potential Contributing Factors
By definition, the causes of unexplained infertility remain unidentified. It is possible for individuals or couples who are otherwise fertile to receive a diagnosis of unexplained infertility if they have not achieved pregnancy after a year of trying. Additionally, some fertility specialists believe that subtle issues may go undetected due to limitations in current testing methods. The most probable causes of unexplained infertility often include:
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Issues with ovulation
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Poor egg quality
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Low sperm quality
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Infrequent or improperly timed intercourse that does not align with ovulation—understanding how to optimize timing can improve chances of conception
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Pelvic health problems, particularly involving the fallopian tubes or uterus
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Hormonal Imbalances
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Difficulties in the interaction between sperm and eggs
It's important to recognize that fertility naturally declines with age, leading to a reduced likelihood of conceiving without assistance as a woman grows older. Consequently, unexplained infertility is more frequently observed in older couples or in women who have been trying to conceive for an extended period, even when ovarian testing appears normal.
Diagnosing Unexplained Infertility
Unexplained infertility is considered a diagnosis of exclusion, meaning all other known causes of fertility issues have been ruled out. For this diagnosis to be made, the woman must demonstrate regular ovulation and have at least one functioning fallopian tube, while the man must show a normal semen analysis. Additionally, examinations of both partners should reveal no other underlying conditions, such as uterine fibroids in the woman or structural abnormalities in the man.
A diagnosis of unexplained infertility is often reached through a process of exclusion, involving:
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Comprehensive Medical History and Physical Exam
Assessing the medical and sexual history of both partners.
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Semen Analysis
Evaluating sperm count, motility, and morphology to rule out male factor infertility.
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Ovulation Assessment
Using hormone level checks, basal body temperature monitoring, and ovulation predictor kits.
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Imaging Tests
Such as ultrasounds and hysterosalpingograms (HSG) to evaluate the uterus and fallopian tubes.
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Laparoscopy
In some cases, minimally invasive surgery may be conducted to identify subtle pelvic issues like endometriosis that standard tests may miss.
If these tests do not reveal a specific cause for infertility, a diagnosis of unexplained infertility may be made.
Treatment Options for Unexplained Infertility
Unexplained infertility does not equate to being untreatable. Although it can be a source of frustration, there are multiple treatment options that may increase the likelihood of pregnancy. The choice of treatment depends on factors such as the couple's age, the length of time they have been trying to conceive, and their personal preferences.
Despite the uncertainty surrounding its causes, unexplained infertility can be treated with several approaches
Maintaining a healthy weight, avoiding smoking, limiting alcohol and caffeine intake, and reducing stress.
Lifestyle Changes
Using medications like Clomid or letrozole to stimulate the ovaries to release more than one egg per cycle.
Ovulation Induction
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Concentrated sperm is placed directly into the uterus during ovulation to enhance the chance of fertilization.
Intrauterine Insemination (IUI)
These hormone injections stimulate egg production and are often combined with IUI.
Injectable Gonadotropins
A highly effective treatment, involving egg retrieval, fertilization in a lab, and transferring the embryo to the uterus. IVF can also help uncover hidden issues with egg quality or fertilization.
In Vitro Fertilization (IVF)
ICSI (Intracytoplasmic Sperm Injection) can be combined with IVF to enhance fertilization success. Genetic screening can detect chromosomal abnormalities in embryos that may cause implantation failure or miscarriage.
ICSI and Genetic Testing
In certain situations, surgery may be suggested to identify or correct structural abnormalities that could be hindering pregnancy.
Surgery
Our specialists will review all available treatment options with patients, taking their personal preferences into account before determining the best course of action. In some cases, a combination of treatments may be advised to enhance the likelihood of conception.
Unexplained Infertility FAQs
Can't find the answer to your question? Contact us here.
Unexplained infertility is challenging because all standard tests for both partners show normal results, yet conception doesn’t occur. This uncertainty can be frustrating for patients who are seeking clear answers.
Yes, unexplained infertility doesn’t mean there’s no cause. It simply means that current diagnostic tools haven’t identified it. Possible factors include egg or sperm quality, subtle fallopian tube defects, or issues with fertilization or implantation.
No, unexplained infertility doesn’t rule out the possibility of pregnancy. Many couples conceive naturally or with treatments like ovulation-stimulating medications, IUI, or IVF.
Up to 20% of women with unexplained infertility have undiagnosed endometriosis. This condition can impact egg quality, fertilization, and embryo implantation, even in mild cases that don’t cause noticeable symptoms.
IVF is often recommended if other treatments, such as timed intercourse or IUI, have failed. IVF can also uncover issues not detected by standard tests, such as egg quality or embryo development problems.
Yes, maintaining a healthy weight, quitting smoking, reducing alcohol and caffeine consumption, and managing stress can positively affect fertility and complement medical treatments.
Genetic testing, such as preimplantation genetic screening (PGS), can identify chromosomal abnormalities in embryos that might contribute to implantation failure or miscarriage.
Yes, intracytoplasmic sperm injection (ICSI) is often part of IVF treatment for unexplained infertility. It increases the chances of fertilization by directly injecting a sperm into the egg.
Success rates vary by treatment:
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No treatment: ~2% per cycle
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Clomid: ~4% per cycle
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Clomid with IUI: ~10% per cycle
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Injectable gonadotropins with IUI: ~20% per cycle
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IVF: Over 50% per cycle
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Unexplained infertility can cause stress, frustration, and emotional exhaustion. Seeking support from a fertility counselor, joining a support group, or working closely with compassionate fertility specialists can provide guidance and reassurance throughout your journey.
Compassionate Care at Nicosia Fertility
At Nicosia Fertility, we understand the emotional burden that comes with an unexplained infertility diagnosis. Our dedicated team offers personalized treatment plans and supportive guidance to help each patient navigate their unique fertility journey. By combining advanced reproductive technologies with holistic approaches, we strive to turn uncertainty into opportunity and help fulfill your dream of parenthood.
