Unexplained Infertility

Unexplained infertility occurs when no cause is found for a couple's inability to conceive. About 10 percent of infertile couples suffer from unexplained infertility.

The good news is that couples with unexplained infertility have a 50 percent chance of getting pregnant naturally within a year following diagnosis. However, this chance of conceiving naturally after unexplained infertility is reduced for the following groups of women:

  • Those over the age of 30
  • Those who have never been pregnant before
  • Those who have been trying to conceive for over three years
It may comfort you to know that women in the above groups do, on occasion, spontaneously conceive on their own.

When to see a fertility specialist
An infertility diagnosis generally occurs after a couple (with the female being under 35 years) has been trying to conceive for over one year with no success. For couples where the woman is 35 or older, infertility is diagnosed after they've been trying unsuccessfully for 6 months.

If you have been trying to get pregnant for six months or more, you may want to meet with an infertility specialist or reproductive endocrinologist (RE). When infertility occurs, your doctor may recommend routine testing of your hormones, ovulatory cycles, anatomy, and even of your partner for male factor infertility (semen analysis). If you have unexplained infertility, no apparent problems will be found. 

When choosing a fertility doctor, know that not all OB/GYNs specialize in testing for infertility. The type of workup that an OB/GYN performs may not be as detailed as one that an RE would perform. If unsure, make an appointment with an RE

Treatment for unexplained infertility
There are a number of avenues you can explore to help you get pregnant with unexplained infertility, including:

  • Acupuncture: Many couples have turned to acupuncture to help them conceive. Acupuncture may improve ovarian function and promote rich blood flow to the endometrium lining. Also, studies have shown more effectiveness of some fertility treatments when they are used in conjunction with acupuncture. It should be noted however that some medical problems such as blocked tubes cannot be helped by acupuncture.
  • Intrauterine insemination (IUI): Intrauterine insemination, also known as artificial insemination, injects specially washed sperm directly into the uterus at the precise timing of ovulation. This increases the chances of successful fertilization by getting the best quality and quantity sperm directly where it needs to be. Couples often try this procedure because it isn’t as expensive and time-consuming as in vitro fertilization (IVF).
  • Fertility drugs: Even though there may not be a documented issue with ovulation, doctors sometimes prescribe fertility medications that induce ovulation. Examples include Clomiphene citrate (Clomid), gonadotropins, or FSH. A downside is that these drugs can increase your chances of having twins or multiples. Some of these fertility drugs may be used in conjunction with IUI or other ART.
  • In vitro fertilization (IVF): In vitro fertilization involves egg retrieval, fertilizing the egg with sperm in a lab setting, and transferring the resulting embryo(s) back into the uterus. 
  • Zygote intrafallopian transfer (ZIFT): Fertilization here also occurs in a lab but the embryos are placed in the fallopian tube rather than the uterus.
  • Gamete intrafallopian transfer (GIFT): Here the eggs and the sperm are placed and fertilized inside the woman’s fallopian tubes. The eggs are never removed from the body.
  • Intracytoplasmic sperm injection (ICSI): Commonly used with IVF, during ICSI a single sperm is injected into a mature egg in a lab and the embryo is then transferred to the uterus.

When dealing with unexplained infertility, it is important to be able to communicate openly and honestly with your doctor about the treatment options you may want to explore. Remember, knowledge is power!

Coping with infertility
An unexplained infertility diagnosis can be a very frustrating diagnosis for couples who are trying to conceive. While it may be reassuring that there is no “problem”, it can also be exasperating that there is no solution, especially when you probably expected pregnancy to come easily.

When a couple knows the reason for their fertility problems, stress is often reduced. Couples with unexplained infertility are still left with unanswered questions, sometimes causing feelings of guilt that they did something to cause the new fertility problems.

It can be difficult to know which path to choose when the source of the problem can’t be determined. Despite all the difficult emotions, couples with unexplained infertility should realize that their diagnosis comes from a limitation of science and not of themselves. Current medical technology just isn’t yet capable of determining why they’re having problems getting pregnant.

Ask a doctor about unexplained infertility

Sources
  • IntegraMed: Causes of Infertility, Male Infertility, Female Infertility:
  • BMJ: Unexplained infertility, endometriosis, and fibroids
  • Bruce DF, Thatcher, S. & Berg, B. Making a Baby: Everything you need to know to get pregnant.
  • RESOLVE: The Dilemma of Unexplained Infertility
  • American Pregnancy Association: Treating Infertility using Acupuncture
  • Womenshealth.gov: Infertility:FAQ