What Is Unexplained Infertility?

Young adults often spend many years trying not to get pregnant. Then, when they’re ready to start a family, it can be a shock to discover it’s not so easy after all. About 15% of U.S. couples struggle with infertility, which is defined as not being able to get pregnant after a full year of trying.

Of those couples who struggle to get pregnant and fulfill their dream of having a family, about one-third learn that the issue is with the woman’s reproductive system and another third learn that the problem is due to issues with the man’s semen. About 25% of them receive a diagnosis of unexplained fertility.

On some level, it may be comforting to find out that there is no cause that the doctor can pinpoint and no one is at fault. But with all of the advances in reproductive technology to help people overcome fertility problems, a diagnosis of unexplained fertility is often extremely vexing. If you can’t figure out the cause, how can you treat it? The first step is to get a professional fertility evaluation.

Diagnosing Unexplained Fertility

If you’ve been trying to conceive without success for over a year — or for more than six months if you’re over 35 — the first thing you should do is see a specialist, such as Jehuda Renan, MD, FACOG, for a comprehensive examination. Common health issues that affect a women’s fertility include:

If the problem is due to the male partner, it’s most likely because of abnormal sperm or sperm production.

Dr. Renan’s exam includes a medical history and pelvic exam, and possibly one or more of the following tests:

Men should see their urologist a semen analysis.

If all test results are normal and no health condition is detected, that means your doctor has eliminated the most common causes of infertility and the diagnosis is unexplained fertility. But, that doesn’t mean your infertility can’t be treated.

Treating Unexplained Fertility

The first step in addressing unexplained fertility is lifestyle changes. Smoking, being overweight or underweight, drinking too much alcohol and exercising too much can contribute to fertility problems. The least expensive and invasive way to treat infertility is to start with modifying these lifestyle factors.

If that doesn’t work, Dr. Renan may recommend the following medications and assisted reproductive technologies:

Medications

Medications to stimulate ovulation, such as clomiphene or clomiphene citrate, can increase your odds of getting pregnant, even if your ovulatory cycle is normal, because an increased production of eggs may increase your chances of one of them getting fertilized.

Intrauterine insemination (IUI)

IUI, which is the placement of the man’s sperm into the women’s uterus to maximize the chances of the sperm penetrating the egg, is used with or without ovulation-stimulating medications. Dr. Renan has used this method successfully in hundreds of pregnancies.

In vitro fertilization (IVF)

If the other treatments fail, IVF would be the next step. In vitro fertilization is a more invasive and expensive process but one with strong success rates for those with unexplained infertility.

During IVF, a woman receives ovulation-stimulating medication so she can produce numerous eggs. Following this stimulation, her eggs are retrieved and combined with her partner’s sperm in a laboratory. After embryos are formed, the healthiest one or ones are transferred back into the woman’s uterus.


If you’re having trouble getting pregnant, or want more information about fertility, make an appointment for a comprehensive fertility evaluation with Dr. Renan.

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