Unexplained Infertility is the diagnosis given to couples when doctors cannot find any medical condition to explain why they have not conceived. It is very common, with up to 30% of couples being told they have it. However, “unexplained” does not mean there is not a cause. It is simply that the doctors cannot identify the reason why the couple aren’t getting pregnant.
The biological process of conception is very complicated. There are potentially hundreds of things that could go wrong with either the man or the woman. Standard infertility tests only look at a few of these things. Non-standard infertility tests are often prohibitively expensive or invasive (require cutting the person open). As Unexplained Infertility usually responds well to treatment, treating it is often preferable to taking these more complicated non-standard tests.
Unexplained Infertility is sometimes referred to as Idiopathic Infertility (“idiopathic” being Greek for a disease or condition for which the cause is not known).
Unexplained Infertility Treatment
Treatment for Unexplained Infertility can vary depending on your specific circumstances or the region you live in. However, in the majority of cases couples are first started off with fertility drugs and lifestyle advice. If the medication and lifestyle changes don’t work, IVF is the next most likely step.
Medication and Lifestyle
There are several fertility drugs that can help couples conceive, but the medication most likely to be prescribed for Unexplained Infertility is Clomiphene. This medicine is a tablet taken by the woman and it encourages ovulation (the release of eggs).
Sometimes gonadotrophins are prescribed instead of Clomiphene. These contain follicle stimulating hormone (FSH) and/or luteinizing hormone (LH) and also stimulate ovulation. However instead of a tablet, these are delivered by injections.
At the same time as the drug treatments, couples are given lifestyle advice to maximise their fertility. This includes when to have sex for the highest chance of fertilisation and changes to diet. For more information on lifestyle changes that can help you conceive, check out the sections:
IVF Treatment of Unexplained Infertility
IVF has a good success rate for couples that have Unexplained Infertility. However, it is usually only recommended after the couple have tried the medication and lifestyle changes for several months without success.
IVF involves removing eggs from the woman and fertilising them outside her body, before transferring the developing embryos back in to her uterus. Depending on the region you live in, you may have to pay for this treatment yourself. If this is the case, I strongly recommend you read the section: What to Know Before Choosing a Fertility Clinic.
If either you or your partner have a medical condition or special circumstances, your doctor may recommend a different course of treatment for you. Or if you have tried medication, drugs and IVF without success, your doctor can recommend further treatments. They may even recommend further tests.
You may also independently see other services claiming to assist fertility. Before you spend money on them, ask to see the scientific evidence supporting them so you can make an informed choice on taking them or not. Unfortunately, there are unscrupulous people out there who are willing to sell you snake oil and couples without a clearly defined reason why they are not falling pregnant are more susceptible to this than those who know why they are having problems.
What Else I Should Know About Unexplained Infertility
Age of the Couple
If the woman is over the age of 35, she is more likely to receive a diagnosis of Unexplained Infertility. This likely due to the quality of her eggs degrading with time. While egg quality can be checked, the tests are not very accurate.
Men are also less fertile over the age of 40, as their sperm producing machinery becomes less reliable with age. The older the man becomes, the more likely his sperm are of a lower quality and the longer it will take him to get his partner pregnant.
The Man Hasn’t Been Tested
Occasionally I see women who tell me they have been given a diagnosis of Unexplained Infertility, however upon questioning them, their partners have not been tested. It is assumed that because the man can ejaculate, there is no problem with him. This does not necessarily follow and several common causes of male infertility have no noticeable symptoms.
Men should always be tested for possible causes of infertility regardless of whether they can ejaculate or not. After all, in roughly 30% of cases of couples not being able to get pregnant, the problem is diagnosed as being with the man.
Statistically speaking, healthy couples have only a 1 in 5 chance of getting pregnant each month that they have regular unprotected sex. To put it another way, your normal couple has an 80% chance of not conceiving each month. It could be that you aren’t getting pregnant purely because the dice rolls aren’t coming up for you.
If you have been trying for more than 12 months however, you should definitely go to see your doctor. You can learn more about that in the section: What to Expect When Seeing Your Doctor About Problems Conceiving.