Causes & Treatment for Unexplained Infertility

After planning to have a baby, a normal and healthy couple could take up to one year to conceive. However, if a couple does not conceive in spite of having regular, unprotected sex for more than a year, it could be because of infertility issues.

Statistics show that infertility problems affect around 10% to 15% couples across the US. In about 33% of the cases, conception does not occur because of female infertility issues.


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Male fertility problems can also be found in around 33% of the cases. In the rest of the cases, infertility causes may be either unexplained, or a combination of both male and female factors.

Unexplained infertility, affecting around 20% of the couples can be described as idiopathic infertility, as the causes remain uncertain, even after conducting an infertility evaluation, which includes –

  • A Hysterosalpingogram or the assessment of the fallopian tubes and the uterus, with the help of an x-ray
  • A confirmation of proper ovulation through lab tests
  • A semen analysis in men

In case the results of these tests are normal in a couple that has not been able to conceive for a year, the diagnosis of unexplained infertility may be made. This means that the couple may have problems conceiving, due to some insufficiency in the conception process, in spite of normal ovulation, fallopian tubes and semen analysis.

Fortunately, most couples with unexplained infertility do get pregnant eventually. The problems caused by inefficiency during conception can be overcome with increased efforts and time. However, it could take up to 6 or 7 years for a couple with unexplained infertility to conceive.

What causes unexplained Infertility

Most instances of unexplained infertility are probably caused by factors that are present, but cannot be detected by current testing methods. Though an infertility evaluation is a good initial screening procedure, it does not detect all the infertility causes. A diagnosis of unexplained infertility could mean that something is wrong at a more basic level.

Causes of unexplained infertility

  • At times, a semen analysis may show that the sperm quality and movement is normal. However, the sperm may not function adequately during the fertilization process.
  • The quality of the eggs has a huge impact on fertilization. Eggs of poor quality may get fertilized at a lower rate, or may not get fertilized at all. The outer shell of the egg may not allow the sperm to enter or could let too many sperm enter the egg.
  • After fertilization it takes around 5 days or so for the egg to develop into a blastocyst of 120 cells with a fluid cavity in the middle.

    If a large percent of the embryo divides slowly, or stops dividing at any point, it can result in infertility problems.
  • Once the embryo reaches the uterine cavity there may be problems with implantation or normal attachment.
  • If implantation does occur, a thick and hard outer shell of the embryo may not allow the hatching to come out.
  • Genetic abnormalities with the embryo could also cause infertility.

Most of these causes are not detected through infertility evaluation tests, which is why the reason of infertility remains unclear.

Treatment for unexplained Infertility

One of the most common approaches for dealing with unexplained infertility is the reassurance to keep trying through natural conception. However, it could take several years to conceive with unexplained fertility, which may not be feasible for older couples. In such instances, a couple could choose to go in for medical intervention to increase the chances for conception. If there is no correctible abnormality causing fertility, the therapy path recommended for the couple will be empiric. Some of the proposed treatment regimens that may be suggested include –

  • Intrauterine insemination
  • Climophene Citrate therapy
  • Injectable fertility drugs and intrauterine insemination
  • Assisted Reproductive Technology (ART)

However, these medical procedures do not guarantee that a couple will conceive. Moreover, these treatment options are quite expensive and therefore, they may be unaffordable for most people. There is also a high chance of multiple pregnancy and subsequent sequela with such medical interventions.

Some of the causes of unexplained infertility can be treated with medical intervention, though certain abnormalities may be beyond the reach of medical experts. It is therefore best to start off with empiric treatment with insemination for around three to six months before switching over to a more aggressive treatment plan that includes In Vitro Fertilization (IVF).

Many couples have managed to conceive successfully with less invasive and less expensive treatment options.

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