Unexplained Infertility: What It Means & What to Do Next

Unexplained infertility is a diagnosis given when a couple has been trying to conceive for over a year (or six months if the person is over 35) without success, yet no clear cause can be identified. Despite thorough testing, including semen analysis, blood tests and pelvic ultrasounds, the results come back normal. This frustrating condition affects 10-15% of infertile couples and can leave many wondering why they are not conceiving. While this diagnosis can feel overwhelming, there are still effective treatments and options available to increase your chances of a successful pregnancy.

What is Unexplained Infertility?

Unexplained infertility occurs when no specific reason for infertility is found after routine testing and assessments. Despite the normal results from fertility tests, pregnancy is still not occurring, leaving doctors unable to pinpoint the exact issue. Common causes of infertility that are typically ruled out include:

• Ovulatory Disorders – Normal ovulation is confirmed.
• Fallopian Tube Blockage or Damage – Tests show no blockages or structural issues.
• Male Factor Infertility – Semen analysis shows sperm count, motility, and morphology within normal ranges.
• Uterine Problems – Tests show no fibroids, polyps, or structural abnormalities in the uterus.

This condition is often frustrating, as it doesn’t provide answers or clear guidance on what might be preventing conception. However, just because there is no clear cause doesn’t mean there isn’t hope.

Possible Causes of Unexplained Infertility

While the diagnosis of unexplained infertility means no cause has been found, some experts believe there may be subtle factors at play that current testing methods cannot detect:

1. Poor Egg Quality

Although egg quality is a major factor in fertility, it can’t always be measured accurately through standard tests. As women age, the quality of their eggs decreases, which may affect conception even when other factors are normal.

2. Subtle Male Fertility Issues

Semen analysis may not always detect certain sperm abnormalities, such as DNA fragmentation, which can impact fertility. In some cases, sperm may be of good quantity and motility but not have the ability to fertilise an egg.

3. Embryo Quality

Even if an egg and sperm are healthy, the embryo may not have the optimal ability to implant in the uterus. This is difficult to detect through standard testing and may be a contributing factor in unexplained infertility.

4. Immune System Factors

Some women may have immune system issues, such as anti-sperm antibodies or a hostile uterine environment, that prevent pregnancy. These conditions are difficult to identify and may go undiagnosed.

5. Stress & Lifestyle Factors

While stress and lifestyle habits like smoking, alcohol consumption, and poor diet can all negatively affect fertility, their impact is not always detectable through tests.

What to Do Next: Treatment Options for Unexplained Infertility

Even with a diagnosis of unexplained infertility, there are several treatment options that can help increase your chances of conceiving.

1. Lifestyle Modifications

The first step in improving fertility is often lifestyle changes. While there is no direct link between lifestyle changes and resolving unexplained infertility, making healthier choices can improve overall fertility.

• Healthy Diet – A diet rich in fruits, vegetables, lean proteins, and whole grains can support reproductive health.
• Weight Management – Maintaining a healthy weight improves hormonal balance and ovulation.
• Stress Reduction – Techniques like yoga, meditation, and regular exercise can help reduce stress, which may have a positive effect on fertility.
• Avoiding Toxins – Limiting exposure to smoking, alcohol, and environmental toxins can improve both male and female fertility.

2. Fertility Medications

In many cases, medications may be prescribed to stimulate ovulation. Common treatments include:

• Letrozole or Clomid – These oral medications stimulate ovulation and are often used as a first-line treatment.
• Gonadotropins – These hormone injections stimulate the ovaries to produce multiple eggs.

3. Intrauterine Insemination (IUI)

IUI is a procedure in which sperm is directly inserted into the uterus during ovulation to increase the chances of fertilisation. This is often recommended when other treatments fail and is considered a less invasive alternative to IVF.

4. In Vitro Fertilisation (IVF)

If simpler treatments like ovulation induction and IUI don’t work, IVF may be recommended. This process involves fertilising an egg with sperm outside the body and then transferring the resulting embryo to the uterus. IVF is often the most effective treatment for unexplained infertility and may be combined with genetic screening of embryos (PGT) to increase success rates.

5. Advanced Techniques

For those who haven’t had success with conventional treatments, more advanced techniques such as ICSI (intracytoplasmic sperm injection) or egg donation may be considered.

When to Seek Fertility Help

If you have been trying to conceive for 12 months (or 6 months if you’re over 35) without success, it’s time to consult a fertility specialist. Even if the cause of infertility is unclear, a fertility specialist can guide you through your options and help determine the best path forward.

Take the Next Step Towards Conception

If unexplained infertility is preventing you from conceiving, Dr. Basu offers compassionate, personalised care to help you navigate your options. Together, we’ll explore the best treatment approach to help you achieve your goal of starting or expanding your family.

Contact us today to schedule a consultation and take the next step in your fertility journey.