Unexplained Infertility

August 26, 2020

Getting a diagnosis of ‘unexplained infertility’ can be frustrating, but it can actually be a good thing, as it may mean there is not anything seriously wrong with either you or your partner. Roughly 20-30% of couples may experience unexplained infertility. However, 30-40% of these people may eventually conceive within 7 years.

So, what is unexplained infertility? Unexplained fertility issues are when a specific reason for the inability to conceive can’t be found after doing a full diagnosis. In the reproductive system and to ensure a viable pregnancy can occur, there are hundreds of factors that contribute. If one of these factors is disrupted, it can lead to infertility. Unfortunately, there are not tests available for all parts of the process. There are also some issues that may only come to light through IVF, such as issues with fertilisation or implantation.

If you are having intercourse regularly and specifically around the time of ovulation and don’t conceive after two years, you may want to go and get a fertility test. Please read our article on how to get pregnant naturally here.

As unexplained infertility is a diagnosis of elimination, your doctor will have to go through a full fertility test with you. You may be given the diagnosis of unexplained infertility if:

– The woman is ovulating correctly and regularly
– The woman’s blood work and or antral follicle count shows that ovarian reserves are adequate
– Fallopian tubes are patent with no adhesions around them
– There are no pelvic adhesions or endometriosis
– There are no uterine fertility issues such as significant fibroids
– The male’s semen analysis is normal (total sperm count, movement and shape)

If you are having trouble conceiving, please get in touch and we can help. At The Evewell, we are fertility experts and have 20+ years experience in gynaecology and fertility, so we will know the best way to support you in your journey.

Are idiopathic infertility and unexplained infertility the same?

No, idiopathic infertility and unexplained infertility are not the same. Although idiopathic translates to ‘unexplained’, in terms of infertility, actually means when either the male semen analysis results are not normal or the female isn’t ovulating correctly, but the reasons that are unknown. With unexplained infertility, the female eggs and sperm seem fine, but the couple still can’t conceive.

Possible causes of unexplained infertility

There will always be a reason for infertility, we just may not currently know what it is. As mentioned, the reproductive process has multiple steps, but there aren’t ways to measure and evaluate all of them yet. Some possible reasons for unexplained infertility are:

Non-reproductive medical problem – poor health or some other medical conditions may affect fertility. If some conditions are underlying and untreated, such as celiac disease, thyroid disorder, diabetes or some autoimmune diseases, they may lead to infertility
Poor egg quality – You may be ovulating and there may be a good quantity of eggs, but if your quality of eggs is poor, this may cause infertility. There is currently no test for egg quality, but it may be caused by age or underlying medical condition
Poor sperm quality – Through semen analysis, we can determine whether the sperm shape, motility or quantity are ok. However, there are some sperm issues which are not recognisable in a semen analysis, such as if the sperm has a low quality of DNA
Fertilised egg development – sometimes a healthy sperm fertilises an egg but then it’s ability to become a healthy embryo is disrupted
Endometrium issues – Sometimes a healthy egg and sperm form a health embryo, however it is unable to impact into the endometrium in the uterus
Vaginal environment – sperm must make its way through the cervical mucus and vagina, into the uterus. However, sometimes there are problems during this journey, for example antibodies in the cervical mucus that attacks the sperm, this is called ‘hostile cervical mucus’

In some cases, the issue could also be unknown to fertility experts or there may not actually be anything seriously wrong.

Unexplained infertility treatment

If you are having issues trying to conceive or are worried that you may be experiencing some fertility issues, please get in touch with us. As fertility specialists, we will be able to guide you through the right tests and options for your specific situation. However, two of the most common treatments for unexplained fertility are IVF and IUI. Find out more below.

Unexplained infertility IVF

IVF has the highest success rates for couples who suffer unexplained fertility and can also help diagnose some of the possible causes of it such as poor sperm, egg or embryo quality, as these will all be examined during the IVF process. Read our guide on what is IVF here.

Unexplained infertility IUI

IUI is also a highly suggested and successful treatment for unexplained infertility. It is a minimally invasive option and leads to increased pregnancy rates, when compared to trying to conceive naturally. Please read our guide on IUI here.


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