Unexplained Infertility
Sometimes, fertility testing reveals no clear cause for why conception hasn’t occurred. This is known as unexplained infertility, a diagnosis that can feel both frustrating and confusing. While all the standard test results may appear normal, that doesn’t mean something isn’t happening beneath the surface.
The good news: treatment is often highly effective, especially when guided by a team with deep experience and access to advanced reproductive technologies.
What is unexplained infertility?
Unexplained infertility is a diagnosis given when standard fertility testing doesn’t identify an obvious issue with ovulation, sperm quality, fallopian tubes, or the uterus. This diagnosis is typically made after one year of trying to conceive (or six months if over age 35), followed by a full fertility workup.
It’s more common than many people realize—affecting up to 30% of couples with infertility.
Unexplained doesn’t mean untreatable. It simply means the next step is a more strategic approach to treatment.
How unexplained infertility affects fertility
Unexplained infertility means that all the pieces appear to be in place—but pregnancy still hasn’t occurred. This can feel especially discouraging because it lacks a clear “problem” to solve. That’s why the focus quickly shifts to what can be done next, rather than finding a definitive cause.
With a diagnosis of unexplained infertility, treatment is designed to increase the chances of conception with each cycle, while minimizing delays.
How unexplained infertility is diagnosed
Unexplained infertility is typically diagnosed after a thorough evaluation confirms:
- Regular ovulation
- Normal semen analysis
- Open fallopian tubes (confirmed by HSG or saline sonogram)
- Healthy-appearing uterus without abnormalities or scarring
Additional testing—such as ovarian reserve evaluation or advanced sperm testing—may also be included. Once all results fall within expected ranges and no other cause is identified, the diagnosis is considered unexplained.
Treatment options for unexplained infertility
Treatment focuses on increasing the chances of egg and sperm meeting under optimal conditions. Options often follow a stepped approach:
- Timed ovulation with IUI: Medication (like letrozole or clomiphene) stimulates ovulation, and IUI helps sperm reach the egg more efficiently. Often used as a first-line approach.
- In vitro fertilization (IVF): Offers greater control over fertilization, embryo development, and selection. IVF can also uncover previously undetected issues, such as failed fertilization or abnormal embryo growth.
Your care team will guide you through these choices with a personalized plan—based on your age, timeline, and previous treatment history.
At IVF Florida, unexplained doesn’t mean unanswered. We’ll help you explore every option with clarity, compassion, and the advanced care you deserve.
Dr. Bou Nemer is extremely knowledgeable and professional. She is always patient with explaining options and procedures and is highly empathetic.