Understanding Unexplained Infertility

HOW DOES UNEXPLAINED INFERTILITY AFFECT CONCEPTION SUCCESS?

Most people with unexplained infertility who get and stick with fertility treatment will successfully conceive - 92% according to one study. The lack of an explanation for infertility doesn’t appear to be an obstacle to getting pregnant in many cases, once fertility treatment is initiated.

Also, data shows that up to 64% of people with unexplained infertility for one pregnancy may eventually conceive spontaneously for a subsequent pregnancy.

WHAT ARE SOME POTENTIAL CAUSES OF UNEXPLAINED INFERTILITY?

By definition, unexplained infertility does not have a known cause. While it can be frustrating to not know the underlying issue, it often makes sense to shift resources toward treatment rather than continuing down the path of finding an explanation. 

Historically, some people with mild or asymptomatic endometriosis would be told they have unexplained infertility. Today, however, we know to look for and rule out endometriosis.

Some causes of unexplained infertility fall outside of what we’re able to test for. For example, the true quality of eggs or sperm can’t be determined using diagnostic testing. Another example is that while we can check that the fallopian tubes and uterus are free of obstacles, that doesn’t necessarily tell us that these organs are working in the precisely orchestrated way that they need to support conception and pregnancy.

Or, there may be an underlying fertilization issue, poor embryo development, an implantation issue, or age-related subfertility, resulting in chromosomally abnormal embryos.

HOW IS UNEXPLAINED INFERTILITY DIAGNOSED?

At Boston IVF, all new patients go through a standard set of diagnostic tests. Plus, additional testing is done if your doctor determines it to be necessary.

For people with female reproductive organs, these tests will look at menstrual hormones and ovulation, egg quantity (ovarian reserve), thyroid function, and whether the uterine cavity is normal and the fallopian tubes are open. A complete health history will indicate important symptoms like very painful periods or pain with sex, which could merit further investigation.

For people with male reproductive organs, a semen analysis gives us an idea of the quantity, shape, and movement of the sperm. Their health history would indicate other potential issues, like premature ejaculation or erectile dysfunction.

If these tests do not give a clear answer, your doctor may determine that your infertility is unexplained. If you have insurance, this paves the way for you to proceed with necessary fertility treatments by providing a diagnosis, even though it isn’t definitive.