Unexplained Infertility: What It Is and What Are Your Options

Infertility is defined as a disease, condition, or status characterized by the need for medical intervention, including, but not limited to, the use of donor gametes or donor embryos in order to achieve a successful pregnancy either as an individual or with a partner and is inclusive of LGBTQ+ and single communities.

In patients having regular, unprotected intercourse and without any known etiology for either partner suggestive of impaired reproductive ability, evaluation should be initiated at 12 months when the female partner is under 35 years of age and at six months when the female partner is 35 years of age or older.

It affects approximately 10 - 15% of couples throughout the United States (one in eight). This diagnosis is given to an individual or couple—depending on their age and medical history—if they have been attempting to conceive for at least a year without achieving or being able to sustain a pregnancy. In this blog, we’ll review what is referred to as, “unexplained infertility,” which is when no clear cause of infertility can be determined, which can be very frustrating.

What is idiopathic infertility?

When you’ve been trying to conceive for the recommended amount of time and have not been able to get pregnant, it’s recommended you see a fertility specialist for an initial consultation. For women, this would entail an ultrasound and blood work to look at hormones such as her Follicle-stimulating hormone (FSH), Luteinizing hormone (LH), Estradiol and her Anti-Müllerian Hormone (AMH). If no clear cause for infertility is seen after a review of health history and these tests are done, it is idiopathic, meaning it remains unknown.

It’s also important to mention that this can come up as a cause of secondary infertility. A report by the National Center for Health Statistics NCHS estimates that there are more than 3 million US women with one child that have a difficult time getting pregnant again. Even if you didn’t have any issues getting pregnant the first time, but you’re having difficulties the second time, unexplained infertility may be a factor.

What are the chances of getting pregnant with unexplained infertility?

What’s both good and bad about unexplained infertility is that while you can’t pinpoint what is preventing you from getting pregnant, you also have room to believe that there’s still nothing fully stopping you from conceiving. According to Oxford Academic, the overall success rate in couples with unexplained infertility is high. In fact, according to the NCBI, those who are diagnosed with unexplained infertility have a 50% chance of getting pregnant naturally within a year following diagnosis. So the odds are encouraging.

How do you treat unexplained infertility?

If no clear cause can be determined through initial tests, there are additional tests that can be ordered to see if they may uncover any additional information regarding yours or your partner’s fertility health. There’s a test that can be performed on a woman called a Hysterosalpingogram (HSG), which is like an x-ray of your uterus to see if it’s misshapen or if you have any uterine polyps, which could be problematic for a pregnancy.

There’s also laparoscopic surgery. This can help your doctor diagnose and remove endometriosis, as well as reopen a blocked fallopian tube, amongst many other indications.

Overall, if the individual or couple is looking to have children, the treatment options would most likely involve looking at fertility treatment options.

How successful is IUI for unexplained infertility?

Intrauterine insemination (IUI) is one fertility treatment option that can be used when you’ve been diagnosed with unexplained infertility. In terms of success rates, it can depend on your age. In general, IUI is typically the first approach when going down the path of assisted reproductive technology. It requires inserting either the male partner’s or a donor’s sperm directly into a woman's uterus when she is ovulating. IUI is often done in conjunction with ovulation-stimulating drugs.

Alternatives for conception

While many don’t necessarily dream of conceiving their child through the assistance of medical intervention, when it comes to unexplained infertility, assisted reproductive technology can be incredibly helpful. In addition to the above mentioned IUI, there are common infertility treatment options you and your doctor can discuss and decide what would be the best course of action for you but some additional options are:

• In vitro fertilization (IVF): This is when a woman’s eggs are retrieved and combined with her partner or donor’s sperm in a laboratory. After fertilization, the resulting embryos will be transferred to the woman’s uterus.
• Intracytoplasmic sperm injection (ICSI): This is when a single sperm is injected directly into a woman’s egg, rather than placing many sperm next to the egg, as in IVF.
• Donor egg or embryo: If a woman is unable to conceive with her own eggs or for same sex male couples, they can have IVF treatment using eggs donated by a woman. The donor egg is combined with a partner's sperm, and the resulting embryo is transferred to the intended mother or gestational carrier’s uterus. This procedure can also be done with a donated embryo or donated sperm.
• Surrogacy (gestational carrier): Another woman carries your embryo or donor embryo to term and gives birth to your baby.

Not having definitive answers can be frustrating especially when you’re eager to hold a baby in your arms. What’s important to remember is that while having a family may not be in the timeline or even in the way that you had hoped, when you hold your child in your arms, how you got there won’t matter. What’s comforting is that the odds are in your favor for success and you have ConceiveAbilities to turn to by clicking here now to explore the many pathways to parenthood.