Unexplained Infertility and What That Means 

Human fertility is incredibly complex. There are so many variables that have to be just right for pregnancy to happen. That’s why we can’t always determine the exact cause of infertility. However, just because there isn’t a detectable reason doesn’t mean there aren’t any options to help you have kids. Below you’ll find possible explanations for unexplained infertility and fertility treatment options, such as IVF treatment, medications, and lifestyle changes, that have helped people all over the world have babies and grow their families. 

What is unexplained infertility? 

Unexplained infertility is the diagnosis you receive when all the standard infertility tests don’t show any obvious problems. Often, your test results will look something like this: 

• Hysteroscopy reveals no uterine fertility issues, such as cysts or fibroids 
• Regular ovulation occurs 
• HSG reveals healthy and open fallopian tubes 
• Blood work or an antral follicle count shows you have good ovarian reserves 

Unexplained vs. idiopathic infertility

When doing research on unexplained infertility, you might come across the term “idiopathic infertility.” This term is generally used when your doctor has narrowed down the cause of infertility to be specifically male or female factor but can’t find a more precise reason.  

Possible explanations for unexplained infertility 

As research into unexplained infertility has advanced, scientists have found possible causes that won’t show up on standard fertility testing. Here are some of the potential explanations: 

• Undiagnosed underlying conditions: There is still a lot of research to be done on how underlying medical conditions influence fertility, but we do know that things like thyroid conditions, diabetes, and celiac disease can contribute to infertility. 

• Endometriosis: The growth of uterine tissue outside the uterus can be very hard to detect, but even mild cases of endometriosis can affect your fertility. 
• Problems with cervical mucus: Your cervical mucus is integral in helping sperm reach your egg. If there are issues with the consistency or makeup of your cervical mucus, it can prevent fertilization. 
• Poor egg quality: While it’s easy enough to measure your egg reserves, those tests can’t provide much detail on the quality of your eggs. 
• Issues with uterine lining: Problems can occur when your endometrium, the lining of your uterus, doesn’t thicken or prepare itself for fertilization. This is also called a luteal phase defect. 
• Problems with timing: If the frequency and timing of sex aren’t synchronized with your ovulation, this can decrease your chances of getting pregnant. 

• Unknown factors: Some factors aren’t yet known to scientists. It’s entirely possible that your infertility doesn’t have a known medical explanation. 
• Nothing may be wrong: It’s not unheard of for people to take longer to get pregnant. Rates of spontaneous pregnancy for women with unexplained infertility in the first two years of trying can be as high as 35%. For under 35, rates can reach as high as 80%. 

How is unexplained infertility diagnosed? 

Diagnosing unexplained infertility in women involves an extensive battery of female fertility tests to rule out any of the usual suspects. The American Society of Reproductive Medicine (ASRM) says female fertility testing should include the following: 

• A complete medical and sexual history 
• A physical exam 
• Assessment of your reproductive organs such as ovaries, fallopian tubes, and uterus 
• Ovarian reserve testing 
• Checking your ovulation 

If comprehensive female fertility testing doesn’t turn up any obvious causes, your fertility specialist may diagnose you with unexplained infertility. Each fertility treatment provider may have a different protocol for testing, so don’t hesitate to seek out a second opinion. Finding the right fertility support might mean consulting several specialists. 

Infertility treatment options

The frustrating thing about unexplained infertility is that there isn’t one specific issue we can point to in order to resolve your infertility. Fortunately, that doesn’t mean there aren’t proven methods to help you get pregnant. 

Assisted reproductive technologies 

Assisted reproductive technologies (ART) are a group of different methods used to help you get pregnant. They involve removing an egg from your body in order to introduce sperm to it and create an embryo, which is then inserted back into your body. 

IVF 

In vitro fertilization (IVF) is a specific process that uses medication to stimulate the production of multiple eggs, which are extracted and introduced to sperm to create multiple embryos. These embryos are then injected directly into your uterus during your peak fertility window. IVF success rates are generally higher than those of other infertility treatments, although the procedure is more invasive. 

Medications 

Clomid is the most commonly prescribed fertility medication. It can help if you ovulate irregularly or not at all. It can also boost sperm production. This first step is often prescribed by your gynecologist before you seek out fertility support services. 

Keep in mind that Clomid has side effects, and doctors don’t recommend that you take it for more than 6 months as it can increase your risk of cancer. 

Lifestyle choices 

While there isn’t any research proving concretely that improving your overall health increases your chances of getting pregnant, we do know that certain lifestyle factors influence fertility. It’s with that logic that doctors recommend making the following lifestyle choices: 

• Avoid smoking, drinking alcohol, and using recreational drugs. 
• Maintain a healthy weight. 
• Eat a well-balanced diet. 
• Try to get 30 minutes of exercise each day. 

• Limit caffeine consumption. 
• Reduce your stress. 

Identify your fertility window 

Your fertility window is the few days around the middle of your menstrual cycle when ovulation occurs and you are at your most fertile. This is the time you and your partner should be having sex. Your doctor can work with you to identify your fertility window, either by charting your cycle, checking your temperature, or using ovulation kits to predict ovulation. 

When should you talk to a fertility specialist? 

Most healthcare providers recommend that you spend at least 12 months trying to get pregnant naturally before seeking out a fertility specialist. If you’re over the age of 35, that window is shortened to just 6 months.

Unexplained infertility is never an easy diagnosis to hear, but don’t give up hope. You have a lot of treatment options and resources to support you on your fertility journey.