"Unexplained" infertility must be one of the most frustrating terms an infertile couple can hear, yet this is exactly what a good many couples are told by fertility specialists each year. If you receive a diagnosis of unexplained infertility, this means that standard fertility testing has not been able to reveal the reason(s) why you can't get pregnant. You may feel very helpless and alone after hearing that even the experts can't tell you why you're struggling to conceive, but you shouldn't - between 10% and 30% of infertile couples never receive an explanation for their fertility problems. This doesn't mean, however, that your infertility cannot be treated. In fact, in many cases, treatment for unexplained infertility follows a similar pattern to treatment for infertility that has a known cause.
One Year Cut Off Point
To be diagnosed as suffering from reduced fertility, and to be considered a candidate for fertility treatment, you normally need to have been having unprotected, regular sex for one year without getting pregnant at all. At this point, your doctor will refer you for fertility testing. If you are a female over 35, your doctor may refer you earlier for testing, as fertility over this age decreases more rapidly. Tests will be carried out on both you and your male partner (the problem may lie with him - indeed it does in 30%-40% of infertility cases). These tests will look at the sperm quality and reproductive organs of your partner, and at your own reproductive organs and hormones. You'll be asked questions about your sexual routine and lifestyle. Your fertility specialist may suggest changes to your diet and behavior. If at the end of all this, you still can't get pregnant, and the tests don't reveal an obvious problem, you'll probably be told that your infertility is "unexplained." Unexplained infertility can be particularly frustrating because you may be following all the experts' advice, having regular periods and regular sex, and yet still, you just can't conceive.
Who Is Affected?
The likelihood of a diagnosis of unexplained infertility increases with the age of the female partner. The number of cases of unexplained infertility among infertile couples begins to go up after the age of 35, and increases greatly after the age of 38. By the time a woman is 40, she has an 80% chance of suffering from unexplained infertility.
Ovulation inducing medications such as clomid are usually the first course of treatment for unexplained infertility. You may be prescribed clomid and told to time sexual intercourse to coincide with ovulation, but it is more likely that you'll be given clomid and then offered IUI (intrauterine insemination) using your partner's semen. Clomid normally isn't prescribed for more than six months.
Usually, after around three attempts at IUI, you would be offered the chance to try IVF. IVF has been successful in treating couples with unexplained infertility if the woman is under 40 years old and tests of her ovarian reserves (how many eggs she has in her ovaries) have come back normal.
Some fertility experts do not accept unexplained infertility as a legitimate diagnosis. They believe that a reason can be found through more extensive testing. Research is ongoing in this area. If you are not satisfied with your diagnosis, you're within your rights to seek a second opinion.