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The Good and Bad News About Unexplained Infertility

Unexplained infertility is undoubtedly a frustrating diagnosis. And the truth is, it’s both good news and bad news.

The good news is unexplained infertility means nothing specific has been found that should keep you from getting pregnant. However, that’s also the bad news — we don’t know exactly why you have not been able to get pregnant.

Let’s address some of the common questions patients ask about unexplained infertility.

How do I get diagnosed with unexplained fertility?

To determine the cause of infertility, we perform several tests on both partners. In men, we look at sperm count and characteristics, including motility and shape, and we determine the likelihood of those sperm to fertilize an egg based on those characteristics.

In women, we evaluate ovarian function, monitor for proper ovulation, perform a tubal and uterine evaluation, and check various hormone levels.

Combined, these tests help us rule out male factor, ovulatory factor, tubal factor and uterine factor infertility. With no apparent form of infertility, this leaves us with the diagnosis of unexplained infertility.

What exactly does unexplained infertility mean?

Unexplained infertility is essentially a diagnosis of elimination. Fertility testing did not find a specific cause for the failure to conceive.

Essentially, patients with unexplained infertility look good on paper, but in practice, things are not working out as they should. Despite being categorized as “unexplained,” there may be a root cause of the infertility, but it’s not showing up in standard fertility testing.

What many couples don’t realize is that a number of things have to happen at the perfect time in order to get pregnant, and an issue anywhere in the process can cause failure to conceive. Even for fertile couples, the chance of getting pregnant in a given month is only between 18 and 20 percent.

Does having unexplained infertility mean I can never get pregnant?

More than 10 percent of couples trying to conceive are diagnosed with unexplained infertility. This does not mean you will never get pregnant. However, after trying to conceive unsuccessfully for more than a year, it may be in your best interest to pursue treatment to improve your chances.

What do I do next?

Given that no specific cause of infertility has been identified, certain lifestyle changes and at-home approaches could improve your chances of pregnancy. This includes eating a healthy diet, exercising regularly, and quitting smoking and excessive drinking. Starting with small steps and setting reasonable goals for yourself is the key to maintaining the best health possible.

When you’re trying to get pregnant, you only have 12 chances per year — your ovulation period each month — so take advantage of every opportunity. With or without the diagnosis of unexplained infertility, ovulation kits can be helpful in maximizing your potential to conceive naturally. Ovulation kits are able to pinpoint exactly when you are ovulating so you can plan accordingly. Make sure to try either the day of or the day after the kit reports ovulation.

What if none of this has worked for me?

If you decide to seek treatment, there are several options available. Your fertility specialist’s recommendation will depend in part on your age.

If you are under 35, we may increase your likelihood of pregnancy with fertility medicines, such as Clomid or Femara, to stimulate ovulation. This can be done with or without intrauterine insemination (IUI). IUI places the sperm into the uterus, making the trip to the fallopian tubes much shorter and improving chances of fertilization. Because it is the most intensive, in vitro fertilization (IVF) is typically our last course of treatment.

If you are over 35, we realize that we may need to proceed with a more aggressive treatment plan, potentially starting with ovulation medications and IUI or going more quickly to IVF based on your unique situation and desires.

Often, IVF can be both diagnostic and therapeutic. We learn more about your specific situation during the IVF process and may be able to determine the previously unexplained reason for your infertility, while also significantly improving your chances of pregnancy. For example, we can evaluate egg quality, fertilization and embryo quality during the process. All of these components are important factors in becoming pregnant.

In any case, remember that being diagnosed with unexplained infertility doesn’t mean you won’t be able to have a family. My advice to you — don’t give up.

If you have more questions, please contact us. To schedule a Fertility Check or a new patient consultation, request an appointment.

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