Treating Unexplained Infertility

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Because treatments for unexplained infertility are not specific to a particular cause, they are called empirical. In 1998, a retrospective analysis of 45 studies on unexplained infertility was published. The findings are as follows:

  • Without treatment, the monthly chance of conception was estimated to be about 2 percent (1.3-4.1%).
  • Treatment with intrauterine insemination (IUI) alone did not raise this conception rate significantly (3.8%).
  • Treatment of unexplained infertility with Clomid plus IUI increases chance of conception per cycle 2-3 fold (2% – 8.3%).
  • Treatment with gonadotropin injections plus IUI raises the conception rate even further to 17 percent per treatment cycle.
  • Lastly, in vitro fertilization (IVF) conception rates for unexplained infertility are typically among a center’s highest, usually at least 50 percent with the transfer of two embryos.

Causes of Unexplained Infertility

There are a number of possible explanations for unexplained infertility, and while we can’t always discover them, we can increase the odds of overcoming them.

In every woman a healthy egg is not always released, the tube does not always pick up the egg, the sperm does not always fertilize the egg, and a healthy embryo is not always formed. Increasing the number of eggs released through the use of fertility drugs, and the number of sperm to meet the eggs through IUI enhances fertility in a given cycle. If a woman’s tubes never pick up an egg, IVF will be needed to achieve conception. If a man’s sperm is unable to fertilize his partner’s eggs, IVF (often with intracytoplasmic sperm injection, ICSI) will be needed.

Empirical treatment of unexplained infertility is often very successful.

What is Unexplained Infertility?

The diagnosis of unexplained Infertility is made after a standard fertility work up fails to provide an explanation for a couple’s infertility.

About one percent of couples that have been trying to conceive for a year without success will have normal findings after a standard fertility work up. By definition, these couples have unexplained infertility. Why is their infertility unexplained? The simple answer is there are limitations to our ability to evaluate human fertility. Even the best, most thorough testing has limitations.

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