What is unexplained infertility?

Around three quarters of infertility problems have a clear and diagnosable cause. A quarter are due to problems with the male, a quarter are due to problems with the female and a quarter are a combination of issues with both partners. However, that still leaves approximately 25 % of cases of unexplained infertility.

Reasons for infertility fall under several categories:

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  • Problems with sperm quality or sperm count.
  • Problems with egg viability or ovulation.
  • Hormonal imbalances that prevent sperm or egg production.
  • Male physical issues that prevent normal passage of sperm into the semen.
  • Female physical problems that block the fallopian tube so the egg cannot get to the uterus.
  • Antibodies to sperm: these can occur in the man’s semen, or in the woman’s vaginal secretions.
  • Conditions that prevent implantation of the embryo, such as endometriosis.

All of these problems can be tested for, and most can be overcome using infertility treatments. However, for some couples all the tests come back normal and there is no obvious cause for their infertility. It seems strange, but they are then diagnosed with unexplained infertility. There is no reason why they have not conceived, despite two years of trying, yet it simply hasn’t happened.

At the end of the day, there are so many chance factors involved in conception, that you may simply be unlucky and it is just a case of persevering. Alternatively, our understanding of the conception process may still be incomplete, and although you may be told you have unexplained infertility, you may actually have a problem or medical condition that has yet to be discovered and understood.

You also need to remember that having unexplained infertility does not exclude you from having infertility treatments. It may be a matter of trying several, starting with unstimulated intrauterine insemination (IUI) and then stimulated IUI, and then perhaps in vitro fertilisation, as your unexplained infertility means your medical team cannot be sure of what problem they are dealing with. The good news is that 90 % of couples with unexplained infertility do manage to start a family eventually.

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