Many couples who are infertile, usually go for infertility treatments like hormone treatments, fertility drugs, and surgery, which is referred to as the management of unexplained infertility. These treatments significantly help improve the chances of getting pregnant. In addition, assisted reproduction technology or ARTs also use various medical techniques to fertilize an egg for improved rates of pregnancy.

Unexplained infertility is one which is idiopathic in a sense that its cause remains unknown despite having infertility work-up. Many people consider examining the semen in the man and also go for assessment of ovulation and fallopian tubes in the woman.

Unexplained infertility occurs when there is no particular cause found for a couple’s inability to conceive. About 10% of infertile couples suffer from unexplained infertility. But the good news is that couples with unexplained infertility have a 50% chance of getting pregnant without the use of ARTs within a year following diagnosis.

The incidence of unexplained infertility is around 15 to 20 percent of such couples who are not able to conceive. Primarily, the management of unexplained infertility is a diagnosis of exclusion. Hence, there are 3 basic investigations to diagnose the problem – normal basic sperm analysis, patent fallopian tube, and ovulation.

But as far as the patients’ interest is considered, let’s know what they really want. New-age couples who are trying to conceive, want to know the reason why they are not able to get through or if they need quick success with a lesser burden of treatments.

Another important aspect is the validity of the diagnosis of unexplained infertility. But there are a few bottlenecks related to endocrine abnormalities, genetic abnormalities, genetic disorders, and immunological disorders. Also, there is another issue of the unavailability of diagnostic tools and a proper condition when there is a risk of ovarian reserve, especially in older patients.

When it comes to the treatment and management of unexplained infertility, its treatment is empiric as it does not address a specific defect or functional impairment. The principal treatments for unexplained infertility include expectant observation with timed intercourse and lifestyle changes, clomiphene citrate and intrauterine insemination (IUI), controlled ovarian hyperstimulation (COH), with IUI, and in-vitro fertilization (IVF).

An infertile couple is required to undergo a thorough investigation prior to the diagnosis and treatment for their condition, for which, couples must undergo a semen analysis, ovulation testing, assessment of the ovarian reserve, and imaging to assess for tubal and uterine factors before a diagnosis and management of unexplained infertility.

The optimal treatment strategy needs to be based on individual patient factors such as age, treatment efficacy, side-effect profile, and cost considerations.

A lot more information along with questions and answers from our other panel experts are covered in a detailed webinar for a better understanding of the management of unexplained infertility – Click here to know more

Dr. Jyothi C, Reproductive Medicine Specialist, Practicing ART, and Representing Team FERTY-9