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Unexplained Infertility

No one can be blamed for infertility any more than anyone is to blame for diabetes or leukemia. In rough terms, about one-third of infertility cases can be attributed to male factors, and about one-third to factors that affect women. For the remaining one-third of infertile couples, infertility is caused by a combination of problems in both partners or, in about 20 percent of cases, is unexplained. 

The most common male infertility factors include azoospermia (no sperm cells are produced) and oligospermia (few sperm cells are produced). Sometimes, sperm cells are malformed or they die before they can reach the egg. In rare cases, infertility in men is caused by a genetic disease such as cystic fibrosis or a chromosomal abnormality. 

The most common female infertility factor is an ovulation disorder. Other causes of female infertility include blocked fallopian tubes, which can occur when a woman has had pelvic inflammatory disease or endometriosis (a sometimes painful condition causing adhesions and cysts). Congenital anomalies (birth defects) involving the structure of the uterus and uterine fibroids are associated with repeated miscarriages. 

In approximately 5% to 10% of couples trying to conceive, all of the above tests are normal and there is no apparent cause for infertility. In a much higher percentage of couples, only minor abnormalities are found that are not severe enough to result in infertility. In these cases, the infertility is referred to as unexplained. Couples with unexplained infertility may have problems with egg quality, tubal function, or sperm function that are difficult to diagnose and/or treat. In the absence of a correctable abnormality, the treatment for unexplained infertility is, by default, empiric. There is a need to help physicians evaluate empiric therapies and understand when to use each of the available approaches. Proposed treatment regimens include intrauterine insemination (IUI), ovulation induction with oral or injectable medications, combination of IUI with ovulation induction, and assisted reproductive technologies (ART). Fertility drugs and IUI have been used in couples with unexplained infertility with some success. In most cases, patients should be encouraged to try the easiest and most inexpensive treatment of IUI, possibly with ovulation induction, as a first-line therapy. If no pregnancy occurs within three to six treatment cycles, IVF may then be recommended.

At Brown Fertility, our goal is for patients to become pregnant as quickly and affordably as possible. Unlike other centers, we encourage patients with unknown infertility to try simple and affordable treatments before moving on to more expensive assisted reproductive technologies (ART) such as In-Vitro Fertilization (IVF). 

If you have questions about unexplained infertility, please call our office at 904-260-0352 or contact us. *Information from ASRM.com