About Unexplained Infertility and Its Causes

If you're reading this, you're probably feeling frustrated and confused about why getting pregnant isn't happening as easily as you'd hoped. Unexplained infertility is a term that can add to that frustration. It's when all the standard tests you go through to figure out why you're not getting pregnant come back normal. No obvious issues, no clear answers. This kind of infertility is often called unknown infertility because, honestly, the reasons behind it aren't fully understood. But don't lose hope—you can still do a lot. Let's dive into what this diagnosis really means and what steps you can take.

What Does Unexplained Infertility Really Mean?

So, what exactly is unexplained infertility? Basically, it's when you've been trying to conceive for over a year (or six months if you're over 35) and, after all the tests, everything seems fine on paper. Here's what those tests typically look at:

Are you ovulating regularly?
Are your fallopian tubes open and clear?
Is there a good supply of eggs in your ovaries?
Are your hormone levels normal?
How does your partner's sperm look in terms of count, movement, and shape?

If everything checks out okay, but you still aren't getting pregnant, you're dealing with unexplained infertility. This can feel like an unexplained pregnancy problem where the exact reasons remain a mystery. You might hear it described as unknown infertility reasons, and that's where a lot of the frustration comes from—not having a clear answer.

What Could Be Behind Unexplained Infertility?

Even though it's called unexplained infertility, there are a few potential causes of unexplained infertility that might be flying under the radar. Some possibilities include:

Subtle Hormonal Imbalances: Hormones are a delicate balance. Even small imbalances that don't show up on standard tests can make a big difference [1].
Egg and Sperm Quality: Sometimes, it's not about the number of eggs or sperm, but their quality. Minor issues here might not be caught in routine testing [2].
Minor Uterine or Tubal Issues: Sometimes, small changes or issues in the uterus or fallopian tubes don't show up in basic scans but could still cause problems [3].
Cervical Mucus Problems: The cervical mucus plays a big role in helping sperm reach the egg. If it's too thick or has the wrong consistency, it might block the sperm from getting where it needs to go [4].
Timing Issues: Maybe you're just missing the optimal window for conception. Timing is everything, and if the timing isn't quite right, conception won't happen [5].

What Can You Do About Unexplained Infertility?

If you've been diagnosed with unexplained infertility, it's normal to feel overwhelmed. But there are several things you can try to improve your chances of getting pregnant:

Lifestyle Changes: Sometimes, making a few healthy changes can make a big difference. Eating well, maintaining a healthy weight, quitting smoking, cutting back on alcohol, and reducing stress can all help. It's not a quick fix, but these changes can create a more supportive environment for conception [6].
Medications: Fertility drugs like Clomiphene (Clomid) or Letrozole can help stimulate ovulation. These medications are often combined with intrauterine insemination (IUI), a procedure where sperm is placed directly into the uterus to increase the chances of fertilization [7].
Assisted Reproductive Technologies (ART): If other methods haven't worked, ART options like IUI and in vitro fertilization (IVF) are available. IVF involves retrieving eggs and fertilizing them with sperm in a lab, then placing the embryo back in the uterus. This can be especially helpful when unknown infertility reasons involve egg or sperm issues that aren't easily detected [8].
Timing It Right: Sometimes, it's about getting the timing just right. Using ovulation predictor kits or tracking your basal body temperature can help you pinpoint the best days for trying to conceive. This approach can help maximize your chances, especially if unexplained infertility is making things more complicated than expected.

Top Tip: It might be helpful to keep a fertility journal to track your cycle, symptoms, and any treatments or lifestyle changes you're trying.

Can You Still Get Pregnant with Unexplained Infertility?

Absolutely. Having unexplained infertility doesn't mean you won't get pregnant. Many couples with this diagnosis do conceive, either naturally or with some assistance. It might take longer, and it might feel like a rollercoaster, but it's important to stay hopeful. Keep in mind that patience, persistence, and sometimes a bit of creativity with treatment options can go a long way.

Top Tip: Keep a positive mindset and remember you're not alone. Many couples facing unexplained infertility find success through various methods.

Final Thoughts

Navigating unexplained infertility is challenging, but it's not a dead end either. It's about understanding what might be causing the issue, even if the causes of unexplained infertility aren't obvious at first. Working closely with your healthcare provider, exploring different treatment options, and making some lifestyle adjustments can all help you move forward. Remember, there's no one-size-fits-all answer here, but with determination and support, many couples find a way.

FAQs

What is unexplained infertility?

Unexplained infertility is when all fertility tests come back normal, but a couple still can't conceive after trying for at least a year.

Why does unexplained infertility happen?

There are many possible causes of unexplained infertility, including hormonal imbalances, egg or sperm quality issues, or subtle anatomical problems that tests can't always detect.

What are the treatment options for unexplained infertility?

Treatments can range from lifestyle changes and medications to assisted reproductive technologies like IUI and IVF.

Is it possible to conceive naturally with unexplained infertility?

Yes, many couples with unexplained infertility eventually conceive naturally, especially with proper timing and lifestyle adjustments.

Citations

Vannuccini S, Clifton VL, Fraser IS, Taylor HS, Critchley H, Giudice LC, Petraglia F. Infertility and reproductive disorders: impact of hormonal and inflammatory mechanisms on pregnancy outcome. Hum Reprod Update. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7289323/
Agarwal A, Majzoub A, Baskaran S, Panner Selvam MK, Cho CL, Henkel R, Finelli R, Leisegang K, Sengupta P, Barbarosie C, Parekh N, Alves MG, Ko E, Arafa M, Tadros N, Ramasamy R, Kavoussi P, Ambar R, Kuchakulla M, Robert KA, Iovine C, Durairajanayagam D, Jindal S, Shah R. Sperm DNA Fragmentation: A New Guideline for Clinicians. World J Mens Health. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7502318/
Infertility Workup for the Women's Health Specialist: ACOG Committee Opinion, Number 781. Obstet Gynecol. Available at: https://pubmed.ncbi.nlm.nih.gov/31135764/
Daunter B, Khoo SK. Role of cervical mucus in human infertility. Aust N Z J Obstet Gynaecol. Available at: https://pubmed.ncbi.nlm.nih.gov/6398697/
Wilcox AJ, Weinberg CR, Baird DD. Timing of sexual intercourse in relation to ovulation. Effects on the probability of conception, survival of the pregnancy, and sex of the baby. N Engl J Med. Available at: https://pubmed.ncbi.nlm.nih.gov/7477165/
Anderson K, Nisenblat V, Norman R. Lifestyle factors in people seeking infertility treatment - A review. Aust N Z J Obstet Gynaecol. Available at: https://pubmed.ncbi.nlm.nih.gov/20218991/
Legro RS, Brzyski RG, Diamond MP, Coutifaris C, Schlaff WD, Casson P, Christman GM, Huang H, Yan Q, Alvero R, Haisenleder DJ, Barnhart KT, Bates GW, Usadi R, Lucidi S, Baker V, Trussell JC, Krawetz SA, Snyder P, Ohl D, Santoro N, Eisenberg E, Zhang H; NICHD Reproductive Medicine Network. Letrozole versus clomiphene for infertility in the polycystic ovary syndrome. N Engl J Med. Available at: https://pubmed.ncbi.nlm.nih.gov/25006718/#:~:text=Conclusions%3A%20As%20compared%20with%20clomiphene,gov%20number%2C%20NCT00719186.).
M. Brandes, C.J.C.M. Hamilton, J.O.M. van der Steen, J.P. de Bruin, R.S.G.M. Bots, W.L.D.M. Nelen, J.A.M. Kremer, Unexplained infertility: overall ongoing pregnancy rate and mode of conception, Human Reproduction. Available at: https://academic.oup.com/humrep/article/26/2/360/595834