Unexplained Infertility/Idiopathic Infertility

The accepted definition of infertility is the inability to get pregnant after one year of unprotected intercourse if you are a female under the age of 35, or six (6) months if you are 35 or older. All couples who are experiencing challenges with achieving pregnancy should undergo a thorough evaluation of both partners to attempt to determine the underlying cause or causes of the infertility. It is possible even with the most comprehensive evaluation and sophisticated testing a diagnosis may not be found. When no specific causes of infertility can be identified, a couple is diagnosed with unexplained or idiopathic infertility.

According to the American Society for Reproductive Medicine (ASRM), 5% to 10% of couples trying to conceive will have completely normal tests, and up to 30% of couples will have fertility challenges that cannot be diagnosed. This can be a frustrating diagnosis, because it deprives the couple of the understanding and sense of control that an identifiable problem offers.

Just because infertility is unexplained, however, does not mean that it is untreatable. According to the ASRM, the first course of action is to begin with a minimally invasive treatment option, such as intrauterine inseminations, and progress towards more advanced treatments like in vitro fertilization (IVF) if the initial attempts are unsuccessful. Early on, your physician may also use clomiphene citrate (commonly known as Clomid) to try and boost a woman's ability to produce FSH and LH which are needed to initiate ovulation. In men with poor sperm production, Clomid may also be used to increase the sperm count. If unsuccessful, the next step may include the use of gonadotropins (e.g. follicle stimulating hormones) to stimulate the ovaries to mature more follicles and produce a higher number of matured oocytes.

When the IUI procedures fail, your doctor will recommend moving to more advanced treatment options. ASRM recommends that only three to six courses of minimally invasive treatment before advancing onward to more complex options such as IVF.