Overview
Normal tests are encouraging. Many couples with unexplained infertility conceive, either with time or with treatment such as IUI or IVF.
Why tests can be normal
Standard tests cannot measure everything. Subtle problems with egg quality, how the egg and sperm meet, fertilisation or implantation may not show up. Age also matters: egg quality falls gradually from the early thirties.
Making sure nothing is missed
- A review of all previous reports and any earlier treatment
- An ultrasound and AMH test to check egg reserve
- Confirmation that the tubes are open, and a repeat semen analysis if needed
- Hysteroscopy or laparoscopy only if symptoms or scans suggest a problem, such as endometriosis
Treatment options
- Trying for a little longer
For younger couples who have been trying for less than two years, this can be reasonable with advice on timing and lifestyle. - Ovulation induction with IUI
Often the next step, especially for women under 35. - IVF
Recommended when IUI has not worked, the woman is older, or time matters. IVF also shows how eggs and sperm interact, which can reveal a cause.
Questions about unexplained infertility
What does unexplained infertility mean?
It means the standard tests for both partners are normal, but pregnancy has not happened after a year of trying. It does not mean there is no answer, only that the usual tests have not found one.
Is IVF the only option for unexplained infertility?
No. Depending on your age and how long you have been trying, IUI with ovulation induction is often tried first. IVF is the next step if that does not work.
Does age matter with unexplained infertility?
Yes. The woman's age is the most important factor in deciding how quickly to move to treatment and which treatment to choose.
Can lifestyle changes help?
A healthy weight, not smoking, limiting alcohol and managing stress support fertility for both partners, alongside any treatment.
