Unexplained Infertility

Understanding your next steps

Unexplained infertility occurs in 15 to 30% of couples seeking a fertility evaluation.

Sometimes, though everything appears to be in working order, a couple may still have trouble conceiving.

Unexplained infertility is what we call a diagnosis of exclusion, and it is reached through the process of elimination. We use this diagnosis when we have ruled out all other possible diagnoses and cannot confidently establish a reason for infertility from a patient’s medical history, examination and testing.

Receiving a diagnosis of unexplained infertility can be frustrating, especially as patients are often eager for clear answers. We understand how stressful infertility can be, and we’re eager to support you through this process.

 Diagnosis for unexplained infertility

Evaluation for both women and men includes:


  • Does the patient have normal, predictable cycles? 

  • Is the patient’s egg reserve normal to robust?

  • Did an evaluation of the uterus and fallopian tubes reveal no abnormalities?


  • Did semen analysis reveal normal semen, including sperm count, sperm movement and sperm shape?

  • Did DNA fragmentation testing reveal no abnormalities?

If any of the above have not been evaluated, it would be premature to reach a diagnosis of unexplained infertility.

Treatment options for unexplained infertility 

Clomid with intrauterine insemination (IUI)

A common treatment for unexplained infertility is Clomid (clomiphene citrate) with IUI for two or three cycles. Similar results occur with letrozole / Femara.

Clomid with IUI is less costly than IVF and is viewed as a relatively simple fertility treatment. However, it typically involves 4 to 5 office visits per cycle which are not planned in advance. Additionally, the success rate is significantly lower than IVF and the multiple birth rate is higher compared to IVF.

 In vitro fertilization (IVF)

IVF offers the highest chance for a live birth as well as, the lowest risk of multiple pregnancy (1-2%) when a single embryo is transferred. It also creates the potential to build a family over time from one initial egg retrieval, through repeated frozen embryo transfers.

The cost of IVF is greater than IUI, however, and many insurance plans don’t cover it. And because for many, IVF represents the ‘pinnacle’ of fertility treatment, if a couple’s IVF cycle is not successful, they can often feel greatly discouraged.

The length of time a couple has experienced unexplained infertility may also factor into the treatment plan their doctor recommends. In couples with greater than two years of infertility, clinical pregnancy rates with IVF were three times greater than with Clomid and IUI. IVF can be a significant option for patients with unexplained infertility.

 effortless IVF®

effortless IVF® is a unique solution that offers a bridge between IUI and conventional IVF. It is simple, natural, streamlined, and requires a low number of office visits.

effortless IVF® is about half the cost of traditional IVF, with success rates comparable to traditional IVF. It uses the revolutionary INVOcell device to incubate the sperm and eggs, rather than an expensive laboratory.

Many couples with unexplained infertility are candidates. Visit effortlessivf.com to learn more.

Coping with unexplained infertility 

 Don’t go this alone. Get support.

An unexplained infertility diagnosis can be very frustrating for couples who are trying to conceive. It can be extremely difficult for those with unexplained infertility to know when to stop looking for a cause.

At CARE Fertility, we are here to help you, and we care about you. We encourage you to seek out support groups in your areas and look into the free resources available from RESOLVE, the National Infertility Association.

See support groups in your area.