Unexplained infertility (or idiopathic infertility) is when no cause for that infertility is found even after a full investigation of both partners. Routine test such as semen analysis , post coital test, hormone measurements and scans to determine regularity of ovulation, hysterosalpingrams or laparoscopy to determine whether the tubes are patent (open), assessment for sperm dysfunction or antibodies.
Often the reason for unexplained infertility may be due to minor irregularities of ovulation, sperm function or the endometrial development is out of synchrony with the rest of the cycle. At other time no real cause can be found - causing considerable stress for both partners. There is often some relief when a definite cause can be indicated - at least that may mean that something can be done about it.
Treatment for unexplained infertility includes attempts to improve the regularity of ovulation with drugs such as clomiphene citrate or gonadotrophins followed by either intrauterine insemination (when a preparation of sperm in a culture medium is placed directly into the uterus) or by IVF when, after stimulation with gonadotrophins the eggs are retrieved and placed with the sperm - if fertilisation occurs the embryos can be transferred to the uterus. One of the great advantages of IVF is that it gives an indication of whether fertilisation has or has not occurred.
The term "Unexplained infertility" diagnosis should be dropped (28.08.06)
Two US experts has recommended that unexplained infertility be abandoned as a formal diagnosis.
N. Gleicher and D. Barad from the Center for Human Reproduction in New York argue that the diagnosis is highly subjective, depending on which tests are performed and to what level of quality, and say that it often conceals recognized diagnoses, including endometriosis, tubal infertility, premature ovarian aging, and immunological infertility.
"Better efforts to reach infertility diagnoses more accurately should improve the diagnostic accuracy of hitherto missed diagnoses, which often falsely have led to a diagnosis of unexplained infertility," they conclude.