Up to 15% of couples in the United States struggle with infertility, which is defined as the inability to conceive after having regular, unprotected intercourse for at least 12 months (or just six months for women age 35 or older). While one-third of fertility problems can be traced to the female partner and another third to the male partner, up to one-third of all cases don’t appear to have an obvious underlying cause.
Hearing that your fertility issue defies medical explanation can be just as stressful as the problem itself, but being diagnosed with unexplained infertility doesn’t mean there’s no way forward. And it certainly doesn’t mean you won’t be able to get pregnant as time goes on. Here’s what you need to know.
Unexplained infertility, explained
By definition, unexplained infertility is a diagnosis of elimination, meaning after you and your partner have gone through a full fertility work-up, your doctor has only been able to determine that there’s no clear or obvious reason that you haven’t been able to get pregnant.
This means that your menstrual cycle is regular, you ovulate normally, your ovarian reserve is adequate, there’s no blockage in your fallopian tubes, and your uterus seems to be healthy and in good working order. It also means that your partner’s sperm is healthy in every respect, including the sperm’s count, shape, and motility.
Receiving a diagnosis of unexplained infertility doesn’t mean there’s no underlying cause of your fertility problem. It simply means that there are still limits to what reproductive medicine can uncover.
Empirical treatment strategies
When you’ve been struggling to get pregnant for a long time, you don’t want to be told you’re completely normal. You want to know why you can’t conceive and what you can do about it. Not knowing the whys of your situation doesn’t mean there’s no solution, it simply means you have to take a more empirical approach.
Based on clinical experience and certain degree of intuitive guesswork, an empirical treatment plan for unexplained infertility takes a methodical, step-by-step approach that aims to cover as many bases as possible. The most common treatment map for unexplained infertility includes these basic strategies:
1. Lifestyle changes
Taking steps to improve your overall health is an excellent strategy for any couple dealing with infertility, including those who have an obvious underlying medical reason.
For both partners, this means eating a wholesome diet and exercising most days of the week. It also means quitting smoking, limiting alcohol consumption, getting enough sleep, and keeping stress levels under control.
Achieving a healthy body weight is particularly important for women, as being overweight or underweight can affect your estrogen levels and interfere with normal ovulation. Cutting back on caffeine can also help women improve their chances of conception.
2. Expectant management
Unless advanced maternal age is a factor, many couples are counseled to continue trying to conceive on their own for a limited amount of time before they resort to assisted reproductive technology (fertility treatments).
For a significant number of couples who keep trying to conceive — especially those who’ve already established healthier lifestyle habits — pregnancy occurs within a few short months. According to a recent clinical trial, over 30% of couples who tried the expectant management route were able to become pregnant on their own within six months.
3. Targeted fertility treatments
When lifestyle changes, improved health, and expectant management aren’t successful, medical assistance may be able to help you overcome your infertility.
The quickest and least invasive approach combines an ovulation-stimulating medication like Clomid with three to six cycles of intrauterine insemination (IUI), a treatment that injects your partner’s sperm directly into your uterus.
If IUI doesn’t work, you may find success with in vitro fertilization (IVF), a treatment that harvests healthy eggs from your ovaries, fertilizes them with your partner’s sperm in a controlled lab environment, then places them back into your uterus for implantation.
Personalized, responsive fertility care
Remember, unexplained infertility isn’t caused by stress, and it’s not just “in your head,” even if medical science hasn’t been able to provide a concrete explanation for your problem.
Whether you’re looking for a second opinion or you’d like to learn about all of your treatment options, we can help. Call your nearest The Center for Women's Health office in Newport News and Hampton, Virginia today, or click here to schedule a visit with one of our fertility experts any time.