Merck Manual

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Unexplained Infertility

By

Robert W. Rebar

, MD, Western Michigan University Homer Stryker M.D. School of Medicine

Reviewed/Revised Feb 2024
VIEW PROFESSIONAL VERSION

Unexplained infertility is diagnosed when sperm in the male partner is normal and when eggs, ovulation, fallopian tubes, and the uterus are normal in the female partner.

Treatment of Unexplained Infertility

  • Controlled ovarian stimulation

  • Sometimes assisted reproductive technologies

When no explanation for infertility is identified, an approach called controlled ovarian stimulation may be used.

Controlled ovarian stimulation may make pregnancy more likely and may help women become pregnant more quickly. This treatment may result in more than 1 fetus.

Controlled ovarian stimulation involves the following:

If pregnancy does not result after this treatment, one of the following may be done:

Prognosis for Unexplained Infertility

Women have the same chance of pregnancy (about 65%) whether unsuccessful treatment with clomiphene plus hCG is followed by stimulation with gonadotropins plus hCG or immediately by in vitro fertilization. However, women become pregnant more quickly and are less likely to have a pregnancy with 3 or more fetuses when unsuccessful treatment with clomiphene is immediately followed by in vitro fertilization. Thus, if clomiphene plus intrauterine insemination is unsuccessful, the next step is often in vitro fertilization.

Some evidence suggests that women who are over age 38 and have unexplained infertility conceive more quickly when in vitro fertilization is done rather than proceeding to controlled ovarian stimulation.

Drugs Mentioned In This Article

Generic Name Select Brand Names
Clomid, Serophene
NOTE: This is the Consumer Version. DOCTORS: VIEW PROFESSIONAL VERSION
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