Why Can't I Get Pregnant? Unexplained Infertility Explained

What Is Unexplained Infertility?

Unexplained infertility is a diagnosis given when a couple is unable to conceive despite having no identifiable abnormalities in standard fertility tests. This typically means that ovulation is regular, fallopian tubes are open, sperm parameters are within normal ranges, and the uterus appears healthy on imaging. Even after a year of regular, unprotected intercourse, pregnancy does not occur.

Instead of saying that everything is fine, the label "unexplained infertility" highlights how far the tests a patient has taken can go. However, the top diagnostic tests cannot detect subtle problems related to egg quality, sperm function, fertilisation, or embryo implantation that may still exist. Instead, this diagnosis gives doctors a way to design a more effective monitoring and treatment plan for the patient, improving the chances of having a baby.

Why Does Unexplained Infertility Happen?

Unexplained infertility happens because conception depends on many finely balanced steps, and not all of them can be fully evaluated through routine fertility testing. Even when reports appear normal, subtle disruptions in this process may prevent pregnancy. Several hidden factors may contribute to unexplained infertility, including:

• Egg quality issues that affect fertilisation or embryo development but are not visible on standard scans
• Sperm function problems, where count and motility are normal, but fertilisation ability is reduced
• Hormonal fluctuations that interfere with ovulation timing or egg release
• Early or mild endometriosis that does not show up on ultrasound
• Implantation challenges, where embryos fail to attach properly to the uterine lining
• Immune or genetic factors that affect early pregnancy development

Treatment Options for Unexplained Infertility:

Even if the exact cause for unexplained infertility remains unknown, that does not mean it can not be cured. Treatment is possible and primarily focuses on improving the chances of fertilisation and implantation by supporting the natural process or bypassing potential barriers.

Although treatment for this type requires a lot of guesswork for doctors, with treatments, subtle to advanced, conception becomes a reality for couples affected with unexplained infertility, which may include:

• Lifestyle and fertility optimisation: Improving nutrition, managing weight, reducing stress, quitting smoking, and correcting sleep patterns can positively influence egg and sperm quality.
• Ovulation induction medications: Drugs such as letrozole or clomiphene are used to stimulate the ovaries to release one or more eggs, increasing the chances of fertilisation.
• Timed intercourse: Ovulation monitoring through scans and blood tests helps identify the most fertile window, ensuring intercourse occurs at the optimal time.
• Intrauterine insemination (IUI): Washed and concentrated sperm are placed directly into the uterus, bringing sperm closer to the egg and improving fertilisation chances.
• In vitro fertilisation (IVF): IVF bypasses many unknown factors by fertilising the egg outside the body and transferring the embryo into the uterus, offering the highest success rates for unexplained infertility.

Note that which treatment approach needs to be used depends on age, duration of infertility, previous treatments, and individual reproductive health, allowing a personalised and strategic approach.

Can Unexplained Infertility Resolve on Its Own?

Yes, unexplained infertility can resolve on its own in many cases. Since no apparent medical cause has been identified, natural conception remains possible, especially when factors such as age, egg reserve, and overall health are favourable. In fact, many couples diagnosed with unexplained infertility go on to achieve healthy pregnancies without any advanced fertility treatments.

This happens because subtle issues affecting fertility may correct themselves over time or fluctuate from cycle to cycle. However, waiting is not always the best option for everyone. Couples with increasing age or longer durations of infertility may benefit from timely treatment to improve success rates. The decision to wait or proceed with treatment should always be personalised and guided by a fertility specialist.

Conclusion

Finally, it can be concluded that infertility can be frustrating, but what is more frustrating is when it is almost impossible to understand the reason behind it. Couples with unexplained fertility often find themselves stranded by confusion about which procedure can help them overcome it. Fortunately, the treatment for this type of infertility is possible, and, in fact, most couples find their happy ending even without an advanced fertility treatment. So, don’t lose hope when you can find answers, just stay patient and let nature, and of course, doctors, do their job.