The Mystery of Unexplained Infertility: Here’s What You Need to Know

A woman is sitting on a blue couch across from a doctor. She is staring off to the side and the doctor is holding a clipboard.

Imagine for a moment that you’re sick and feel like something is happening inside your body. You go to the doctor searching for the answers you believe they’ll have. They take blood, run tests, and conduct examinations before telling you they don’t know what’s wrong–your illness is a mystery. That is exactly what unexplained infertility feels like.

It’s the dream of pregnancy and the reality of not knowing why conception feels impossible. The longing to grow a family and the loss you experience when your doctor doesn’t know why you can’t. 

Is this where you’re at, Mama?

Are you fighting to overcome an invisible monster that no one can name?

It might feel like an uphill battle with no end, but let me share something important with you: treatment options DO exist. 

If you’re ready to find the solutions you deserve, stick around. Below you’ll find information to help you better understand the ins and outs of unexplained infertility and what you can do to make it through. 

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What is Unexplained Infertility?

Poor sperm health.

Insufficient ovaries.



These, and many more, are diagnosable causes of fertility problems. They’re specific reproductive incidents that doctors can test for, identify, and treat. 

But what happens if your fertility testing doesn’t produce results? Your sperm looks good; your reproductive organs are tip-top; and your eggs are still viable and healthy. 

Per the Cleveland Clinic, once both partners undergo complete fertility workups that don’t provide any explanations, they might receive a diagnosis of unexplained infertility. 

Let me make something clear, though–just because there isn’t an identifiable cause for your infertility doesn’t invalidate its existence. You’re not doing anything wrong, and you’re certainly not crazy. 

As a matter of fact, it’s more common than you might think. Approximately 15-30% of infertility patients deal with unknown causes for infertility.

How is it Diagnosed?

So, you want to grow a family and actively try for a year or more with no success (six months if you’re over 35), your doctor will probably tell you it’s time to consider a fertility workup for answers. This series of tests and screenings could highlight potential reproductive problems or provide an unknown infertility diagnosis. 

American College of Obstetricians and Gynecologists (ACOG) advises that the tests included in a typical infertility evaluation could include:

What Are the Chances of Eventually Getting Pregnant Naturally?

Thanks to a study by the National Institute of Health (NIH), we know that 92% of couples with unexplained infertility go on to have a baby when using various fertility treatment options

While these are AMAZING odds, that’s probably not what you want to know.

You’re probably wondering whether there’s a chance you can get pregnant naturally without all the conversations about IVF vs. IUI, infertility grants, and worries over canceled IVF cycles

The answer is yes, but unfortunately, not likely.

Research shows that couples with unexplained infertility have a 2-4% chance of pregnancy during every monthly cycle. This is significantly lower than the 20-25% standard conception rate.

Just remember that there is always a silver lining, though. 

Yes, the chances are small, but if you don’t want to undergo treatment, there’s still hope to hold onto. If you are considering alternative fertility options, you can always ask to start with things like ovarian stimulation medications that are minimally invasive. 

Are There Causes of Unexplained Infertility?

Given the word “unexplained” is in the name of the diagnosis, this doesn’t bode well for explaining the actual causes of infertility you might be experiencing. 

HOWEVER, some experts have an idea of what might be going on.

The catalyst behind unknown infertility may stem from poor egg viability, sperm health, or issues with implantation success

An article in Medical News Today also claims up to 80% of couples with unexplained infertility could suffer from high sperm DNA damage.

So, if this is the case, why don’t our labs and tests show it?

These problems may be minor enough not to appear in normal lab results but can still cause reproductive issues. As tests are continually changing and advancing, however, we can only hope that we’ll have the technology required to provide better answers in the future.

A man and woman are sitting on a light grey couch. They are both looking down at a pregnancy test the woman is holding and they look sad.
If unexplained infertility is so unexplainable, how can we treat it? Finding answers might seem challenging, but thankfully, treatments do exist.

Understanding Your Unexplained Infertility Treatment Options

Once your healthcare provider establishes that unexplained infertility is the culprit of your pregnancy troubles, they’ll likely help you choose a fertility clinic to move forward with possible treatment options. 

During your first consultation and appointment, your fertility specialist will likely review your testing results and explain the best family-building options for you moving forward. 

Healthcare-assisted treatments like assisted reproductive technologies (ART) and fertility medications, such as clomiphene (Clomid) and letrozole (Femara), usually offer the most success. However, there is a chance that making minor lifestyle changes could help you on your pregnancy journey. 

Are There Natural Solutions for this Condition?

Does jumping into intrauterine insemination (IUI) or in vitro fertilization (IVF) to combat your unexplained infertility make you nervous?

That’s completely understandable, and you’re not alone.

I was terrified of leaping into ART services when it was time to treat my PCOS infertility and begged my doctor to let me try something else first.

In our particular situation, IVF was necessary, but that doesn’t mean there aren’t less-invasive ways to achieve pregnancy success when dealing with unexplainable infertility.

The Cleveland Clinic, for example, reports that making changes to various lifestyle factors could benefit your chances of getting pregnant naturally. Some of their suggestions include:

Another great option is to work on tracking and identifying ovulation symptoms. An ovulation tracker app or test strips gives you a better idea of when to time out sex for higher conception rates. 

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Can You Use IUI for Unexplained Infertility?

Not only can you use IUI for unexplained infertility, but it’s also often a preferred first-line treatment because it’s simpler and more budget-friendly than other protocols, like IVF with ICSI. 

The protocol is pretty laid back–well, in terms of ART services, that is.

It involves tracking your reproductive cycle for ovulation, collecting sperm from your partner or a donor, and placing that sperm directly into your uterus with a catheter when your body is ready.

Your doctor might also suggest using fertility medications, such as gonadotropin ovarian stimulation drugs, to increase your chances of IUI success. You’ll have a 7 – 20% success rate when adding stimulation medications to your IUI cycle. Without them, your pregnancy rate is around 5% with IUI. 

Many fertility specialists will recommend 3 – 6 IUI cycles before suggesting you move on to IVF. 

Breaking Down the Unexplained Infertility IVF Success Rates

Now, I know we want to remain positive and hope and hope that fertility medications or IUI will help you get pregnant with unexplained infertility. But what if, worst case scenario, they don’t?

You’ll still have IVF to try!

In IVF, your ovaries are stimulated to produce more egg follicles during a cycle. Once these eggs develop, your doctor will collect them during an outpatient egg retrieval.

From there, your fertility specialist will fertilize the highest quality eggs with your partner’s or donor’s sperm. The developing embryo will be placed into your uterus using the same type of catheter discussed in the above section on IUI. 

There’s no denying that IVF is more invasive than taking medication or undergoing IUI. The silver lining, however, is that it yields impressive success rates. Per the national registry, 31.8% of IVF cycles resulted in a live birth.

It could take multiple tries, but you have a high chance of growing a family with IVF, even when dealing with unknown infertility.  

A woman in a yellow sweater is sitting with a woman in a green sweater. The woman in the green sweater is looking down at a pregnancy test with her hand over her mouth.
Struggling with unexplained infertility? You’re not alone, friend.

Is Unexplained Secondary Infertility a “Thing?”

Here’s where things get interesting: what if you already have a baby? You started your family years ago and had no trouble getting pregnant. Now, you’re ready to give your precious little one a sibling, and it’s just not working.

It doesn’t make much sense, does it? If you could do it before, what’s happening now? This is what we call secondary infertility, and yes, it could be unexplainable.

Maybe your egg quality isn’t as excellent as it was previously. Or, perhaps your partner is dealing with less than spectacular sperm motility. While issues like these usually pop up during fertility testing, there’s a chance they might not. 

Most of us know that age and fertility go hand-in-hand. Your biological clock may have started messing around with your reproductive system in the years between pregnancies

Don’t stress about it too much, though. We’re fortunate to live during the most technologically advanced time in human history. Reproductive services aren’t the same as they once were, and we have plenty of ways to try and conceive, even when our bodies are uncooperative.

Getting Support After an Unexplained Infertility Diagnosis

It’s a total gut punch when you go to your doctor for answers about why you can’t get pregnant, and they basically tell you, “I don’t know.”

We go in waiting to hear that our sperm sample was crap or our uterus has a stupid polyp that needs removal. Essentially, we expect answers that we can do something with. Hearing that we have “unexplained infertility,” however, is incredibly frustrating, to say the least.

If you’ve recently heard you have unknown infertility causes, feel free to get pissed. Scream, cry, beg, and barter for something else–do whatever you need to grieve the diagnosis. 

When you’re ready to proceed, seek the fertility support you deserve, and choose which treatment path is best for your unique situation. 

Whether you make those lifestyle changes we discussed or choose IUI for unexplained infertility, there are lots of fertility options out there for you. 

Have you dealt with unexplained infertility? Which treatment options did you pick?