Unexplained infertility

This chapter examines how to reach a diagnosis of unexplained infertility. Unexplained infertility does not exclude the possibility of a number of putative causes which are undetectable by standard tests. Human conception is a complex series of events that involves an interaction between the egg and sperm, fertilization and implantation of the embryo. Absence of conception within months does not equate to sterility, and in the absence of any obvious barriers to infertility, a significant proportion of couples with unexplained infertility can expect to become pregnant without active treatment. Expectant management is the first-line approach for couples with unexplained infertility of relatively short duration where the female partner is young. Oral clomiphene citrate therapy has been commonly used for management of unexplained infertility. Intrauterine insemination has been widely used as a fertility treatment for unexplained infertility. It involves preparation of a semen sample in the laboratory to isolate spermatozoa with high motility.