Unexplained Infertility means that even after doing all the basic tests, doctors can’t find any clear reason why a couple is not able to get pregnant. In this, everything seems normal—the woman is ovulating, the fallopian tubes are open, and the man’s sperm count is good but still pregnancy doesn’t happen. This can be very confusing and emotionally difficult for couples.
At Risaa IVF, we meet many couples who go through this same situation. Our Senior IVF Specialist and Gynaecologist, Dr. Rita Bakshi, tries to find the hidden reasons and offer the right treatment. In this blog, we will explain everything about unexplained infertility. We will explain what it means, why it happens, and more.
What is Unexplained Infertility?
Unexplained infertility means when a couple is not able to get pregnant, even though all their test results look normal. The woman is releasing eggs on time, her fallopian tubes are open, and the man’s sperm is healthy. However, pregnancy still does not happen.
This can be very confusing because there is no clear reason for the problem. The doctors check everything, but they still can’t find why the couple is not able to conceive.
Unexplained infertility is common and can happen to many couples. Additionally, it’s important to know that there are treatments that can help. So, couples can still get pregnant with the right care and guidance.
Unexplained Infertility Symptoms
Unexplained infertility doesn’t have any clear symptoms and this can be very confusing for couples. You may have regular periods, a healthy lifestyle, no pain or health problems but still, pregnancy doesn’t happen. So, here are a few signs that might lead to a diagnosis of unexplained infertility:
- Trying to get pregnant for over a year with no success (or 6 months if the woman is over 35)
- Regular periods but no pregnancy
- No known problems in sperm or egg tests
- All fertility tests appear normal, but pregnancy still doesn’t happen
- No signs of conditions like PCOS, endometriosis, or blocked tubes
In short, there are no specific symptoms—you only find out when everything seems fine medically, yet conception doesn’t happen. That’s when doctors may call it unexplained infertility.
Hidden Causes of Unexplained Infertility
In unexplained infertility, all the basic tests show normal results, but pregnancy still doesn’t happen. This may be because there are small or hidden issues that regular tests can’t detect. These problems may not be serious but they can still affect the chances of getting pregnant.
Here are some possible hidden causes:
Poor Egg Quality
Even if eggs are released on time, they may not be healthy enough to be fertilized or grow into an embryo.
Sperm Function Issues
A man’s sperm count may look normal, but the sperm may not swim well or may not be able to fertilize the egg.
Egg and Sperm Not Meeting at the Right Time
Sometimes, timing can be slightly off. Even with regular cycles, the egg and sperm may not meet when needed.
Problems with the Uterus or Lining
The uterus may look normal in a scan, but the lining may not be ready for the embryo to stick and grow.
Minor Hormonal Imbalances
Small hormone issues may not show up in basic tests but can affect ovulation or embryo growth.
Immune System Problems
In some cases, the body may treat the embryo like a foreign object and stop it from growing.
Lifestyle or Stress Factors
High stress, poor sleep, unhealthy eating, or too much exercise can quietly affect fertility without showing in test results.
Tests You May Need
When basic fertility tests don’t show any clear reason for infertility, your doctor may suggest some advanced or repeated tests to take a closer look. These tests can help to find small issues that may have been missed earlier.
Here are some important ones:
Hormone Level Tests
These blood tests check if your body is making the right amount of hormones like FSH, LH, AMH, and thyroid hor mones. They help to understand your egg reserve and if you’re ovulating properly.
Ultrasound Scan
A detailed pelvic ultrasound checks your ovaries, uterus, and the lining of the womb. It can spot small cysts, fibroids, or thin endometrial lining.
HSG (Hysterosalpingography)
This is an X-ray test where a special dye is passed into the uterus and fallopian tubes to check if they are open and healthy. Sometimes, blockages or tube issues may be found this way.
Semen Analysis (Repeated)
Even if one semen test looks normal, repeating it can give a better idea about sperm count, movement, and shape. Small issues in sperm function can affect fertilization.
Advanced Sperm Tests
These check for DNA damage in sperm or how well they can fertilize an egg—something regular tests might not show.
Laparoscopy
This is a small surgery where a camera is used to look inside the abdomen and check for problems like endometriosis, scar tissues, or hidden infections. It’s done when all other tests are normal but pregnancy still doesn’t happen.
Endometrial Receptivity Tests
These tests check if the lining of the uterus is ready for the embryo to attach. Sometimes, timing issues or inflammation may stop implantation.
Treatment for Unexplained Infertility
There are many treatment options that can still help you conceive even when the reason for infertility is not known. Your doctor may suggest starting with basic steps and move toward advanced options if needed. The goal is to support your body in the best way to achieve pregnancy.
Here are some common treatment options that include the following:
- Healthy lifestyle changes – Eat well, manage stress, maintain a healthy weight, avoid smoking and alcohol.
- Ovulation medicines – Help the ovaries to release more eggs to increase chances of pregnancy.
- Timed intercourse – Planning intercourse around the most fertile days.
- IUI (Intrauterine Insemination) – Sperm is placed directly into the uterus during ovulation.
- IVF (In-Vitro Fertilization) – Eggs and sperm are combined in a lab, and an embryo is transferred to the uterus.
- Use of donor eggs or sperm – Suggested if hidden egg or sperm issues are later found.
- Emotional support – Counseling or support groups can help manage stress and stay positive during the journey.
How IVF Can Help When Nothing Else Works?
When all other methods like ovulation medicines, lifestyle changes, and IUI don’t lead to pregnancy, IVF (In-Vitro Fertilization) can be a next step. In unexplained infertility, IVF gives doctors more control over each stage of the process. It allows them to carefully combine the egg and sperm in a lab and choose the best embryo to transfer into the uterus. This greatly increases the chances of pregnancy, even when the exact reason behind infertility is not clear.
IVF can also help identify hidden issues like poor egg quality, weak sperm, or problems with fertilization that may not be detected in normal tests. In this way, IVF not only helps couples conceive but also gives more insight into what might be going wrong.
Final Words
Unexplained infertility can be emotionally exhausting, especially when all test reports come back normal but pregnancy still doesn’t happen. But with the right approach and advanced treatment options like IVF, many couples do find success. Timely diagnosis, emotional support, and expert care can make all the difference in turning hope into reality.
At RISAA IVF, Dr. Rita Bakshi, Senior IVF Specialist and Gynaecologist, offers personalized care for couples facing unexplained infertility. From in-depth testing to step-by-step treatment planning, we’re here to support your journey with empathy and experience. Call us at 95555 44421/22/23 or email at doctor@risaaivf.com to start your journey with the right care and guidance.
Frequently asked questions (FAQs)
How common is unexplained infertility?
It is quite common. Around 10-20% of couples who visit fertility clinics are told they have unexplained infertility.
Can I still get pregnant naturally with unexplained infertility?
Yes, some couples do conceive naturally over time, but others may need treatments like IUI or IVF to help.
Is unexplained infertility permanent?
Not always. Some couples go on to conceive naturally or with treatment. Each case is different, so don’t lose hope.
Can frozen embryo transfer help in unexplained infertility?
Yes. In some cases, frozen embryo transfers (FET) may improve outcomes by allowing the body time to recover before implantation.
How many IVF cycles may be needed?
Some couples conceive in the first IVF cycle, while others may need 2–3 attempts. Your doctor will guide you based on your case.