What Is ‘Unexplained Infertility?’ How to Navigate a Challengingly Vague Diagnosis

What Is ‘Unexplained Infertility?’ How to Navigate a Challengingly Vague Diagnosis

When you’re dealing with infertility, getting a proper diagnosis can be the first step toward a successful pregnancy. But sometimes, even that can be an elusive pursuit. However, up to 30 percent of couples facing infertility will receive the frustrating diagnosis of unexplained infertility.1 This simply means that routine fertility testing failed to find a clear cause for a couple’s infertility.

As if infertility wasn’t stressful enough already, this can add an extra layer of uncertainty—how do you find the best fertility treatment plan when you’re not fully sure what’s wrong? 

The good news is, even with a diagnosis of unexplained infertility, the odds of getting pregnant are still solidly in your favor. In fact, with fertility treatments, 92 percent of couples with unexplained infertility eventually have a child.2

How Unexplained Infertility Is Diagnosed

Unexplained infertility is diagnosed by ruling out other possible causes of infertility.3

An estimated 1 in 8 couples experience infertility. When a couple seeks the help of a fertility specialist, they can expect to undergo a series of routine tests to look for some of the most common causes of infertility. These will likely include:

  • A semen analysis to assess male sperm count and characteristics
  • An ultrasound and/or blood tests to assess ovarian reserve (the remaining number of eggs in the ovaries)
  • An ultrasound and/or blood tests to evaluate ovulation
  • Blood tests to check hormone levels
  • An imaging test called a hysterosalpingogram (HSG) which examines the uterus and fallopian tubes and looks for any abnormal conditions that may affect fertility 

“The first step is assessment, where we figure out why,” says Dr. Andy Huang, M.D., a board-certified OB/GYN specializing in reproductive endocrinology and infertility. “After assessment, we make a diagnosis. And then, once you get the diagnosis, we go into treatment.”

In around 15 to 30 percent of infertility cases, however, these tests fail to pinpoint the exact problem, resulting in the vague-sounding diagnosis of unexplained infertility. This can be nerve-wracking, but rest assured—even without a clear explanation for infertility, you still have a wide range of treatment options available.4

How Is Unexplained Infertility Treated?

If you’ve been diagnosed with unexplained infertility, it’s important to explore all of your fertility treatment options. Without treatment, research suggests a couple with infertility has between a 1 and 4 percent chance of getting pregnant each cycle.5 A healthy 30-year-old, by comparison, has about a 20 percent chance of getting pregnant each month.6

Unexplained infertility may be treated with medication, such as clomiphene citrate or injectable gonadotropins, to help induce ovulation. Your provider may also work with you to pinpoint your fertile window that you can time sex around. Procedures such as intrauterine insemination (IUI) and in vitro fertilization (IVF) may also be used to help you get pregnant. 

Of these options, IVF is typically the most successful. Research suggests IVF results in a healthy pregnancy in around 40 percent of women experiencing unexplained infertility.7 

Coping with an Unexplained Infertility Diagnosis

While the unknowns of unexplained infertility can feel like a heaven burden to carry, there are a few simple things you can do to practice self-care and support your fertility during the next phase of your journey. 

Adopt healthy habits.

“Focus on foundational practices like getting adequate sleep, moderating stress, limiting caffeine intake to less than 100 mg per day, and decreasing or abstaining altogether from alcohol,” says Dr. Caitlin O’Connor, a Naturopathic Doctor specializing in holistic treatment for women and children. “These are all significant steps to help increase fertility.”  

Work together.

A Perelel study of women found that 92 percent of women who were trying to conceive were taking supplements to support their fertility, compared to only 42 percent of men. But fertility is 50/50, so it’s important to face it as a team. “Everything women are doing, their partners should be doing as well,” says O’Connor. While women are typically advised to start taking prenatal vitamins six months before trying to conceive, men can support their own reproductive health by taking a Men’s Multi designed to support their reproductive health. 

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Support your mental health. 

Worrying about infertility (and all the what-ifs) can consume your thoughts, so be sure to make your mental and emotional wellbeing a priority. Here are a few simple ways to protect your inner peace: 

  • Practice mindful meditation.
  • Take a yoga class.
  • Put your feelings to paper in a journal. 
  • Schedule quality time to nurture your relationship with your partner — without focusing on the stress of TTC. 
  • Ask for support when you need it from family, friends, a counselor, or a support group.

All fertility journeys are unique, but it's important to remember that you're not along in your struggles. When surveying nearly 1000 members of our community about their TTC experience, we were struck not by the individuality of these different journeys but by how much they had in common. When we asked, for example, what they wished others knew about fertility, one answer rang out again and again: “It’s not as easy as we’re taught.” When the narrative we’re raised with starkly contrasts our reality, it’s easy to feel frustrated and alone. Moral of the story? Be gentle with yourself, and, as always, lean on your community.

Find support with other women by joining Village by Perelel on Geneva.


  1. Alexander Quaas, MD, PhD and Anuja Dokras, MD, PhD; Diagnosis and Treatment of Unexplained Infertility; Spring 2008
  2. Cleveland Clinic: Unexplained Infertility
  3. Yale Medicine: Unexplained Infertility
  4. The American College of Obstetricians and Gynecologists: Treating Infertility
  5. Alexander Quaas, MD, PhD and Anuja Dokras, MD, PhD; Diagnosis and Treatment of Unexplained Infertility; Spring 2008
  6. American Pregnancy Association: How to Get Pregnant – Best Tips to Help You Conceive
  7. Alexander Quaas, MD, PhD and Anuja Dokras, MD, PhD; Diagnosis and Treatment of Unexplained Infertility; Spring 2008