Unexplained infertility (or idiopathic infertility) is when no cause for that infertility is found even after a full investigation of both partners. Routine test such as semen analysis, post coital test, hormone measurements and ultrasound scans to determine regularity of ovulation, hysterosalpingorams or laparoscopy to determine whether the tubes are patent (open), assessment for sperm dysfunction or antibodies.
Often the reason for unexplained infertility may be due to minor irregularities of ovulation, sperm function or the endometrial development is out of synchrony with the rest of the cycle. At other time no real cause can be found - causing considerable stress for both partners. There is often some relief when a definite cause can be indicated - at least that may mean that something can be done about it. Even a slight 'asynchrony' between many of the factors necessary for conception may also be important.
Treatment for unexplained infertility includes attempts to improve the regularity of ovulation with drugs such as clomiphene citrate or gonadotrophins followed by either intrauterine insemination (when a preparation of sperm in a culture medium is placed directly into the uterus) or by IVF when, after stimulation with gonadotrophins the eggs are retrieved and placed with the sperm - if fertilization occurs the embryos can be transferred to the uterus. One of the great advantages of IVF is that it gives an indication of whether fertilization has or has not occurred.
Unexplained infertility is one of the most difficult circumstances for patients to cope with - there always seems to be more hope when you know what the cause of the problem is - when there is no apparent cause is like living in a vacuum. As more and more experience is gained in the treatment of infertility it is likely that the number of patients diagnosed as 'unexplained' will decrease.