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Diagnosis and Treatment of Unexplained Infertility

When you are under 35 and have been trying to conceive for one year or over 35 and trying to conceive for six months, and your infertility workup shows normal results, your diagnosis may be "unexplained infertility." About one in five couples are diagnosed with unexplained infertility.

Diagnosis of Unexplained Infertility

Fertility tests may include:

  • Medical history
  • Physical exam (may include pelvic ultrasound)
  • Various ovulation tests
  • FSH and/or AMH tests to check the quality and quantity of your eggs
  • Blood tests to determine hormone levels of you and your partner
  • Semen analysis
  • Hysterosalpingogram (HSG) to examine your uterus and fallopian tubes
  • Laparoscopy to check for endometriosis or pelvic scarring

Treatment of Unexplained Infertility

Unexplained infertility is usually treated with a combination of fertility drugs and intrauterine insemination (IUI) or assisted reproductive technology (ART) such as in vitro fertilization (IVF).

One of the most common fertility drugs is clomiphene citrate (brand names Clomid or Serophene). It stimulates production of the hormones FSH and LH which are needed to trigger or regulate ovulation. You take it in pill form for five days and should start ovulating about a week after taking the last pill.

If you’re older than 35, you’re more likely to get pregnant if you combine clomiphene citrate with IUI, which uses a thin tube to place your partner’s (or donor) sperm into your uterus while you’re ovulating. IUI is usually not effective if you’re over 40-years-old.

Some women have success combining IUI with injections of fertility drugs that stimulate the ovaries to produce mature eggs.

Depending on your age and the results of your fertility work up, many fertility doctors recommend IVF as a first line of treatment.


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