What is unexplained infertility? Doctors say quarter of Brits struggling with fertility have it

Unexplained infertility affects around a quarter of couples with fertility issues. (Getty Images)
Unexplained infertility affects around a quarter of couples with fertility issues. (Getty Images)

It can be heartbreaking when you are trying to have a baby and the pregnancy test comes back negative month after month - but even more so when you are trying to get to the root cause of the issue only to be told you have ‘unexplained infertility’.

According to the National Institute for Health and Care Excellence (NICE), around one in seven heterosexual couples in the UK are affected by infertility.

It adds that since it began publishing its guidelines on fertility in 2004, there has been a small increase in the prevalence of fertility problems, and a greater portion of people now seeking help for problems.

For people struggling to conceive, unexplained infertility is actually quite common. According to NICE, 25% of people experiencing fertility issues have been diagnosed with unexplained infertility by their doctor.

The other most common causes of infertility include ovulatory disorders (25%), tubal damage (20%), factors in the male causing infertility (30%) and uterine or peritoneal disorders (10%).

What is unexplained infertility?

"Unexplained infertility is a diagnosis given to couples who are struggling to conceive a child through regular intercourse when no clear cause for infertility can be found," Tess Cosad, fertility expert and CEO and co-founder at Béa Fertility, says.

Cosad adds that an unexplained infertility diagnosis is only given once a thorough medical evaluation has been completed, which can include hormone level assessments, ovulations, sperm quality, and fallopian tube function.

"If there are no apparent abnormalities, a diagnosis of unexplained infertility may be given," Cosad continues. "Unexplained infertility can be frustrating and emotionally challenging because it doesn’t give individuals or couples a clear understanding of why they are struggling to conceive."

used pregnancy tests ~ shot with canon eos rp
Unexplained infertility can be frustrating and emotionally challenging. (Getty Images)

However, Cosad reassures that many people who are given the unexplained infertility diagnosis can go on to have a successful pregnancy.

It is not known why unexplained infertility happens, and it can affect any couple regardless of their age, ethnicity or background.

"We do know that age can be a factor that makes it more difficult to conceive, due to a decline in our ovarian reserves, reduced egg reserves and hormonal changes after the age of 35," Cosad says.

"While unexplained infertility is not linked to specific health conditions or lifestyles, we do know that certain factors such as smoking, excessive alcohol consumption and high stress levels can affect fertility."

Options for couples with unexplained infertility

There are several options for couples who are diagnosed with unexplained infertility, embryologist and fertility coach Sandy Christiansen says.

Lifestyle changes

Changes to your lifestyle should always be a first port of call if you are suffering from unexplained infertility as it can optimise your chance of conception. Christiansen recommends quitting smoking, reducing alcohol and caffeine intake, and managing stress.


"In some cases, unexplained infertility may be linked to irregular ovulation or thyroid problems," Christiansen explains. "Medications may be prescribed to promote hormonal balance and stimulate the ovaries to improve the likelihood of ovulation."

Mature couple holding hands at a doctors office. Doctor can be seen in the background.
There are some medical options for people struggling with unexplained infertility. (Getty Images)

Intracervical Insemination (ICI)

One type of fertility treatment you could pursue is intracervical insemination (ICI), which can be carried out at home without visiting a fertility clinic.

"ICI involves placing a small cap of semen close to the cervix using a specially-designed applicator, where it remains in place for several hours," Christiansen says.

"This can increase the chances of fertilisation for people with unexplained infertility because it improves the sperm's proximity to the egg."

In vitro fertilisation (IVF)

In vitro fertilisation is more commonly known as IVF and is a more advanced fertility treatment that is more commonly recommended if you have been trying to conceive a child for two or more years.

IVF sees a woman inject herself with fertility hormones to stimulate the ovaries to produce several eggs, which are then collected and mixed with sperm in a laboratory before being placed back inside the woman for pregnancy.

IVF is available on the NHS, but it is dependent on a ‘IVF postcode lottery’, so it is not available for everyone.

Exploratory laparoscopy

In some instances, Christiansen explains that a laparoscopic procedure "may be recommended to examine the pelvic organs for any hidden issues such as endometriosis or adhesions that might not be visible on routine tests".

"It's important for couples with unexplained infertility to work closely with a fertility specialist who can provide personalised guidance and recommendations based on their specific situation," she adds.

How to cope with unexplained infertility

Unexplained infertility can take a toll on your mental health, but Christiansen says there are several things you can do to make the process easier such as seeking support, educating yourself on the fertility process, and limiting your exposure to triggers.

Young woman under pressure
Unexplained infertility can take a toll on your mental health. (Getty Images)

"If certain situations or conversations trigger negative emotions related to infertility, it's OK to set boundaries and limit your exposure to those triggers when possible," she adds.

"This might mean not hanging out with friends and their babies, or unfollowing people on social media who are regularly posting about their families."

She also recommends setting realistic expectations and timelines. "Be prepared for setbacks and the possibility that it may take multiple treatment cycles before achieving a successful pregnancy," she adds.

"Don't hesitate to take breaks from fertility treatments if they become overwhelming. This can give you time to recharge and regain your strength, both emotionally and physically."

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