Approximately 5 to 15% of patients with infertility have an unidentifiable cause. Thus, unexplained infertility is a failure of both the couple to conceive and the physician to explain why. Perhaps even more psychologically difficult to accept than sterility, unexplained infertility poses impressive stress to the couple. Despite doing all they can correctly, the couple is unable to conceive and has no answer to their problem even after enduring expensive, painful testing. Their only recourse is empiric therapy.
Couples with unexplained infertility have routine intercourse, have regular menstrual cycles and normal infertility testing results.
Physical Examination-
Inherent to the diagnosis, physical examination reveals no abnormalities.
The diagnosis of unexplained in fertility is made in couples who have intercourse regularly or well-timed intercourse and fail to conceive despite regular ovulatory cycles, a normal semen analysis, normal laparoscopy, and normal hysterosalpingography
Couples with unexplained infertility may conceive without therapy but it may take from 3 to 7 years. (44). To decrease the waiting time, empiric therapy is instituted. Empiric therapy usually begins with parenteral gonadotropin therapy combined with intrauterine insemination. This combined therapy increases the cyclic fecundity over either alone in couples with unexplained infertility (45). After three or four unsuccessful cycles, or alternatively, in vitro fertilization may be offered.