Infertility may be caused by male factors, female factors, or a combination of the two. Unexplained infertility is the medical term for when doctors cannot find a clear explanation for infertility.

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Pregnancy happens when a sperm fertilizes an egg and then travels from the fallopian tubes to the uterus, implanting into the endometrium. While most people get pregnant within a year while trying to conceive, many factors may make this process anything but straightforward.

Here’s what you need to know about unexplained infertility, how it’s diagnosed, and what treatments may help.

If you and your partner have been having sex regularly without a barrier method or other birth control method for one year and have not conceived, it’s considered infertility.

There are several conditions and considerations that may lead to infertility in both males and females, such as:

Infertility is “unexplained” when exams and testing don’t identify a clear cause.

Doctors use a variety of tests to determine the root cause of infertility. Testing is suggested when you have been trying for a year without conceiving — sooner if you or your partner are over age 35.

Unexplained infertility is a diagnosis of exclusion. This means that if fertility testing doesn’t find a clear reason for infertility, a doctor may diagnose unexplained infertility.

Fertility testing for females may include:

The most important fertility test for males is semen analysis. In this test, males provide a sample of semen to be analyzed in a lab. Trained healthcare professionals look at sperm motility (movement) and overall sperm count to evaluate if sperm issues are contributing to infertility.

Depending on your age, health, and other factors, the following treatment options may be available to you:

Timed intercourse

This less invasive treatment involves timing intercourse to correspond with ovulation. There are various ways to determine if ovulation has or may occur, including:

It’s suggested that you have intercourse 1 or 2 days before ovulation. In some cases, your doctor may also suggest using fertility medications to stimulate the ovaries to produce eggs.

Ovulation stimulation

Ovulation stimulation or induction uses prescription medications (fertility medications) to induce ovulation.

Ovulation stimulation is often used at the same time as other treatment options, such as IUI and IVF.

Research from 2020 suggests that ovarian stimulation leads to higher pregnancy rates but there is a risk that the pregnancy results in having multiples (twins, triplets, etc.).

Intrauterine insemination

With intrauterine insemination (IUI), sperm is placed directly into the uterus using a tube through the cervix. This procedure may be performed with or without fertility medications.

IUI with ovulation induction is considered a first-line treatment for unexplained infertility.

In vitro fertilization

In vitro fertilization (IVF) is a procedure that involves harvesting eggs from the female and fertilizing them with sperm in a lab setting.

You may also have an embryo transfer following IVF, in which one or more embryos are transferred and introduced back into the uterus in the hopes they will implant in the endometrium and grow.

This process can be done with the couple’s eggs and sperm, but donor eggs, donor sperm, or both are also options in some cases.

Many people who are diagnosed with unexplained infertility go on to have a child, whether after making lifestyle changes, employing techniques like timing intercourse, or using assisted reproductive technology (ART) like IVF.

In a 2022 study, 18.5% of couples become pregnant within two cycles by using fertility medications and timed intercourse. The success rate with IUI is between 4% and 13% per cycle — higher with drugs like Clomid. The success rate with IVF is around 30% per cycle.

Can unexplained infertility be cured?

The diagnosis of “unexplained” infertility means that doctors do not know the cause. It’s not a condition that has a prescribed cure. However, fertility treatments can help couples overcome infertility.

How to get pregnant if you think you have unexplained fertility?

Couples may use fertility procedures like ovulation induction, IUI, IVF, or a combination of these to become pregnant. Some couples may get pregnant after making lifestyle changes or timing intercourse.

Does Clomid help with unexplained infertility?

It may. Clomid is a drug used to stimulate the ovaries to produce mature eggs. It may help couples with unexplained infertility, mainly when used along with IUI.

You may also be prescribed other medications.

Unexplained infertility can be a difficult diagnosis, but there are many ways doctors can help you conceive.

If you’re younger than 35 years old and have been trying for over a year or are over age 35 and have been trying to conceive for 6 months or longer, speak with a fertility specialist.

People over age 40 or anyone with other health conditions that may affect their fertility may need to see a fertility specialist sooner.

These healthcare professionals can work with you to help assess your fertility, conduct infertility testing, and identify the best treatment options for you.