Why Can't I Get Pregnant? Unexplained Infertility Explained

What Is Unexplained Infertility?

When a couple has been trying to conceive for at least 12 months without success, doctors run fertility tests. Women are checked for hormones, ovulation, and fallopian tube health, while men usually undergo semen and hormone tests. If all results are normal, the diagnosis may be unexplained infertility.

Experts emphasise that unexplained infertility does not mean pregnancy is impossible. Instead, it indicates that current testing has not identified the subtle factors affecting conception.

What Are the Types of Unexplained Infertility?

Clinically, unexplained infertility is generally categorised into two primary types:

1. Primary Unexplained Infertility

   Primary infertility is diagnosed in couples unable to achieve a clinical pregnancy despite at least 12 months of unprotected intercourse, with normal standard investigations. The paradox of “normal results” yet absent conception often creates psychological distress.

2. Secondary Unexplained Infertility

   When a couple has already had a pregnancy but can’t conceive again, it’s called secondary infertility. It’s confusing, painful, and often misunderstood, but very real.

Both forms of infertility can be difficult, but identifying which applies allows doctors to create a more precise and effective treatment plan.

What are the Causes and Risk Factors of Unexplained Infertility?

It’s confusing when all the tests say “everything’s fine,” yet pregnancy still doesn’t happen. Doctors often discuss the hidden causes of unexplained infertility, such as:

• Endocrine variations: Minor undetected imbalances in reproductive hormones may impact ovulation efficiency and implantation success.
• Ovulation issues: Regular cycles don’t guarantee ovulation, but identifying and correcting issues can boost conception chances.
• Sperm problems: Even with normal counts, addressing motility, morphology, or DNA issues can improve fertilisation outcomes.
• Tube trouble: Your tubes might look fine on scans, but small damage or issues can still block egg and sperm from meeting.
• Immune system involvement: Sometimes the immune system can unintentionally interfere with conception, but doctors can help.
• Lifestyle influences: Stress, bad eating habits, toxins, smoking, or big weight changes can all affect your fertility in ways tests might not catch.

How Is Unexplained Infertility Diagnosed?

“Unexplained infertility” just means doctors couldn’t find a reason after testing everything. Here’s the typical step-by-step process.

• Fertility evaluation: A thorough review of cycles, reproductive history, and health ensures that no subtle concern is overlooked.
• Ovulation tracking: Blood tests and scans make sure your eggs are being released regularly.
• Hormones: FSH, LH, AMH, and thyroid hormone levels are measured to assess ovarian reserve and function.
• Tubes: HSG or an ultrasound can check if your fallopian tubes are open.
• Male fertility: A semen test checks sperm health, and extra tests look at anything unusual.
• Combined assessment: Doctors review age, health history, lifestyle, and timing of intercourse for a full picture of fertility.
• Laparoscopy (if indicated): If needed, laparoscopy is a small, minimally invasive surgery that can reveal hidden endometriosis or pelvic adhesions that scans might miss.

If your tests all come back normal and no cause is found, the term “unexplained infertility” may be used, but it doesn’t mean there’s no hope.

Treatment Options

Even when nothing seems “wrong,” there are many ways to increase your chances of conceiving. Doctors usually personalise treatment based on your age and health. Typical treatment for unexplained infertility include:

• Track ovulation & time it right: Your doctor may suggest using blood tests, ultrasounds, or home kits to find your fertile window. Having sex at this time boosts your chances.
• Timed intercourse: Tracking ovulation through tests or scans can help identify fertile days. Timing intercourse carefully can give you hope and a better chance of conceiving.
• Medications: Advised medicines from doctors can gently support ovulation, giving your body a stronger, more predictable response.
• IUI: IUI is a simple procedure that helps sperm reach the uterus during ovulation, bypassing minor obstacles and improving your chances.
• IVF: IVF can help when other options fail, overcoming hidden issues that may make conception difficult.
• Lifestyle: Keeping a healthy weight, eating well, exercising moderately, managing stress, and avoiding alcohol or smoking can boost your fertility.
• Support and counselling: Therapy, support groups, and honest conversations with your partner are vital tools for coping with infertility stress.

A fertility specialist can create a plan that treats medical issues while nurturing emotional health, paving the way toward conception.

Conclusion

Coping with unexplained infertility is as emotional as medical, and support groups or counselling can make the journey manageable. While there may be no clear medical reason, hope is far from lost. Understanding subtle factors, seeking early evaluation, and accessing treatment options can improve your chances of pregnancy. Emotional support, expert counselling at Indira IVF, and open communication with your partner can make the journey less overwhelming and more manageable.

Frequently Asked Questions

How long should I try before seeing a fertility specialist?

Fertility guidance recommends that couples under 35 attempt conception for up to 12 months. Women over 35 should seek consultation after six months to optimise fertility outcomes.

Does “unexplained infertility” mean I can’t get pregnant naturally?

Unexplained infertility doesn’t mean you can’t get pregnant. Many couples do. Having sex at the right time, eating well, exercising, and sometimes getting medical help improve chances.

Can age affect unexplained infertility?

Yes, fertility drops as we get older; women after 35, men more slowly. Seeing a doctor sooner rather than later can make a difference.

Are there lifestyle changes that improve fertility?

Yes, eat well, move your body, maintain a healthy weight, manage stress, sleep enough, and avoid smoking, heavy drinking, and junk food to improve fertility.

What treatments have the highest success for unexplained infertility?

IVF typically represents the most effective intervention for unexplained infertility. Protocols are personalised to the patient’s age, reproductive history, and specific objectives, especially after unsuccessful IUI or timed intercourse attempts.

Can emotional stress cause unexplained infertility?

Stress usually isn’t the main reason couples struggle to conceive, but it can throw off hormones, cycles, and intimacy. Looking after your mental health through therapy, meditation, or support groups can actually improve your fertility journey.