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Unexplained infertility: Causes , Diagnosis and Treatment Options

Unexplained infertility: Causes , Diagnosis and Treatment Options


Unexplained infertility is responsible for about 10-12% of infertility cases in couples around the world. In this video, Dr Abayomi Ajayi explains the causes of unexplained infertility and the diagnosis and treatment options available for couples.

My name is Dr. Abayomi Ajayi  and today we are discussing something very interesting, unexplained infertility i.e the group that is under the “doctors can’t figure out what’s happening”. There are four basic tests for infertility evaluation:

  •  Semen analysis
  • Ultrasound scan
  • Ovarian assay (to see what the present store of eggs are like)
  • HSG or Laparoscopy (to see what the tubes are like).

When we do these four tests, we are able to discover the reason for about 85 – 90% percent of the time what is wrong with the couple. But in about 10 to 12% of the couples, we are not able to find out any reason why this is so. This is the group labelled ”unexplained infertility”. 

Common Causes Of Unexplained Infertility

We keep talking about age, especially in women. This is because the older a woman becomes, the more difficult it is for her to get pregnant. For even the same person, if you got pregnant when you were 30, it would be more difficult when you are 35. It can also depend on some other factors that are not pronounced, but by the time you are 40, definitely there would be a decline in the chances for you to get pregnant.

Endometriosis is a situation where the lining of the uterus which a woman sheds every month, is in another place apart from where it is supposed to be. So instead of it being shed out like menstrual period, it sheds probably to the abdomen and this is the common thing. It occurs in about 1 in every 10 women. When it is mild, we might not get the telltale signs, except you do Laparoscopy and you know what you are looking out for. 

DNA Fragmentation
Another reason for the unexplained infertility is the DNA fragmentation in the semen sample of the husband. This is tricky because what we look out for normally during semen analysis is to see if the sperm count, density and motility are good. However, men also have abnormal sperm forms or sperm DNA structure. It has also been found out that people who are exposed to chemicals are more likely to have fragmented sperm DNA. Examples are people in the petrochemical industry or people who smoke or people who regularly put their laptop on their laps.

Treatment For Unexplained Infertility
The treatment for unexplained infertility are:

  • Intrauterine insemination: If the woman is below 35year intrauterine insemination with ovulation induction can yield very good results. But if she is over 35, then she should consider doing IVF. 
  • In-vitro Fertilization: 

People with unexplained infertility need a lot of emotional support, so it is important for them to seek professional counseling. Always remember together we can conquer infertility. 


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