Patient Resources

Achieving Pregnancy with Unexplained Infertility 

Unexplained infertility does not mean there is not a solution. Instead, it is a reason to have hope. Unexplained infertility is a frustrating diagnosis to receive, but it is common. Approximately one in four couples dealing with infertility will be told there is no explanation for why they can’t conceive. Unexplained infertility is treated based on clinical experience and guesswork. Here are some treatment options:

Lifestyle Changes

The most common suggestions to improve fertility naturally is to exercise, quit smoking, avoid excessive alcohol consumption, cut back on caffeinated drinks, and reduce overall stress. These lifestyle changes are in general good for your health. There is no research proving that these lifestyle changes will increase fertility, but it is a good rule of thumb for increasing overall health and in turn fertility.

Try to Conceive Naturally

It is best to try conceiving naturally when infertility is unexplained instead of jumping straight into IVF at NCCRM. Fertility treatments are not necessary and could do more harm than good in this situation. According to VeryWell Family, a randomized clinical trial was conducted comparing expectant management (for couples with a good prognosis) with IUI plus fertility drugs over a six-month period. 33 percent of women who received IUI plus fertility drugs achieved pregnancy and 23 percent of the pregnancies were on-going at the end of the study. For the women who did not receive treatment, going the expectant management route 32 percent got pregnant on their own and 27 percent of the pregnancies were on-going at the end of the study. IUI plus fertility drugs for those with good prognosis did not improve their odds of pregnancy success. The couples that kept trying on their own were just as likely to conceive as those who received treatment.

Fertility Prescriptions

Clomid is the most common fertility prescription for women that are not ovulating. Clomid treatment is not harmless and is also only recommended for up to six cycles, due to the possible increased risk of cancer. If your doctor suggests Clomid alone, discuss whether it would be better to continue trying on your own for a while longer, or discuss whether they would consider moving straight to IUI with Clomid. For unexplained infertility, it may need more aggressive treatment like IVF.

IVF Treatment

The pregnancy rates in a randomized control study were 7.6 percent per cycle for Clomid with IUI, 9.8 percent per cycle for gonadotropins with IUI, and 30.7 percent per cycle for IVF. IVF has the best chance of a successful pregnancy. As mentioned before, IVF treatment is three times as effective than IUI with Clomid. Not only that, but the cause of the “unexplained” infertility is sometimes discovered during treatment. However, IVF is invasive and expensive. You might think going straight to IVF is the best choice due to its success rate, but it is actually better to give IUI with Clomid a try first. The exception being if you are 30 years old or older, proceeding straight to IVF, and skipping IUI may be the best choice. This is best discussed with your doctor.


The North Carolina Center for Reproductive Medicine/Talbert Fertility Institute is the premiere center for reproductive health in North Carolina and the East Coast. Our team specializes in fertility testing, diagnosis, and treatment of infertility conditions. We’re experts in IVF, Tubal Ligation Reversal, Male Infertility, Intrauterine Insemination (IUI), Gestation Surrogacy, Family Balancing, and more. Contact us today.

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