International Clinical and Medical Case Reports Journal (ISSN: 2832-5788) | Volume 5, Issue 10 | Review Article | Open Access
Shahdab*
Shahdab*, Roohi Jan
Hospital Bradford Royal Infirmary
Fulltext PDFOf the couples unable to conceive without any identifiable cause, 30% are defined as having unexplained infertility. Management depends on duration of infertility and age of female partner. This review describes and comments on the definition and evidence for the management of unexplained infertility. A literature search was conducted in EMBASE, Medline, Ovid and Cochrane Database of Systematic reviews using the terms ‘infertility’, ‘unexplained infertility’, ‘idiopathic infertility’, ‘definition of infertility’, ‘treatment options’, ‘intrauterine insemination’, ‘ovulation induction’, ‘Fallopian tubAe sperm’, ‘GIFT’ and ‘IVF’. There is no uniform definition for unexplained infertility. This varies in the literature depending on the duration of infertility and the age of the female partner. Although additional investigations are reported to explain or define other causes of infertility, these have high false-positive results and therefore cannot be recommended for routine clinical practice. Couples with unexplained infertility might be reassured that even after 12 months of unsuccessful attempts, 50% will conceive in the following 12 months and another 12% in the year after the treatment of unexplained infertility is empirical and many different regimens have been used. Among these are expectant management, ovulation stimulation with clomiphene citrate, gonadotrophins and aromatase inhibitors, Fallopian tube sperm perfusion, tubal flushing, intrauterine insemination, gamete intra-Fallopian transfer and IVF. The standard protocol is to progress from low-technology to high-technology treatment options. On the best available evidence, an algorithm for management is suggested. There is a definite need for multicentre randomized controlled trials to identify the best treatment option in unexplained infertility using a standard definition.
Of the couples unable to conceive without any identifiable cause, 30% are defined as having unexplained infertility. The management for unexplained infertility is empirical. There is no uniform definition for unexplained infertility. The timely access to effective treatment for subfertility is important as many couples have a narrow window of opportunity before the age-related effects of subfertility limit the likelihood of success. Assisted reproduction can overcome the barriers to fertility caused by tubal disease and low sperm count, but little progress has been made in reducing the effect of increasing age on ovarian function. The next 5–10 years will likely see further increases in birth rates in women with subfertility, a greater awareness of lifestyle factors and a possible refinement of current assisted reproduction techniques and the development of new ones. The treatment of unexplained infertility is empirical and many different regimens have been used. Among these various treatment options are expectant management, ovulation stimulation with clomiphene citrate, gonadotrophins and other agents, Fallopian tube sperm perfusion, tubal flushing, intrauterine insemination, gamete intra-Fallopian transfer and IVF. There is no definite evidence to show that any one treatment is better than the other. Treatment of unexplained infertility is very much dependent on availability of resources and patients’ age and duration of infertility.
There is a definite need for multicentre randomized controlled trials to identify the best treatment option in unexplained infertility.
Shahdab, Roohi Jan. Literature Review on Unexplained Infertility: An update and Review of Practice. Int Clinc Med Case Rep Jour. 2026;5(10):1-11.