What does "unexplained" mean?
It means the standard tests have not found a cause. Usually this includes:
- The woman is ovulating (releasing an egg)
- The fallopian tubes are open
- The womb looks normal on a scan
- The man's semen test is normal
It does not mean nothing is wrong. There may be small problems that current tests cannot pick up, for example with egg quality, fertilisation, or how the embryo attaches to the womb.
Common signs
There are usually no signs other than not getting pregnant after trying for a year (or six months if the woman is 35 or older). Periods are often regular, and both partners feel healthy.
How it affects fertility
Many couples with unexplained infertility do get pregnant naturally over time. But the chance each month is lower than usual, and it falls as the woman gets older. That's why age is the most important factor when deciding what to do next.
How it is diagnosed
Unexplained infertility is diagnosed only after a full check-up of both partners: blood tests for hormones and egg reserve, an ultrasound scan, a tube test, and a semen analysis. If any of these were not done before, we will suggest completing them. See our fertility tests page.
Treatment options
- Trying naturally a little longerFor younger couples who haven't been trying for long, your doctor may suggest timed intercourse for a few more months.
- Ovulation induction with IUIMedicines to help release an egg, with washed sperm placed in the womb at the right time. Learn more about IUI
- IVFOften advised if IUI hasn't worked, if the woman is older, or if you have been trying for a long time. IVF can also show problems with eggs or fertilisation that other tests miss. Learn more about IVF
Things you can do
- Have intercourse every 2–3 days through the month, especially around your fertile days (see our ovulation calculator)
- Both partners: stop smoking and tobacco, and limit alcohol
- Keep a healthy weight
- Start folic acid if you are trying to conceive (ask your doctor)
- Don't wait too long if the woman is over 35
Common questions
If all our tests are normal, why aren't we pregnant?
Tests can check the main things, but not everything. Small issues with egg quality or fertilisation can't always be seen on tests. This is common and is not anyone's fault.
Should we just keep trying?
It depends on the woman's age and how long you have been trying. Your doctor will help you decide whether to wait or start treatment.
Do we need to go straight to IVF?
Not always. Many couples start with IUI. IVF may be suggested sooner if the woman is older or you have been trying for several years.