• June 10, 2025

Understanding Unexplained Infertility - Dr. Kriti Agarwal

Unexplained infertility is diagnosed when a couple has been trying to conceive for over a year without success—and standard fertility tests reveal no clear cause. This diagnosis is more common in women over 40 due to the natural decline in egg quality.

Key Fertility Tests

If you've had regular, unprotected intercourse for 12 months (or 6 months if you're over 35) without conceiving, a fertility evaluation is recommended. The essential tests typically include:

1. Ovulation Confirmation: Your doctor will assess your menstrual cycle. A normal cycle ranges from 24 to 38 days.
2. Pelvic Ultrasound: This checks for uterine abnormalities such as fibroids, polyps, or structural issues (e.g., arcuate, bicornuate uterus, or septum).
3. Semen Analysis: Evaluates sperm count, motility (movement), shape, and overall sperm health.
4. Tubal Patency Test: A dye test (via X-ray guided HSG or ultrasound-guided HYCOSY) determines whether the fallopian tubes are open.

If all these results are normal, the diagnosis is considered unexplained infertility.

Additional Consideration: Coeliac Disease

Though primarily a digestive condition, coeliac disease can also impact fertility. It's found more frequently in women with unexplained infertility. If you exhibit symptoms or risk factors, your doctor may recommend testing for it.

Tests Usually Not Required Unless Indicated

Unless there's a specific medical history or symptom suggesting otherwise, the following tests are not typically part of the initial evaluation:

1. For Women: Hysteroscopy, laparoscopy, autoimmune panels (excluding coeliac screening).
2. For Men: Sperm DNA fragmentation, hormone profiling, and scrotal ultrasound.
3. For Both: Genetic studies or tests for oxidative stress.

Treatment Options

Most couples with unexplained infertility still conceive naturally. If you're younger, have been trying for a shorter duration, and have no concerning findings, your doctor may recommend:

1. Expectant Management: Timed intercourse during your fertile window for up to 6 months.
2. IUI with Ovarian Stimulation: If no success with expectant management, this is often the next step. It’s less invasive and more affordable than IVF, with a success rate of approximately 12–15% per cycle.

When IVF is Recommended:

IVF is typically considered after several unsuccessful IUI cycles—unless other factors suggest a lower chance of success with IUI.

You’re Not Alone in This Journey

Exploring fertility options can be overwhelming, but you're supported every step of the way by experienced professionals.

Dr. Kriti Agarwal is a highly regarded fertility specialist with extensive experience at leading IVF centers in Kolkata.

For comprehensive gynecological care and fertility treatment, visit Dr. Kriti Agarwal—Best Gynecologist in Kolkata: www.drkritiagarwal.com