The diagnosis of ‘unexplained’ occurs in about 20% of couples who have been actively trying to become pregnant for 12 months or more and for whom no reason has been found for pregnancy not occurring. It can be extremely frustrating because there is no ‘reason’ that can be ‘treated’, leaving you feeling powerless.
It then becomes a process of elimination as much thorough testing is undertaken in both the man and the woman, which can be both lengthy and in some cases fruitless.
Most couples turn to IVF at this point as it can improve your chances of pregnancy by bypassing many of the steps in the conception process. In some cases, a fertilization issue can be discovered, only becoming apparent in the IVF lab as the process is watched under a microscope. In other cases, poor egg quality or inadequate embryo development will be found as a cause. It may be an implantation issue whereby the woman’s uterus is not receptive to the embryo. Couples may move onto PGD, so that their embryos can be tested for chromosomal anomalies. In some cases this may provide the answer.
Other couples may turn to natural/alternative therapies and find that they become pregnant this way. For others still, their number may finally come up and they will become pregnant without ever finding out what the cause of their troubles was.
Sadly though, for some couples, after many many failed cycles, still no reason will be found for their infertility and no baby will result from all that they’ve been through. In these cases, next steps need to be discussed, which may include donor eggs, surrogacy, fostering, adoption (though this is a long and expensive road), or even deciding to put trying to have a baby behind them.