In approximately 15% of all infertility cases, the cause remains unknown after a thorough examination and testing of both the male and the female. In some cases, a comprehensive review of all testing and treatment previously performed reveals clues in a past evaluation that may help lead to a diagnosis. Your physician may also request that your partner repeat a semen analysis for a more recent specimen and that you undergo a hysterosalpingogram (HSG) to confirm that there is no scarring or abnormalities in the uterine cavity. If risk factors suggest tubal disease, a laparoscopy may be performed to treat endometriosis and rule out pelvic scarring.
If the cause of infertility is still unexplained after additional testing, your physician will work with you to determine the most effective treatment plan. Treatment options for unexplained infertility cases are based on a number of factors including age of the female, duration of infertility, working diagnosis of the problem and the desired outcome of the couple. Treatment options include controlled ovarian hyperstimulation, intrauterine insemination (IUI) and in vitro fertilization (IVF).