Q. My husband and I have been trying to conceive for over a year without success. We've both been to specialists for testing, and no one has been able to find anything wrong with us. We're told we have "unexplained infertility." What does that mean, and what could be causing our problems?
A. Unexplained infertility indicates that all diagnostic tests have come back normal. However, this doesn't necessarily mean that there is no explanation for your infertility. It may be that only the basic tests have been performed, and more complex testing might indicate there's a problem. For example, an x-ray of your fallopian tubes may show the tubes are open, but surgery (i.e. laparoscopy) may show that the tubes are embedded in scar tissue and are nonfunctional. Similarly, tests may reveal that there is no egg problem, but a further test to stimulate egg development with fertility drugs may yield very few eggs. Sometimes, when in vitro fertilization (IVF) is attempted in someone with normal egg and sperm tests, it results in poor or no fertilization of the eggs because in fact there was a sperm or egg problem that was undetected. What all this means is that, in the end, only a small percentage of couples truly have unexplained infertility. More often than not there is a problem that can be diagnosed if the proper tests are done. And once the problem has been detected, it can often be treated successfully with either fertility drugs and intrauterine insemination or IVF.