Management Options for Unexplained Infertility

In a New Zealand trial, mild ovarian stimulation plus intrauterine insemination was more effective than expectant management.

Unexplained infertility is diagnosed when a couple has attempted to conceive for 12 months (6 months if the female partner is older than 35) and testing of both partners demonstrates ovulatory menstrual cycles, patent fallopian tubes, and normal semen. Treatment options include expectant management (EM) with guidance on identifying the fertile window, mild ovarian stimulation with clomiphene or letrozole plus intrauterine insemination (mild OS-IUI), ovarian stimulation with gonadotropins plus IUI, or in vitro fertilization and embryo transfer (IVF-ET). Ovarian stimulation with gonadotropins plus IUI is associated with a 20% multiple gestation rate; hence, this approach is less commonly recommended.

To compare the outcomes of EM versus mild O…

Reviewing Author

Robert L. Barbieri, MD

Disclosures

Grant/Research SupportNational Institutes of Health

Editorial BoardsUpToDate

Robert L. Barbieri, MD

Disclosures

Grant/Research SupportNational Institutes of Health

Editorial BoardsUpToDate

Management Options for Unexplained Infertility

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Reviewing Author