Health & Medical STDs Sexual Health & Reproduction

What If My Doctor Doesn"t Know Why I Can"t Get Pregnant?



Written or medically reviewed by a board-certified physician. See About.com's Medical Review Policy.

Updated January 06, 2015.

Idiopathic infertility is the more proper medical term for unexplained infertility. It is a frustrating diagnosis to receive, but not uncommon. Between 15 and 30% of couples are told they have unexplained infertility.

However, the term is sometimes applied prematurely. Unless a through fertility evaluation has been done, it’s possible that the cause of infertility is detectable – but just hasn’t been discovered yet.


For example, a woman may be told by her gynecologist that all her tests came back normal, and say the cause of infertility is unexplained. But if the male partner hasn’t been tested, they you can’t really say it’s unexplained infertility. It may be male infertility.

At the very least, before a diagnosis of idiopathic infertility is made, the following fertility tests should be done:
  • Testing for ovulation (usually done with blood work during the luteal phase, testing for LH)
  • Semen analysis
  • Ovarian reserve testing (usually done by testing FSH and estradiol blood levels, or by ovarian antral follicle count via ultrasound)
  • Pelvic ultrasound, to test for uterine abnormalities, fibroids, or polyps.
  • An HSG, to check the fallopian tubes

Some doctors believe an exploratory laparoscopy should also be conducted if no cause of infertility can be found.

However, because this test is invasive and has some risks, many doctors will only perform one if there are symptoms of endometriosis (which can only be diagnosed via laparoscopy) or if repairing blocked fallopian tubes can be done at the same time.

In all of the above tests are normal, a diagnosis of unexplained infertility can be made.

More on causes of infertility:

Infertility symptom quizzes:

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Sources:

Rev Obstet Gynecol. 2008 Spring; 1(2): 69–76. Diagnosis and Treatment of Unexplained Infertility. Accessed April 25, 2014. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2505167/

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