Unexplained Infertility: Treatment for Fewer Side Effects

Infertility is a significant global problem affecting 1:7 worldwide. An estimated 24% of couples had no detected conception within 12 and 24 months of unprotected intercourse on a nation-wide representative sample of couples from the general population. Unexplained infertility is one of the most frequent infertility diagnoses given to women, encompassing up to approximately 30% of all cases.


Women with unexplained infertility are commonly treated with drugs for ovarian stimulation.

Unexplained infertility refers to couples who fail to conceive, even though the female ovulates normally, has no obvious abnormalities in the reproductive tract, and the male is producing an adequate number of motile sperm. Nowadays, there are plenty of infertility treatments available, however many assisted reproduction techniques like IVF are very expensive and not often covered by insurance; therefore IVF is an option less commonly offered.

Women with unexplained infertility are commonly treated with drugs for ovarian stimulation. During this procedure the ovaries release an egg and sperm is directly inserted into the uterus. This is a quite successful treatment and definitely less costly. Letrozole, gonadotropins and clomiphene citrate are the drugs most commonly used for ovarian stimulation.
Unfortunately, medication for ovarian stimulation has its side effects and can be complicated by ovarian hyperstimulation syndrome, which results in multiple pregnancies with increased risk of preterm birth. The challenge is to determine which medication is best at achieving and maintaining pregnancy while reducing multiple pregnancies.

In a recent study, scientists assessed the frequency of multiple pregnancies among women with clinical pregnancies. Women age 18 to 40 who were ovulating and had at least one Fallopian tube were treated with letrozole, gonadotropins or clomiphene for up to four cycles, comparing the outcome for the three drugs. According to the study, ovarian stimulation with letrozole resulted in significantly lower frequency of multiple pregnancies, but also a lower frequency of live births, as compared with gonadotropins, but not as compared with clomiphene. Therefore, scientists concluded that clomiphene citrate is the most appropriate means to stimulate ovulation in unexplained infertility treated with intrauterine insemination (IUI).

Would clomiphene, as the least invasive treatment, be your first option among other alternatives for unexplained infertility treatment?

IVF Is Not Always Your Best Option

IVF Is Not Always Your Best Option

IVF is not always the best option for infertility treatment and it is highly recommended for patients to go through a thorough investigation in order to have a clear idea about why they need IVF.

Professor Robert Winston, one of the founding fathers of IVF, has recently published his new book, The Essential Fertility Guide, in which he outlines

fertility treatment options suggesting that IVF is not always your best option for infertility treatment.

For many people, there is no other experience that matches the birth of a baby. One in every seven couples in the UK struggle with infertility. There are various reasons for this and a number of treatments available for optimizing their chances of having a baby.

However, there is also a lot of misinformation out there about infertility treatment, so experts say people should be careful about which advice they heed.  Especially in the private sector where expensive IVF, which only has a 25 percent success rate, is a highly profitable industry.  The fact that a large number of patients address to private clinics for solving their infertility problems could perhaps explain why many people assume the best option for overcoming infertility is IVF (in vitro fertilisation), which according to Professor Winston is often not the case.

When patients meet with their doctor they are often surprised to learn that IVF may not be their first treatment option for infertility. In reality, IVF technique is used far too often before other, usually cheaper and less stressful options, are fully explored. For that reason, it is highly recommended for patients to go through a thorough investigation in order to find out the exact cause of their infertility and have a clear idea about why they need IVF. Prof. Winston adds that most of the infertile couples do not require such a complex treatment and often expectant treatment, ie. waiting to get pregnant, is likely to be more effective than IVF.

It is advisable for infertile patients to start with low tech treatments. Starting with the simplest, most affordable treatment options first and move up to more advanced treatments as medically indicated, is the best way to deal with it.”There are numerous causes of infertility,” says Prof. Winston, “and the best treatment may be different in each circumstance.

Intrauterine insemination (IUI) is an example of a low tech treatment frequently requiring less medication and fewer monitoring appointments with a lower cost. Depending on the cause, other alternatives to IVF could be drug treatments to encourage ovulation, laparoscopic (minimally invasive) surgery or treatment for endometriosis.

Have you asked the right questions to your doctor?

Make sure you are properly tested to identify the cause of infertility and choose the best treatment option for you.