Unexplained infertility

Miguel A. Ramírez-Marrero, Steven J. Ory
In: Current Opinion in Obstetrics and Gynecology · 1991 · vol. 3(2) , pp. 211–218 · doi:10.1097/00001703-199104000-00008 · W4234601475
article OA: closed CC0 ⤵ 8 in-corpus citations
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This review analyzes potential causes of unexplained infertility, including decreased uterine perfusion and endometrial factors, and evaluates current treatment options while noting the lack of comparative studies.

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This review examines the multifactorial nature of unexplained infertility, exploring potential causes such as decreased uterine perfusion, obscure luteal phase defects, intrinsic endometrial factors, and microscopic endometriosis. The authors note that while specific therapies do not exist and spontaneous pregnancy is common, various treatments like in vitro fertilization and intrauterine insemination are frequently pursued by couples. A significant limitation highlighted is the lack of randomized prospective studies with uniform protocols to determine which patients benefit most from specific procedures. Relevance to endometriosis: microscopic endometriosis is listed as one of several potential contributing factors to the condition, though the paper's main focus remains on the broader diagnosis of unexplained infertility.

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Abstract

Unexplained infertility is a multifactorial disorder of reproduction. This review examines the potential contribution of decreased uterine perfusion, obscure luteal phase defect, intrinsic endometrial factor, ovum captor inhibitor, microscopic endometriosis, and psychologic factors for the cause of unexplained infertility. Although specific therapy for unexplained infertility does not exist and treatment-independent pregnancy frequently occurs in this group of patients, many couples pursue treatment. In vitro fertilization, gamete intrafallopian transfer, zygote intrafallopian transfer, superovulation with intrauterine insemination, and direct intraperitoneal inseminations are several treatment options reported to be successful. However, a randomized prospective study using a uniform diagnostic assessment, strict entry criteria, identical ovulation-induction schemes, and semen-processing protocols is lacking to determine which patients will be most appropriately treated with each procedure and which is more effective. Unexplained infertility is not and should not be considered a permanent state. These couples should be considered to be subfertile rather than infertile.
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Unexplained infertility - Miguel A. Marrero - Steven J. Ory Unexplained infertility is a multifactorial disorder of reproduction. This review examines the potential contribution of decreased uterine perfusion, obscure luteal phase defect, intrinsic endometrial factor, ovum captor inhibitor, microscopic endometriosis, and psychologic factors for the cause of unexplained infertility. Although specific therapy for unexplained infertility does not exist and treatment-independent pregnancy frequently occurs in this group of patients, many couples pursue treatment. In vitro fertilization, gamete intrafallopian transfer, zygote intrafallopian transfer, superovulation with intrauterine insemination, and direct intraperitoneal inseminations are several treatment options reported to be successful. However, a randomized prospective study using a uniform diagnostic assessment, strict entry criteria, identical ovulation-induction schemes, and semen-processing protocols is lacking to determine which patients will be most appropriately treated with each procedure and which is more effective. Unexplained infertility is not and should not be considered a permanent state. These couples should be considered to be subfertile rather than infertile.

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endometriosisinfertility

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