Unexplained infertility: Does it really exist?

N Gleicher, Norbert Gleicher, David H. Barad, D Barad
Human Reproduction · 2006 · vol. 21(8) , pp. 1951–1955 · doi:10.1093/humrep/del135 · PMID:16684842 · W2064179465
article OA: bronze CC0 ⤵ 19 in-corpus citations
📄 Open PDF View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This paper argues that unexplained infertility is an unreliable and subjective diagnosis that should be abandoned in favor of more thorough investigations for conditions like endometriosis and tubal infertility.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

Recent medical literature has quite extensively addressed the use of various terminologies within the field of reproductive medicine. This discussion has, however, so far overlooked the fact that one of the most frequently made diagnosis, so-called unexplained infertility (UI), not only didactically but, even more importantly, clinically, appears unsustainable as an independent diagnosis. The arguments in support of such a contention are manifold. The diagnosis of UI is highly subjective. It is dependent on which diagnostic tests have been performed (or have been omitted) and at what level of quality. Paradoxically, a diagnosis of UI will, therefore, be more often reached if the diagnostic workup is incomplete or of poor quality. Supported by evidence from the literature, the argument is made that the conditions, most frequently misdiagnosed as UI, are endometriosis, tubal infertility (especially distal and peritubal disease), premature ovarian ageing and immunological infertility. Because of the obvious unreliability of a diagnosis of UI and the widely reported unevenness in diagnostic criteria, we recommend the abandonment of UI as a formal infertility diagnosis. Better efforts to reach infertility diagnoses more accurately should improve the diagnostic accuracy of hitherto frequently missed diagnoses, which often falsely have led to a diagnosis of UI.

My notes (saved in your browser only)

Condition tags

endometriosisinfertility

MeSH descriptors

Diagnostic Errors Infertility Adult Autoimmune Diseases Autoimmune Diseases Endometriosis Endometriosis Fallopian Tube Diseases Fallopian Tube Diseases Female Fertilization in Vitro Humans Hysterosalpingography Infertility Infertility Infertility Male Primary Ovarian Insufficiency Primary Ovarian Insufficiency

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (49)

Cited by (19)

Source provenance

europepmc
last seen: 2026-06-20T06:14:18.781669+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-05-13T22:15:18.313808+00:00
License: CC0 · commercial use OK