Treatment & Diagnosis

If studies for ovulation, male factor and the reproductive tract are all normal, then the couple has unexplained infertility. Approximately 10-15% of couples with infertility will fall into this category. They require further testing with a blood test done early in the menstrual cycle for follicle stimulating hormone. This is a test of egg quality and an abnormal test indicates a problem with poor ovarian reserve which requires consideration of more advanced therapy. All female partners over the age of thirty-five should also undergo this test, as poor ovarian reserve becomes a more frequent problem as women age.

Not all couples need to undergo all these tests. If the woman has very irregular periods, this is indicative of an ovulation disorder and she should to be placed on therapy with ovulation induction agents such as clomiphene citrate. Almost half of all couples with an ovulation disorder will conceive with clomiphene and avoid going through any further extensive testing or treatment. If the male factor evaluation shows a very abnormal semen analysis, then standard therapies are not indicated. That couple will need to be evaluated for more advanced reproductive technologies, such as in vitro fertilization with sperm injection.