Laparoscopic evaluation in such couples may be beneficial in cases of endometriosis, abnormal HSG findings, pelvic pain, painful periods, fibroids, pelvic adhesions or the presence of endometriotic cysts (endometriomas) on pelvic ultrasound.

The chances of conceiving with unexplained infertility after 2 years of trying are 1-3% per month, compared to 10-20% for a fertile couple. These percentages are based on cumulative pregnancy rates, and the female reproductive age has a big impact on them. Overall pregnancy rates improves over time with additional months of trying, although they tend to stay the same per attempt or cycle.

The treatment of unexplained infertility may include continuation of timed intercourse for cases of early infertility and in young couples with a completely normal infertility evaluation for maximum of 3 years. In others, the first line of treatment is generally Clomid with intrauterine insemination (IUI) or injectable FSH medications with IUI. The goal of this treatment is allowing increase number of mature eggs available for fertilization at the time of IUI by superovulation. The success rate is improved by increasing the number of eggs and sperm in the fallopian tubes.

Superovulation (Clomid or injectibles) and IUI is most appropriate in young couples with unexplained infertility, but the benefit may be limited in women with advanced reproductive age. In the younger population, Clomid and IUI may increase the chances of a pregnancy up to 6-8% per cycle/attempt from a baseline rate of 1-3% (if the couple continues to try on their own). The success rate with injectibles and IUI increases to 5-15% per cycle compared to 1-3% in untreated couples and 4-8% in Clomid + IUI cycles.

Up to 3–4 cycles of clomid and IUI treatment can be continued before switching to an IVF treatment that is more aggressive.

If none of these treatments result are successful, IVF becomes the best treatment option and results in a success rate of 60-65% per cycle. All of these percentages reflect the success rates in women below the age of 35 and the numbers declines with the increasing women age with all treatment options.

According to the opinion of Dr Ripal Madnani the best IVF doctor in Abu Dhabi irrespective of age, IVF results in the highest pregnancy rate compared to other treatment options and is the recommend treatment for most couples with unexplained infertility after 3 years of trying naturally and using milder treatment option.

Each case of “unexplained infertility” is individual. In such cases, success rates may vary and are generally higher than true unexplained infertility where the cause is found. Dr. Ripal Madnani, the fertility specialist in Abu Dhabi, recommends that patients should seek an expert opinion of fertility doctor when they are detected with “unexplained infertility”.