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Treatment options

Details the treatment options available tocouples with unexplained infertility.


Unexplained infertility

There are several treatment options available to couples with unexplained infertility. Treatment options may include one of the following techniques: the wait and see approach, intrauterine insemination, GIFT, IVF and ZIFT.

Expectant management (The wait and see approach)

Without treatment about 50% of the infertile couples will conceive within 3 years, this will depend on many factors such as: the women's age, duration of infertility, previous pregnancy, and the couple wishes.

Empirical Clomiphene treatment

Women with unexplained infertility may have higher pregnancy rates if they take Clomiphene tablets. It works by correcting subtle ovulatory problems and encouraging the development of many follicles. However, offering ovulation stimulation for unexplained infertility was not advocated by NICE in the UK (2013).

Intrauterine insemination (IUI) with or without ovarian stimulation

IUI overcomes hostile cervical factors and ensures close proximity of sperm and egg. Intrauterine insemination is considered the first line treatment in sub fertile couples with unexplained infertility (The INeS Study Group BMJ 2015). It may be as effective as IVF, less invasive, and less costly. Moreover, IUI is option for patients who have social, cultural or religious objections to IVF. Success rates per IUI treatment cycle is about 10-20%, with 80% of pregnancies occuring within the first four treatment cycles.

GIFT

IVF

IVF treatment with live birth rates between 15-30% is widely accepted treatment for unexplained infertility for couple tried to conceive for a total of 2 years. IVF bypasses unknown potential fertility problems.For older women IVF may be the primary treatment option.

IVF is preferred to GIFT because it provides information about fertilization. In addition, it avoids laparoscopy with its associated risks and may be performed under a local anesthetic and thus avoiding a general anaesthetic.

ZIFT

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