Diagnosis and Management of Unexplained Infertility

Cornelis B. Lambalk*, Jan Willem van der Steeg, Pieternel Steures

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapterAcademicpeer-review

Abstract

Unexplained subfertility is a diagnosis by exclusion in the diagnostic work-up of known causes of subfertility such as anovulation, tubal occlusion, endometriosis, cervical hostility, and abnormal sperm counts. The basic fertility work-up consists of history-taking, physical examination, ovulation detection, evaluation of tubal patency, a postcoital test, and a sperm analysis. In case of unexplained subfertility a prognosis of a natural conception can be calculated by female age, presence of previous pregnancies, duration of the subfertility, sperm motility, and referral status. The formula for the prognosis can be determined by means of calculators publicly available on the Internet. Treatment is empirical and depends on the prognosis of a natural pregnancy of the couple. The treatment modalities vary from an expectant management to six or more cycles of intrauterine insemination with mild hormonal ovarian stimulation and three or more cycles of in-vitro fertilization.

Original languageEnglish
Title of host publicationInfertility
PublisherWiley-Blackwell
Pages83-89
Number of pages7
ISBN (Print)9781444333534
DOIs
Publication statusPublished - 8 Mar 2011

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