Updated by the Progyny Clinical Team - January 2026.
Sometimes fertility testing identifies a clear cause, but many people are diagnosed with unexplained infertility. If that feels frustrating or overwhelming, know that those feelings are valid, and support is available.
Understanding the diagnosis
A fertility evaluation can feel like a scavenger hunt. You may:
- Answer detailed questions about your medical history
- Have blood tests for multiple hormones
- Undergo an exam and ultrasound
- Have a dye test (hysterosalpingogram) to check the fallopian tubes
- Ask your partner or donor to provide a semen sample
After reviewing all results, you might be told everything appears normal. It's natural to ask, "Why am I not getting pregnant?" Unexplained infertility simply means testing did not reveal a clear cause - conception is still possible.
Pregnancy and treatment options
Many people with unexplained infertility achieve pregnancy with standard fertility therapies. Some conceive naturally without additional treatment.
IUI and IVF
Initial treatments often include ovulation medication combined with intrauterine insemination (IUI), sometimes called "clomiphene/IUI" or "letrozole/IUI."
If pregnancy doesn't occur after 3 to 6 cycles, in vitro fertilization (IVF) is usually the next step. For those over 37 or with several years of unexplained infertility, doctors may recommend moving directly to IVF. IVF with preimplantation genetic testing (PGT) can be considered to improve embryo selection, but it's not required for everyone and is typically discussed based on age, prior IVF outcomes, or personal preference.
If you have questions or concerns, Progyny is here for you. Please contact your Progyny Care Advocate for support.
Disclaimer: The information provided by Progyny is for educational purposes only and is not medical advice. Always consult a qualified healthcare provider for medical guidance.
