9 papers reviewed
Unexplained Infertility - Root Cause Investigation
2025 · guideline · 1 of 9
Diagnostic workup for a couple with unexplained infertility: VVOG guidance
Various · PMC / European Journal of OB/GYN
Comprehensive guidance for unexplained infertility workup. Standard workup does not include molecular or microbial assessment of endometrium, though endometrial factors may contribute significantly.
Read the paper ↗2026 · review · 2 of 9
Unexplained infertility: an update
Raperport C et al. · The Obstetrician & Gynecologist
Updated review noting potential causes including reduced oocyte quality, poor endometrial receptivity, ovulatory PCOS, subclinical endometriosis, and low semen quality. 10-30% of couples seeking care receive this diagnosis.
Read the paper ↗2008 · review · 3 of 9
Diagnosis and treatment of unexplained infertility
Ray A et al. · Journal of Obstetrics and Gynecology of India
Laparoscopy is the test of choice to identify unrecognized peritoneal factors, specifically endometriosis and pelvic adhesions, in unexplained infertility. Provides foundation for root-cause diagnostic approach.
Read the paper ↗2024 · systematic review · 4 of 9
The prevalence of endometriosis in unexplained infertility: a systematic review
Various · Reproductive BioMedicine Online
Endometriosis prevalence of 44% in unexplained infertility (most lesions minimal/mild at 74%). Detection rate higher in women with prior fertility treatment (75% vs 53%). Laparoscopy revealed normal pelvis in only 42%.
Read the paper ↗2024 · cross-sectional · 5 of 9
The prevalence of endometriosis in patients with unexplained infertility
Various · Journal of Clinical Medicine
In 215 patients with unexplained infertility, pathology revealed tissue abnormalities in 98.6%, with 90.7% showing endometriosis. Results suggest high prevalence of occult endometriosis (selection bias acknowledged).
Read the paper ↗2018 · cohort · 6 of 9
Chronic endometritis in patients with unexplained infertility: prevalence and effects of antibiotic treatment on spontaneous conception
Cicinelli E et al. · American Journal of Reproductive Immunology
CE prevalence of 56.8% in unexplained infertility. Treatment resolved CE in 82.3% of cases, leading to 61.3% clinical pregnancy rate and 60% baby-carrying-home rate.
Read the paper ↗2025 · diagnostic study · 7 of 9
Evaluating chronic endometritis in unexplained infertility through hysteroscopy and immunohistochemistry
Various · Journal of Reproductive Immunology
Evaluating CE through hysteroscopy and CD138 immunohistochemistry in unexplained infertility. Confirms high prevalence and supports routine screening in this population.
Read the paper ↗2011 · cohort · 8 of 9
Increased prevalence of celiac disease in patients with unexplained infertility in the United States
Singh P et al. · Journal of Clinical Gastroenterology
5.9% prevalence of undiagnosed celiac disease in unexplained infertility vs ~1% general population. Supports celiac screening as part of root-cause workup.
Read the paper ↗2025 · clinical practice guideline · 9 of 9
Guideline for the prevention, diagnosis and treatment of infertility
World Health Organization · World Health Organization guideline
WHO's first global infertility guideline provides 40 evidence-based recommendations spanning prevention, evaluation, ovulatory dysfunction, tubal and uterine factors, male factors, and unexplained infertility. It also identifies evidence gaps and emphasizes person-centered, rights-based care.
Read the paper ↗A paper's presence documents the evidence reviewed; it does not mean Filia endorses every intervention or conclusion.