Should we adopt a prognosis-based approach to unexplained infertility?

Laxmi Shingshetty* (Corresponding Author), Abha Maheshwari, David J McLernon, Siladitya Bhattacharya

*Corresponding author for this work

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The treatment of unexplained infertility is a contentious topic that continues to attract a great deal of interest amongst clinicians, patients and policy makers. The inability to identify an underlying pathology makes it difficult to devise effective treatments for this condition. Couples with unexplained infertility can conceive on their own and any proposed intervention needs to offer a better chance of having a baby. Over the years, several prognostic and prediction models based on routinely collected clinical data have been developed, but these are not widely used by clinicians and patients. In this opinion paper, we propose a prognosis-based approach such that a decision to access treatment is based on the estimated chances of natural and treatment-related conception, which, in the same couple, can change over time. This approach avoids treating all couples as a homogeneous group and minimizes unnecessary treatment whilst ensuring access to those who need it early.

Original languageEnglish
Article numberhoac046
Number of pages7
JournalHuman Reproduction Open
Issue number4
Early online date14 Nov 2022
Publication statusPublished - 2022

Bibliographical note

No external funding was sought for this study.

Data Availability Statement

No new data have been generated or analysed in support of this publication.


  • unexplained infertility
  • prediction models
  • expectant management
  • treatment
  • Assisted conception
  • spontaneous pregnancy
  • live birth


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