{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:04:31Z","timestamp":1791432271972,"version":"4.3.3"},"reference-count":54,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Reprod Med"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Unexplained infertility represents up to 30% of all cases of infertility. It is a diagnosis of exclusion, where no cause for infertility may be identified in the investigation of the couple, be it anovulation, fallopian tube blockage, or severe male factor. Unexplained infertility therefore cannot be considered a diagnosis to which a specific treatment is directed, rather that it indicates a failure to reach a diagnosis of the true cause of infertility. In this review, we explore the evidence base and potential limitations of the current routine infertility assessment. We also aim to highlight the importance of considering the prognosis of each individual couple through the process of assessment and propose a reconsidered approach to treatment, targeted to the prognosis rather than the diagnosis. Ultimately, a better understanding of the mechanisms of infertility will reduce the number of couples diagnosed with \u201cunexplained\u201d infertility.<\/jats:p>","DOI":"10.1055\/s-0040-1718709","type":"journal-article","created":{"date-parts":[[2020,10,15]],"date-time":"2020-10-15T05:24:35Z","timestamp":1602739475000},"page":"055-060","source":"Crossref","is-referenced-by-count":13,"title":["How and Why to Define Unexplained Infertility?"],"prefix":"10.1055","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6833-6729","authenticated-orcid":false,"given":"Karim S.","family":"Abdallah","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt"},{"name":"Department of Obstetrics and Gynecology, Monash University, Clayton, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Hunt","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Monash University, Clayton, Australia"},{"name":"Department of Obstetrics and Gynecology, Monash Health, Clayton, Australia"},{"name":"Monash IVF, Richmond, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayed A.","family":"Abdullah","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben W.J.","family":"Mol","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Monash University, Clayton, Australia"},{"name":"Aberdeen Centre for Women's Health Research, University of Aberdeen, Aberdeen, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed A.","family":"Youssef","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,10,14]]},"reference":[{"issue":"09","key":"ref1","first-page":"1786","article-title":"The international glossary on infertility and fertility care, 2017","volume":"32","author":"F Zegers-Hochschild","year":"2017","journal-title":"Hum Reprod"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1093\/humrep\/dem046","article-title":"International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care","volume":"22","author":"J Boivin","year":"2007","journal-title":"Hum Reprod"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/0277-9536(94)00124-C","article-title":"Stigma: the hidden burden of infertility","volume":"40","author":"L M Whiteford","year":"1995","journal-title":"Soc Sci Med"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/S0015-0282(16)60912-3","article-title":"Mood disorders, psychiatric symptoms, and distress in women presenting for infertility evaluation","volume":"52","author":"J Downey","year":"1989","journal-title":"Fertil Steril"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1093\/humrep\/des422","article-title":"Psychiatric disorders in women with fertility problems: results from a large Danish register-based cohort study","volume":"28","author":"B Baldur-Felskov","year":"2013","journal-title":"Hum Reprod"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"1693","DOI":"10.1136\/bmj.291.6510.1693","article-title":"Population study of causes, treatment, and outcome of infertility","volume":"291","author":"M G Hull","year":"1985","journal-title":"Br Med J (Clin Res Ed)"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/S0140-6736(02)09417-5","article-title":"Female subfertility","volume":"360","author":"J L Evers","year":"2002","journal-title":"Lancet"},{"issue":"02","key":"ref8","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.fertnstert.2019.10.014","article-title":"Evidence-based treatments for couples with unexplained infertility: a guideline","volume":"113","author":"Practice Committee of the American Society for Reproductive Medicine. 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