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This leads to heterogeneity and bias affecting meta\u2010analysis and best practice advice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This systematic review analyses the variability of inclusion criteria applied to couples with unexplained infertility. We propose standardised criteria for use both in future research studies and clinical diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Search strategy<\/jats:title><jats:p>CINAHL and MEDLINE online databases were searched up to November 2022 for all published studies recruiting couples with unexplained infertility, available in full text in the English language.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data collection and analysis<\/jats:title><jats:p>Data were collected in an Excel spreadsheet. Results were analysed per category and methodology or reference range.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main results<\/jats:title><jats:p>Of 375 relevant studies, only 258 defined their inclusion criteria. The most commonly applied inclusion criteria were semen analysis, tubal patency and assessment of ovulation in 220 (85%), 232 (90%), 205 (79.5%) respectively. Only 87\/220 (39.5%) studies reporting semen analysis used the World Health Organization (WHO) limits. Tubal patency was accepted if bilateral in 145\/232 (62.5%) and if unilateral in 24\/232 (10.3%). Ovulation was assessed using mid\u2010luteal serum progesterone in 115\/205 (56.1%) and by a history of regular cycles in 87\/205 (42.4%). Other criteria, including uterine cavity assessment and hormone profile, were applied in less than 50% of included studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This review highlights the heterogeneity among studied populations with unexplained infertility. Development and application of internationally accepted criteria will improve the quality of research and future clinical care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17697","type":"journal-article","created":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T02:25:13Z","timestamp":1699928713000},"page":"880-897","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["The definition of unexplained infertility: A systematic review"],"prefix":"10.1111","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2969-2437","authenticated-orcid":false,"given":"Claudia","family":"Raperport","sequence":"first","affiliation":[{"name":"Women's Health Research Unit, Wolfson Institute of Population Health Queen Mary University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Desai","sequence":"additional","affiliation":[{"name":"Queen Mary University of 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