Current management of unexplained infertility

During the last decade, numerous studies have evaluated the effectiveness of various treatments for unexplained infertility. Few studies employ a design that allows for appropriate comparison with an untreated control group. This article reviews the efficacy of clomiphene citrate, human menopausal gonadotropin, intrauterine insemination, superovulation with intrauterine insemination, and gamete intrafallopian transfer in the treatment of unexplained infertility. Treatment for patients with unexplained infertility with superovulation or gamete intrafallopian transfer is promising, but the incremental contributions of intrauterine insemination, superovulation, or gamete intrafallopian transfer beyond untreated controls await appropriately designed trials. When counseling patients regarding treatment options, both the expected increase in cycle fecundity and treatment expense should be considered.