Unexplained fertility problems in people trying to conceive through unprotected vaginal sexual intercourse

1.38 Unexplained fertility problems

1.38.1

Advise people with unexplained fertility problems who are having regular unprotected vaginal sexual intercourse to try to conceive for a total of 2 years before treatment. [2013, amended 2026]

1.38.2

Do not offer ovarian stimulation as a stand-alone treatment for unexplained fertility problems. [2026]

1.38.3

For people with unexplained fertility problems who have tried to conceive for 2 years through regular unprotected vaginal sexual intercourse, discuss the treatment options, including the benefits, risks and their individual preferences and:

before in vitro fertilisation (IVF) treatment, consider up to 4 cycles of intrauterine insemination (IUI) with ovarian stimulation using gonadotrophins, or
offer IVF treatment (see the section on access criteria for IVF). [2026]

For a short explanation of why the committee made the 2026 recommendations and how they might affect practice, see the rationale and impact section on unexplained fertility problems in people trying to conceive through unprotected vaginal sexual intercourse.

Full details of the evidence and the committee's discussion are in evidence review K: assisted reproduction techniques for people with unexplained fertility problems, mild endometriosis, and mild male factor fertility problems.