Unexplained infertility: Is it over-diagnosed and over-treated?

Unexplained infertility is defined as the absence of conception despite 12 months of unprotected intercourse, not explained by anovulation, poor sperm quality, tubal pathology or any known cause of infertility. The two most applied treatments for unexplained infertility are intra-uterine insemination and in vitro fertilisation. As these treatments do not target a specific mechanism but rather increase the probability of conception as compared to natural conception chances, they should be weighed against the prognosis of natural conception. The use of prognostic models could facilitate in identifying who benefits from treatment and who can delay treatment for 6 months, thus aiming for natural conception. This is important, as treatments can have side effects for the woman and her offspring, and their cost may jeopardise access to care.