Unexplained infertility presents a significant reproductive challenge globally, affecting couples who are unable to conceive despite comprehensive fertility evaluations. This condition carries emotional, physical, and economic burdens, with a moderate to high prevalence, underscoring the need for effective interventions. In vitro fertilization (IVF) has emerged as a crucial treatment option for unexplained infertility, offering a unique approach to conception when traditional diagnostic tests fail to identify specific causes. However, the efficacy, safety, and comparative benefits of IVF in this context warrant comprehensive evaluation through systematic reviews. A systematic review was conducted to assess the effectiveness and outcomes of IVF in cases of unexplained infertility. Inclusion criteria encompassed peer-reviewed studies focusing on human subjects diagnosed with unexplained infertility and evaluating IVF outcomes.
Comprehensive searches were performed across electronic databases, and eligible studies were selected based on predetermined criteria. Data extraction was conducted independently by two researchers, and quality assessment was performed using standardized tools. The search yielded 10 studies comprising 73,884 patients, published between 2000 and 2021. Variability in methodological quality was observed across randomized controlled trials, while cohort studies demonstrated consistently high quality. Studies assessed outcomes like pregnancy success rate (46.2-47.9%), live birth rates (29.4-49%), time to pregnancy (9-14 months), cost-effectiveness, and adverse events such as ovarian hyperstimulation syndrome. Elective single embryo transfer (eSET) was found effective, and donor oocytes had higher live birth rates than autologous cycles. Multiple gestations and canceled IVF cycles were common. The systematic review underscores the complexity of IVF treatment for unexplained infertility, with variability in outcomes influenced by multiple factors. Strategies such as eSET and donor oocyte cycles show promise in optimizing treatment efficacy and safety. However, challenges such as heterogeneity, moderate to high risk of bias across studies, and cost considerations warrant careful interpretation and further research.
