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How many couples have un‐explained infertility? • Infertility is defined as the inability to conceive after 1 year of regular unprotected intercourse • Standard infertility evaluation includes semen analysis, assessment of ovulation, a hysterosalpingogram, and if indicated, tests for ovarian reserve and laparoscopy • If normal, a diagnosis of unexplained infertility can be assigned • The likelihood after testing that the couple has unexplained infertility is approximately 15% to 30% The Practice Committee of the American Society for Reproductive Medicine. Fertil Steril. 2006 Quaas A and Dokras A, Reviews in obstetrics and gynecology, 2008 Outline ”unexplained” infertility 4 main factors causing unexplained infertility: • Maternal factor (Age = oocyte and embryo aneuploidy) • Paternal factor (DFI, oxidative stress, HPV) • The genital tract microbiome • Luteal phase insufficiency? 46 43