{"id":21994,"date":"2026-05-16T09:49:59","date_gmt":"2026-05-16T06:19:59","guid":{"rendered":"https:\/\/drpegahkeramati.com\/3-%d8%aa%d9%88%d8%b5%db%8c%d9%87-%d9%85%d9%87%d9%85-%d8%a8%d8%b1%d8%a7%db%8c-%d8%af%d8%b1%d9%85%d8%a7%d9%86-%d9%86%d8%a7%d8%a8%d8%a7%d8%b1%d9%88%d8%b1%db%8c-%d8%b2%d9%88%d8%ac%db%8c%d9%86-%d8%a8%d8%af\/"},"modified":"2026-05-18T13:48:05","modified_gmt":"2026-05-18T10:18:05","slug":"treating-infertility-in-couples-known-cause","status":"publish","type":"post","link":"https:\/\/drpegahkeramati.com\/en\/treating-infertility-in-couples-known-cause\/","title":{"rendered":"3 Important advice for Treating Infertility in Couples with No Known Cause by Dr. Pegah Keramati"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"21994\" class=\"elementor elementor-21994 elementor-21892\" data-elementor-post-type=\"post\">\n\t\t\t\t<div class=\"elementor-element elementor-element-e2871af e-flex e-con-boxed e-con e-parent\" data-id=\"e2871af\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;ekit_has_onepagescroll_dot&quot;:&quot;yes&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-649bea2 elementor-widget elementor-widget-heading\" data-id=\"649bea2\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\"><a href=\"https:\/\/www.youtube.com\/watch?v=rhaSyZAmYH8\" target=\"_blank\" rel=\"noopener\">3 Important advice for Treating Infertility in Couples with No Known Cause by Dr. Pegah Keramati<\/a><\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-426fb90 e-flex e-con-boxed e-con e-parent\" data-id=\"426fb90\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;ekit_has_onepagescroll_dot&quot;:&quot;yes&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2adea5d elementor-widget elementor-widget-spacer\" data-id=\"2adea5d\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-f7b0d35 e-con-full e-flex e-con e-parent\" data-id=\"f7b0d35\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;ekit_has_onepagescroll_dot&quot;:&quot;yes&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-094af61 elementor-widget elementor-widget-text-editor\" data-id=\"094af61\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Unexplained infertility is one of the most challenging conditions in the field of reproductive medicine. In this situation, despite conducting complete examinations including: hormonal tests, ovulation assessment, fallopian tube examination and sperm analysis, no specific cause for infertility can be found.<\/p><p>In such situations, choosing the right path for treating infertility in couples is of great importance in order to avoid unnecessary interventions and increase the chances of pregnancy in a logical and stepwise manner.<\/p><p>The World Health Organization (<a href=\"https:\/\/www.who.int\/\" target=\"_blank\" rel=\"noopener\">WHO<\/a>) recommends a three-step approach for treating infertility in couples with unexplained infertility, which is fully explained below.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e542d1e elementor-widget elementor-widget-image\" data-id=\"e542d1e\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"450\" src=\"https:\/\/drpegahkeramati.com\/wp-content\/uploads\/2026\/05\/\u062f\u0631\u0645\u0627\u0646-\u0646\u0627\u0628\u0627\u0631\u0648\u0631\u06cc-\u0632\u0648\u062c\u06cc\u0646-1-copy.webp\" class=\"attachment-large size-large wp-image-21894\" alt=\"Treating Infertility in Couples\" srcset=\"https:\/\/drpegahkeramati.com\/wp-content\/uploads\/2026\/05\/\u062f\u0631\u0645\u0627\u0646-\u0646\u0627\u0628\u0627\u0631\u0648\u0631\u06cc-\u0632\u0648\u062c\u06cc\u0646-1-copy.webp 960w, https:\/\/drpegahkeramati.com\/wp-content\/uploads\/2026\/05\/\u062f\u0631\u0645\u0627\u0646-\u0646\u0627\u0628\u0627\u0631\u0648\u0631\u06cc-\u0632\u0648\u062c\u06cc\u0646-1-copy-300x169.webp 300w, https:\/\/drpegahkeramati.com\/wp-content\/uploads\/2026\/05\/\u062f\u0631\u0645\u0627\u0646-\u0646\u0627\u0628\u0627\u0631\u0648\u0631\u06cc-\u0632\u0648\u062c\u06cc\u0646-1-copy-768x432.webp 768w\" sizes=\"(max-width: 800px) 100vw, 800px\" title=\"\">\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-cea476d elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"cea476d\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#P1\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-dharmachakra\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M495 225.06l-17.22 1.08c-5.27-39.49-20.79-75.64-43.86-105.84l12.95-11.43c6.92-6.11 7.25-16.79.73-23.31L426.44 64.4c-6.53-6.53-17.21-6.19-23.31.73L391.7 78.07c-30.2-23.06-66.35-38.58-105.83-43.86L286.94 17c.58-9.21-6.74-17-15.97-17h-29.94c-9.23 0-16.54 7.79-15.97 17l1.08 17.22c-39.49 5.27-75.64 20.79-105.83 43.86l-11.43-12.95c-6.11-6.92-16.79-7.25-23.31-.73L64.4 85.56c-6.53 6.53-6.19 17.21.73 23.31l12.95 11.43c-23.06 30.2-38.58 66.35-43.86 105.84L17 225.06c-9.21-.58-17 6.74-17 15.97v29.94c0 9.23 7.79 16.54 17 15.97l17.22-1.08c5.27 39.49 20.79 75.64 43.86 105.83l-12.95 11.43c-6.92 6.11-7.25 16.79-.73 23.31l21.17 21.17c6.53 6.53 17.21 6.19 23.31-.73l11.43-12.95c30.2 23.06 66.35 38.58 105.84 43.86L225.06 495c-.58 9.21 6.74 17 15.97 17h29.94c9.23 0 16.54-7.79 15.97-17l-1.08-17.22c39.49-5.27 75.64-20.79 105.84-43.86l11.43 12.95c6.11 6.92 16.79 7.25 23.31.73l21.17-21.17c6.53-6.53 6.19-17.21-.73-23.31l-12.95-11.43c23.06-30.2 38.58-66.35 43.86-105.83l17.22 1.08c9.21.58 17-6.74 17-15.97v-29.94c-.01-9.23-7.8-16.54-17.01-15.97zM281.84 98.61c24.81 4.07 47.63 13.66 67.23 27.78l-42.62 48.29c-8.73-5.44-18.32-9.54-28.62-11.95l4.01-64.12zm-51.68 0l4.01 64.12c-10.29 2.41-19.89 6.52-28.62 11.95l-42.62-48.29c19.6-14.12 42.42-23.71 67.23-27.78zm-103.77 64.33l48.3 42.61c-5.44 8.73-9.54 18.33-11.96 28.62l-64.12-4.01c4.07-24.81 13.66-47.62 27.78-67.22zm-27.78 118.9l64.12-4.01c2.41 10.29 6.52 19.89 11.95 28.62l-48.29 42.62c-14.12-19.6-23.71-42.42-27.78-67.23zm131.55 131.55c-24.81-4.07-47.63-13.66-67.23-27.78l42.61-48.3c8.73 5.44 18.33 9.54 28.62 11.96l-4 64.12zM256 288c-17.67 0-32-14.33-32-32s14.33-32 32-32 32 14.33 32 32-14.33 32-32 32zm25.84 125.39l-4.01-64.12c10.29-2.41 19.89-6.52 28.62-11.96l42.61 48.3c-19.6 14.12-42.41 23.71-67.22 27.78zm103.77-64.33l-48.29-42.62c5.44-8.73 9.54-18.32 11.95-28.62l64.12 4.01c-4.07 24.82-13.66 47.64-27.78 67.23zm-36.34-114.89c-2.41-10.29-6.52-19.89-11.96-28.62l48.3-42.61c14.12 19.6 23.71 42.42 27.78 67.23l-64.12 4z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">First-line treatment: Expectant Management<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#P2\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-dharmachakra\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M495 225.06l-17.22 1.08c-5.27-39.49-20.79-75.64-43.86-105.84l12.95-11.43c6.92-6.11 7.25-16.79.73-23.31L426.44 64.4c-6.53-6.53-17.21-6.19-23.31.73L391.7 78.07c-30.2-23.06-66.35-38.58-105.83-43.86L286.94 17c.58-9.21-6.74-17-15.97-17h-29.94c-9.23 0-16.54 7.79-15.97 17l1.08 17.22c-39.49 5.27-75.64 20.79-105.83 43.86l-11.43-12.95c-6.11-6.92-16.79-7.25-23.31-.73L64.4 85.56c-6.53 6.53-6.19 17.21.73 23.31l12.95 11.43c-23.06 30.2-38.58 66.35-43.86 105.84L17 225.06c-9.21-.58-17 6.74-17 15.97v29.94c0 9.23 7.79 16.54 17 15.97l17.22-1.08c5.27 39.49 20.79 75.64 43.86 105.83l-12.95 11.43c-6.92 6.11-7.25 16.79-.73 23.31l21.17 21.17c6.53 6.53 17.21 6.19 23.31-.73l11.43-12.95c30.2 23.06 66.35 38.58 105.84 43.86L225.06 495c-.58 9.21 6.74 17 15.97 17h29.94c9.23 0 16.54-7.79 15.97-17l-1.08-17.22c39.49-5.27 75.64-20.79 105.84-43.86l11.43 12.95c6.11 6.92 16.79 7.25 23.31.73l21.17-21.17c6.53-6.53 6.19-17.21-.73-23.31l-12.95-11.43c23.06-30.2 38.58-66.35 43.86-105.83l17.22 1.08c9.21.58 17-6.74 17-15.97v-29.94c-.01-9.23-7.8-16.54-17.01-15.97zM281.84 98.61c24.81 4.07 47.63 13.66 67.23 27.78l-42.62 48.29c-8.73-5.44-18.32-9.54-28.62-11.95l4.01-64.12zm-51.68 0l4.01 64.12c-10.29 2.41-19.89 6.52-28.62 11.95l-42.62-48.29c19.6-14.12 42.42-23.71 67.23-27.78zm-103.77 64.33l48.3 42.61c-5.44 8.73-9.54 18.33-11.96 28.62l-64.12-4.01c4.07-24.81 13.66-47.62 27.78-67.22zm-27.78 118.9l64.12-4.01c2.41 10.29 6.52 19.89 11.95 28.62l-48.29 42.62c-14.12-19.6-23.71-42.42-27.78-67.23zm131.55 131.55c-24.81-4.07-47.63-13.66-67.23-27.78l42.61-48.3c8.73 5.44 18.33 9.54 28.62 11.96l-4 64.12zM256 288c-17.67 0-32-14.33-32-32s14.33-32 32-32 32 14.33 32 32-14.33 32-32 32zm25.84 125.39l-4.01-64.12c10.29-2.41 19.89-6.52 28.62-11.96l42.61 48.3c-19.6 14.12-42.41 23.71-67.22 27.78zm103.77-64.33l-48.29-42.62c5.44-8.73 9.54-18.32 11.95-28.62l64.12 4.01c-4.07 24.82-13.66 47.64-27.78 67.23zm-36.34-114.89c-2.41-10.29-6.52-19.89-11.96-28.62l48.3-42.61c14.12 19.6 23.71 42.42 27.78 67.23l-64.12 4z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Second-line treatment: IUI with ovarian stimulation (S-IUI)<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#P3\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-dharmachakra\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M495 225.06l-17.22 1.08c-5.27-39.49-20.79-75.64-43.86-105.84l12.95-11.43c6.92-6.11 7.25-16.79.73-23.31L426.44 64.4c-6.53-6.53-17.21-6.19-23.31.73L391.7 78.07c-30.2-23.06-66.35-38.58-105.83-43.86L286.94 17c.58-9.21-6.74-17-15.97-17h-29.94c-9.23 0-16.54 7.79-15.97 17l1.08 17.22c-39.49 5.27-75.64 20.79-105.83 43.86l-11.43-12.95c-6.11-6.92-16.79-7.25-23.31-.73L64.4 85.56c-6.53 6.53-6.19 17.21.73 23.31l12.95 11.43c-23.06 30.2-38.58 66.35-43.86 105.84L17 225.06c-9.21-.58-17 6.74-17 15.97v29.94c0 9.23 7.79 16.54 17 15.97l17.22-1.08c5.27 39.49 20.79 75.64 43.86 105.83l-12.95 11.43c-6.92 6.11-7.25 16.79-.73 23.31l21.17 21.17c6.53 6.53 17.21 6.19 23.31-.73l11.43-12.95c30.2 23.06 66.35 38.58 105.84 43.86L225.06 495c-.58 9.21 6.74 17 15.97 17h29.94c9.23 0 16.54-7.79 15.97-17l-1.08-17.22c39.49-5.27 75.64-20.79 105.84-43.86l11.43 12.95c6.11 6.92 16.79 7.25 23.31.73l21.17-21.17c6.53-6.53 6.19-17.21-.73-23.31l-12.95-11.43c23.06-30.2 38.58-66.35 43.86-105.83l17.22 1.08c9.21.58 17-6.74 17-15.97v-29.94c-.01-9.23-7.8-16.54-17.01-15.97zM281.84 98.61c24.81 4.07 47.63 13.66 67.23 27.78l-42.62 48.29c-8.73-5.44-18.32-9.54-28.62-11.95l4.01-64.12zm-51.68 0l4.01 64.12c-10.29 2.41-19.89 6.52-28.62 11.95l-42.62-48.29c19.6-14.12 42.42-23.71 67.23-27.78zm-103.77 64.33l48.3 42.61c-5.44 8.73-9.54 18.33-11.96 28.62l-64.12-4.01c4.07-24.81 13.66-47.62 27.78-67.22zm-27.78 118.9l64.12-4.01c2.41 10.29 6.52 19.89 11.95 28.62l-48.29 42.62c-14.12-19.6-23.71-42.42-27.78-67.23zm131.55 131.55c-24.81-4.07-47.63-13.66-67.23-27.78l42.61-48.3c8.73 5.44 18.33 9.54 28.62 11.96l-4 64.12zM256 288c-17.67 0-32-14.33-32-32s14.33-32 32-32 32 14.33 32 32-14.33 32-32 32zm25.84 125.39l-4.01-64.12c10.29-2.41 19.89-6.52 28.62-11.96l42.61 48.3c-19.6 14.12-42.41 23.71-67.22 27.78zm103.77-64.33l-48.29-42.62c5.44-8.73 9.54-18.32 11.95-28.62l64.12 4.01c-4.07 24.82-13.66 47.64-27.78 67.23zm-36.34-114.89c-2.41-10.29-6.52-19.89-11.96-28.62l48.3-42.61c14.12 19.6 23.71 42.42 27.78 67.23l-64.12 4z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Third line of treatment: In vitro fertilization (IVF)<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-11de537 e-flex e-con-boxed e-con e-parent\" data-id=\"11de537\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;ekit_has_onepagescroll_dot&quot;:&quot;yes&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-0bebd02 elementor-widget elementor-widget-spacer\" data-id=\"0bebd02\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-36008ae e-con-full e-flex e-con e-parent\" data-id=\"36008ae\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;ekit_has_onepagescroll_dot&quot;:&quot;yes&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-bbdc9f8 elementor-view-framed elementor-position-inline-start elementor-mobile-position-inline-start elementor-shape-circle elementor-widget elementor-widget-icon-box\" data-id=\"bbdc9f8\" data-element_type=\"widget\" data-e-type=\"widget\" id=\"P1\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"icon-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-box-wrapper\">\n\n\t\t\t\t\t\t<div class=\"elementor-icon-box-icon\">\n\t\t\t\t<span  class=\"elementor-icon\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-star-of-life\" viewBox=\"0 0 480 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M471.99 334.43L336.06 256l135.93-78.43c7.66-4.42 10.28-14.2 5.86-21.86l-32.02-55.43c-4.42-7.65-14.21-10.28-21.87-5.86l-135.93 78.43V16c0-8.84-7.17-16-16.01-16h-64.04c-8.84 0-16.01 7.16-16.01 16v156.86L56.04 94.43c-7.66-4.42-17.45-1.79-21.87 5.86L2.15 155.71c-4.42 7.65-1.8 17.44 5.86 21.86L143.94 256 8.01 334.43c-7.66 4.42-10.28 14.21-5.86 21.86l32.02 55.43c4.42 7.65 14.21 10.27 21.87 5.86l135.93-78.43V496c0 8.84 7.17 16 16.01 16h64.04c8.84 0 16.01-7.16 16.01-16V339.14l135.93 78.43c7.66 4.42 17.45 1.8 21.87-5.86l32.02-55.43c4.42-7.65 1.8-17.43-5.86-21.85z\"><\/path><\/svg>\t\t\t\t<\/span>\n\t\t\t<\/div>\n\t\t\t\n\t\t\t\t\t\t<div class=\"elementor-icon-box-content\">\n\n\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-icon-box-title\">\n\t\t\t\t\t\t<span  >\n\t\t\t\t\t\t\tFirst-line treatment: Expectant Management\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\n\t\t\t\t\n\t\t\t<\/div>\n\t\t\t\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-912cd93 elementor-widget elementor-widget-text-editor\" data-id=\"912cd93\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>At this stage of treatment for couples with unexplained <a href=\"https:\/\/drpegahkeramati.com\/en\/treatment-through-vitro-fertilization-ivf\/\">infertility<\/a>, the World Health Organization recommends that expectant management be substituted for unstimulated intrauterine insemination (U-IUI).<\/p><p><strong>Recommendation type:<\/strong> Conditional<\/p><p><strong>Evidence level<\/strong>: Low<\/p><p><strong>What is expectant management?<\/strong><\/p><p>Expectant management means that couples are monitored for a period of time, but no active medical intervention is performed. During this time:<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2b2ed34 elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"2b2ed34\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-compact-disc\" viewBox=\"0 0 496 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M248 8C111 8 0 119 0 256s111 248 248 248 248-111 248-248S385 8 248 8zM88 256H56c0-105.9 86.1-192 192-192v32c-88.2 0-160 71.8-160 160zm160 96c-53 0-96-43-96-96s43-96 96-96 96 43 96 96-43 96-96 96zm0-128c-17.7 0-32 14.3-32 32s14.3 32 32 32 32-14.3 32-32-14.3-32-32-32z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Education is provided about fertile days.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-compact-disc\" viewBox=\"0 0 496 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M248 8C111 8 0 119 0 256s111 248 248 248 248-111 248-248S385 8 248 8zM88 256H56c0-105.9 86.1-192 192-192v32c-88.2 0-160 71.8-160 160zm160 96c-53 0-96-43-96-96s43-96 96-96 96 43 96 96-43 96-96 96zm0-128c-17.7 0-32 14.3-32 32s14.3 32 32 32 32-14.3 32-32-14.3-32-32-32z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Recommendations related to lifestyle modification are made.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-compact-disc\" viewBox=\"0 0 496 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M248 8C111 8 0 119 0 256s111 248 248 248 248-111 248-248S385 8 248 8zM88 256H56c0-105.9 86.1-192 192-192v32c-88.2 0-160 71.8-160 160zm160 96c-53 0-96-43-96-96s43-96 96-96 96 43 96 96-43 96-96 96zm0-128c-17.7 0-32 14.3-32 32s14.3 32 32 32 32-14.3 32-32-14.3-32-32-32z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">General health and fertility status are monitored.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-compact-disc\" viewBox=\"0 0 496 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M248 8C111 8 0 119 0 256s111 248 248 248 248-111 248-248S385 8 248 8zM88 256H56c0-105.9 86.1-192 192-192v32c-88.2 0-160 71.8-160 160zm160 96c-53 0-96-43-96-96s43-96 96-96 96 43 96 96-43 96-96 96zm0-128c-17.7 0-32 14.3-32 32s14.3 32 32 32 32-14.3 32-32-14.3-32-32-32z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Trying to conceive continues naturally.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-15ddec2 elementor-widget elementor-widget-text-editor\" data-id=\"15ddec2\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>In the studies that have informed this recommendation, expectant management has typically been considered to be between 3 and 6 months.<\/p><p>This approach suggests that in many cases, even without drug intervention, <a href=\"https:\/\/drpegahkeramati.com\/en\/pregnancy-at-an-advanced-age-and-solution\/\">pregnancy<\/a> is possible and there may be no need to immediately begin more aggressive treatments in the course of treating couples&#8217; infertility.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d2b0f11 elementor-widget elementor-widget-image\" data-id=\"d2b0f11\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;none&quot;,&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"750\" height=\"501\" src=\"https:\/\/drpegahkeramati.com\/wp-content\/uploads\/2026\/05\/\u062f\u0631\u0645\u0627\u0646-\u0646\u0627\u0628\u0627\u0631\u0648\u0631\u06cc-\u0632\u0648\u062c\u06cc\u0646.jpg\" class=\"attachment-large size-large wp-image-21913\" alt=\"\u062f\u0631\u0645\u0627\u0646 \u0646\u0627\u0628\u0627\u0631\u0648\u0631\u06cc \u0632\u0648\u062c\u06cc\u0646\" title=\"\">\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-cb2b62a e-flex e-con-boxed e-con e-parent\" data-id=\"cb2b62a\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;ekit_has_onepagescroll_dot&quot;:&quot;yes&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1d50ea1 elementor-widget elementor-widget-spacer\" data-id=\"1d50ea1\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-bd7c891 e-con-full e-flex e-con e-parent\" data-id=\"bd7c891\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;ekit_has_onepagescroll_dot&quot;:&quot;yes&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-609948e elementor-view-framed elementor-position-inline-start elementor-mobile-position-inline-start elementor-shape-circle elementor-widget elementor-widget-icon-box\" data-id=\"609948e\" data-element_type=\"widget\" data-e-type=\"widget\" id=\"P2\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"icon-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-box-wrapper\">\n\n\t\t\t\t\t\t<div class=\"elementor-icon-box-icon\">\n\t\t\t\t<span  class=\"elementor-icon\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-star-of-life\" viewBox=\"0 0 480 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M471.99 334.43L336.06 256l135.93-78.43c7.66-4.42 10.28-14.2 5.86-21.86l-32.02-55.43c-4.42-7.65-14.21-10.28-21.87-5.86l-135.93 78.43V16c0-8.84-7.17-16-16.01-16h-64.04c-8.84 0-16.01 7.16-16.01 16v156.86L56.04 94.43c-7.66-4.42-17.45-1.79-21.87 5.86L2.15 155.71c-4.42 7.65-1.8 17.44 5.86 21.86L143.94 256 8.01 334.43c-7.66 4.42-10.28 14.21-5.86 21.86l32.02 55.43c4.42 7.65 14.21 10.27 21.87 5.86l135.93-78.43V496c0 8.84 7.17 16 16.01 16h64.04c8.84 0 16.01-7.16 16.01-16V339.14l135.93 78.43c7.66 4.42 17.45 1.8 21.87-5.86l32.02-55.43c4.42-7.65 1.8-17.43-5.86-21.85z\"><\/path><\/svg>\t\t\t\t<\/span>\n\t\t\t<\/div>\n\t\t\t\n\t\t\t\t\t\t<div class=\"elementor-icon-box-content\">\n\n\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-icon-box-title\">\n\t\t\t\t\t\t<span  >\n\t\t\t\t\t\t\tSecond-line treatment: IUI with ovarian stimulation (S-IUI)\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\n\t\t\t\t\n\t\t\t<\/div>\n\t\t\t\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-61edef7 elementor-widget elementor-widget-text-editor\" data-id=\"61edef7\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>If pregnancy does not occur after the expectant management period, the second stage of infertility treatment for couples begins.<\/p><p>At this stage, the World Health Organization recommends the use of intrauterine insemination with ovarian stimulation (S-IUI).<\/p><p><strong>Type of recommendation:<\/strong> Conditional<\/p><p><strong>Level of certainty of evidence:<\/strong> Low<\/p><p><strong>Recommended medications:<\/strong><\/p><p>For ovarian stimulation in this method: Two medications are recommended:<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5986205 elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"5986205\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-compact-disc\" viewBox=\"0 0 496 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M248 8C111 8 0 119 0 256s111 248 248 248 248-111 248-248S385 8 248 8zM88 256H56c0-105.9 86.1-192 192-192v32c-88.2 0-160 71.8-160 160zm160 96c-53 0-96-43-96-96s43-96 96-96 96 43 96 96-43 96-96 96zm0-128c-17.7 0-32 14.3-32 32s14.3 32 32 32 32-14.3 32-32-14.3-32-32-32z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Clomiphen Citrate<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-compact-disc\" viewBox=\"0 0 496 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M248 8C111 8 0 119 0 256s111 248 248 248 248-111 248-248S385 8 248 8zM88 256H56c0-105.9 86.1-192 192-192v32c-88.2 0-160 71.8-160 160zm160 96c-53 0-96-43-96-96s43-96 96-96 96 43 96 96-43 96-96 96zm0-128c-17.7 0-32 14.3-32 32s14.3 32 32 32 32-14.3 32-32-14.3-32-32-32z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Letrozole<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6df37ef elementor-widget elementor-widget-text-editor\" data-id=\"6df37ef\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>When choosing between these two drugs, national regulations regarding off-label use of letrozole should be considered.<\/p><p><strong>How many treatment cycles are required?<\/strong><\/p><p>The optimal number of S-IUI cycles is still not definitively known. In various studies, between 1 and 6 cycles have been reported, but in more recent research, 3 to 6 cycles are usually performed.<\/p><p>Importantly, <a href=\"https:\/\/drpegahkeramati.com\/en\/5-steps-to-improve-bone-health-in-men\/\">WHO<\/a> recommends that gonadotropins not be used at this stage and that S-IUI be performed only with clomiphene or letrozole.<\/p><p><strong>Type of recommendation regarding the non-use of gonadotropins:<\/strong> Conditional<\/p><p><strong>Level of certainty of evidence:<\/strong> Very low<\/p><p>This stage is considered one of the most important steps in the scientific and stepwise approach to treating couples&#8217; infertility, as it provides an appropriate balance between effectiveness and invasiveness of the treatment.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-563e4d8 elementor-widget elementor-widget-image\" data-id=\"563e4d8\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;none&quot;,&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"800\" height=\"500\" src=\"https:\/\/drpegahkeramati.com\/wp-content\/uploads\/2026\/05\/\u062f\u0631\u0645\u0627\u0646-\u0646\u0627\u0628\u0627\u0631\u0648\u0631\u06cc-\u0632\u0648\u062c\u06cc\u0646-2.jpg\" class=\"attachment-large size-large wp-image-21911\" alt=\"\u062f\u0631\u0645\u0627\u0646 \u0646\u0627\u0628\u0627\u0631\u0648\u0631\u06cc \u0632\u0648\u062c\u06cc\u0646\" title=\"\">\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-a99c993 e-flex e-con-boxed e-con e-parent\" data-id=\"a99c993\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;ekit_has_onepagescroll_dot&quot;:&quot;yes&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8b0d6d5 elementor-widget elementor-widget-spacer\" data-id=\"8b0d6d5\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-2b83e16 e-con-full e-flex e-con e-parent\" data-id=\"2b83e16\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;ekit_has_onepagescroll_dot&quot;:&quot;yes&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-452b8b2 elementor-view-framed elementor-position-inline-start elementor-mobile-position-inline-start elementor-shape-circle elementor-widget elementor-widget-icon-box\" data-id=\"452b8b2\" data-element_type=\"widget\" data-e-type=\"widget\" id=\"P3\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"icon-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-box-wrapper\">\n\n\t\t\t\t\t\t<div class=\"elementor-icon-box-icon\">\n\t\t\t\t<span  class=\"elementor-icon\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-star-of-life\" viewBox=\"0 0 480 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M471.99 334.43L336.06 256l135.93-78.43c7.66-4.42 10.28-14.2 5.86-21.86l-32.02-55.43c-4.42-7.65-14.21-10.28-21.87-5.86l-135.93 78.43V16c0-8.84-7.17-16-16.01-16h-64.04c-8.84 0-16.01 7.16-16.01 16v156.86L56.04 94.43c-7.66-4.42-17.45-1.79-21.87 5.86L2.15 155.71c-4.42 7.65-1.8 17.44 5.86 21.86L143.94 256 8.01 334.43c-7.66 4.42-10.28 14.21-5.86 21.86l32.02 55.43c4.42 7.65 14.21 10.27 21.87 5.86l135.93-78.43V496c0 8.84 7.17 16 16.01 16h64.04c8.84 0 16.01-7.16 16.01-16V339.14l135.93 78.43c7.66 4.42 17.45 1.8 21.87-5.86l32.02-55.43c4.42-7.65 1.8-17.43-5.86-21.85z\"><\/path><\/svg>\t\t\t\t<\/span>\n\t\t\t<\/div>\n\t\t\t\n\t\t\t\t\t\t<div class=\"elementor-icon-box-content\">\n\n\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-icon-box-title\">\n\t\t\t\t\t\t<span  >\n\t\t\t\t\t\t\tThird line of treatment: In vitro fertilization (IVF)\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\n\t\t\t\t\n\t\t\t<\/div>\n\t\t\t\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-137221f elementor-widget elementor-widget-text-editor\" data-id=\"137221f\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>If S-IUI is also unsuccessful, we enter the third stage of infertility treatment for couples.<\/p><p>In these situations, the World Health Organization recommends that <a href=\"https:\/\/drpegahkeramati.com\/en\/cost-of-ivf-with-different-insurance-types\/\">IVF<\/a> be used instead of expectant management.<\/p><p><strong>Type of recommendation:<\/strong> Conditional<\/p><p><strong>Level of certainty of evidence:<\/strong> Low<\/p><p>IVF is an advanced assisted reproductive technology in which eggs and sperm are combined in a laboratory environment and, after the embryo is formed, they are transferred to the uterus. This method significantly increases the chances of pregnancy in many cases of infertility without a clear cause.<\/p><p><strong>Should ICSI be used?<\/strong><\/p><p>For couples who are challenged with IVF after S-IUI failure, WHO recommends that IVF be performed alone and that ICSI (intracytoplasmic sperm injection) not be used unless there is a specific indication.<\/p><p><strong>Recommendation Type:<\/strong> Certain<\/p><p><strong>Evidence Level:<\/strong> Low<\/p><p>This recommendation suggests that in unexplained infertility, routine use of <a href=\"https:\/\/drpegahkeramati.com\/en\/ivf-icsi\/\">ICSI<\/a> is not necessary and the choice of method should be based on the specific circumstances of each couple.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b50cb32 elementor-widget elementor-widget-image\" data-id=\"b50cb32\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;none&quot;,&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"680\" height=\"353\" src=\"https:\/\/drpegahkeramati.com\/wp-content\/uploads\/2026\/05\/\u0647\u0632\u06cc\u0646\u0647-\u0641\u0631\u06cc\u0632-\u062a\u062e\u0645\u06a9.webp\" class=\"attachment-large size-large wp-image-21788\" alt=\"\u0647\u0632\u06cc\u0646\u0647 \u0641\u0631\u06cc\u0632 \u062a\u062e\u0645\u06a9\" srcset=\"https:\/\/drpegahkeramati.com\/wp-content\/uploads\/2026\/05\/\u0647\u0632\u06cc\u0646\u0647-\u0641\u0631\u06cc\u0632-\u062a\u062e\u0645\u06a9.webp 680w, https:\/\/drpegahkeramati.com\/wp-content\/uploads\/2026\/05\/\u0647\u0632\u06cc\u0646\u0647-\u0641\u0631\u06cc\u0632-\u062a\u062e\u0645\u06a9-300x156.webp 300w\" sizes=\"(max-width: 680px) 100vw, 680px\" title=\"\">\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-79d5a12 e-flex e-con-boxed e-con e-parent\" data-id=\"79d5a12\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;ekit_has_onepagescroll_dot&quot;:&quot;yes&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-63cd26b elementor-widget elementor-widget-spacer\" data-id=\"63cd26b\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>3 Important advice for Treating Infertility in Couples with No Known Cause by Dr. Pegah Keramati Unexplained infertility is one of the most challenging conditions in the field of reproductive medicine. In this situation, despite conducting complete examinations including: hormonal tests, ovulation assessment, fallopian tube examination and sperm analysis, no specific cause for infertility can [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":21894,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[101,131],"tags":[],"wf_post_folders":[80],"class_list":["post-21994","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-article","category-infertility-and-repeated-pregnancies-and-abortions"],"_links":{"self":[{"href":"https:\/\/drpegahkeramati.com\/en\/wp-json\/wp\/v2\/posts\/21994","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drpegahkeramati.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drpegahkeramati.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drpegahkeramati.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/drpegahkeramati.com\/en\/wp-json\/wp\/v2\/comments?post=21994"}],"version-history":[{"count":16,"href":"https:\/\/drpegahkeramati.com\/en\/wp-json\/wp\/v2\/posts\/21994\/revisions"}],"predecessor-version":[{"id":22013,"href":"https:\/\/drpegahkeramati.com\/en\/wp-json\/wp\/v2\/posts\/21994\/revisions\/22013"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drpegahkeramati.com\/en\/wp-json\/wp\/v2\/media\/21894"}],"wp:attachment":[{"href":"https:\/\/drpegahkeramati.com\/en\/wp-json\/wp\/v2\/media?parent=21994"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drpegahkeramati.com\/en\/wp-json\/wp\/v2\/categories?post=21994"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drpegahkeramati.com\/en\/wp-json\/wp\/v2\/tags?post=21994"},{"taxonomy":"wf_post_folders","embeddable":true,"href":"https:\/\/drpegahkeramati.com\/en\/wp-json\/wp\/v2\/wf_post_folders?post=21994"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}