IVF and fertility treatment in India

Before any treatment, both partners are investigated. For the woman: hormone profile, AMH, antral follicle count and assessment of whether the tubes are open. For the man: a properly performed semen analysis, repeated if abnormal. Around a third of couples have a male factor, a third female, and a third both or neither — which is why testing only one partner wastes months.

Tablets or low-dose injections stimulate ovulation, and prepared sperm is placed directly into the uterus at the right moment. It is far simpler and cheaper than IVF and appropriate for specific situations — mild male factor, unexplained infertility, ovulation disorders — with open tubes. Success per cycle is modest, and after three or four failed attempts moving to IVF is usually right.

Injections stimulate the ovaries to produce multiple eggs, which are collected under sedation and fertilised in the laboratory. Embryos are grown for three to five days and one is transferred to the uterus. It is the standard treatment where tubes are blocked, where other treatments have failed, and in many cases of unexplained infertility.

A single sperm is injected directly into each egg. It was developed for severe male factor infertility, where sperm counts or motility are too low for conventional fertilisation, and for men needing surgical sperm retrieval. It is now used very widely — sometimes more widely than the evidence supports, since it adds cost without benefit where sperm are normal.

Surplus embryos are vitrified and stored for later transfer, so a second attempt does not require another stimulation and egg collection. Freezing all embryos and transferring in a later cycle is now standard where there is a risk of ovarian hyperstimulation. Egg freezing is also used before cancer treatment that would damage fertility.

A few cells are removed from an embryo and tested before transfer. PGT-M screens for a specific inherited condition where both parents are carriers — thalassemia and sickle cell disease being the most relevant for our patients. PGT-A screens chromosome numbers and is more contested; its benefit is debated and it is frequently oversold.