IVF — In Vitro Fertilisation
IVF is the most effective fertility treatment available, and it is also demanding — financially, physically and emotionally. Our fertility specialists will tell you your realistic chance based on your age and your test results, not a headline success rate. Most couples need more than one cycle, and you deserve to know that before you start, not after.
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What is IVF?
IVF brings egg and sperm together in a laboratory rather than inside the body. The ovaries are stimulated to grow several eggs at once, the eggs are collected through a short procedure, they are fertilised in the laboratory, and the resulting embryo is placed into the uterus a few days later. It bypasses several of the things that can go wrong along the natural route — blocked tubes, poor sperm counts, failed ovulation — which is why it is the most effective fertility treatment available.
It is not the first treatment for everybody. Depending on the cause, ovulation induction with tablets, or IUI — where prepared sperm is placed directly into the uterus — may be tried first, and they are considerably cheaper and simpler. IVF is the right first step where the tubes are blocked or absent, where the sperm count is very low, where ovarian reserve is falling, where the woman is older, or where simpler treatments have already failed.
The most important number in fertility medicine is the woman's age, because egg quality declines with it and no treatment reverses that. A single IVF cycle gives roughly a 40 to 50% chance of a live birth for a woman under 35; around 30 to 35% in the late thirties; around 15 to 20% at 40 to 42; and under 5% above 43 with her own eggs. These are honest figures, and they are per cycle rather than cumulative. Any clinic advertising a single high success rate without stating the age band it applies to is quoting a number that will not apply to most of the people reading it.
Which leads to the thing couples most often are not told at the start: most people need more than one cycle. Planning emotionally and financially for two or three attempts from the outset is far kinder than planning for one and being told after a failed cycle that you should try again. A failed cycle is not usually a sign that IVF will not work for you — it is a common part of a process that succeeds cumulatively.
Two more honest points. IVF is emotionally demanding in a way that no consent form conveys: daily injections, frequent scans, an anxious two-week wait, and the particular grief of a negative result after months of hope. Counselling support is not a soft extra; couples who use it cope measurably better. And male factors account for roughly 40 to 50% of infertility, so a semen analysis should be among the very first tests done. It is simple, cheap and non-invasive, yet women are still routinely investigated extensively before anyone tests the man.
Treatment information
| Condition | Infertility — Male, Female or Unexplained |
|---|---|
| Procedure | In Vitro Fertilisation, with ICSI where indicated |
| Duration | One cycle takes 4 to 6 weeks |
| Treated by | Reproductive Medicine Specialist / Embryologist |
| Anaesthesia | Short general anaesthesia or sedation for retrieval |
| Success rate | Strongly age-dependent — see the FAQs |
| Recovery time | 1 to 2 days after egg retrieval |
| Hospital stay | Daycare — home a few hours after retrieval |
Signs you may need IVF treatment
- Not conceiving after 12 months of regular unprotected intercourse, or after 6 months if the woman is over 35
- Irregular or absent periods, suggesting problems with ovulation
- Very painful periods or pain during intercourse, which may indicate endometriosis
- Two or more miscarriages
- Known blocked or damaged fallopian tubes
- A previous ectopic pregnancy or tubal surgery
- A low sperm count, poor motility or abnormal morphology on semen analysis
- Previous cancer treatment affecting fertility in either partner
- Signs of PCOS — irregular cycles, excess hair growth, difficulty losing weight
- A woman over 35 who wishes to assess her ovarian reserve before trying
What causes it?
- Blocked or damaged fallopian tubes, often after infection or endometriosis
- Ovulation disorders, most commonly PCOS
- Reduced ovarian reserve, whether age-related or premature
- Endometriosis affecting egg quality, tubal function and implantation
- Male factor — low count, poor motility, abnormal morphology or absent sperm
- Uterine problems including fibroids, polyps and intrauterine adhesions
- Unexplained infertility, where all tests are normal in both partners
- Genetic conditions in either partner
- Previous chemotherapy or radiotherapy
- Recurrent miscarriage, sometimes due to chromosomal issues in the embryos
Who is more likely to be affected
- The woman's age above 35, and particularly above 40
- Smoking by either partner, which reduces both egg and sperm quality
- Obesity or being significantly underweight
- Untreated PCOS, thyroid disorder or diabetes
- Endometriosis
- A history of pelvic infection or sexually transmitted infection
- Heavy alcohol use
- Occupational heat exposure or exposure to industrial toxins, particularly for men
- Previous pelvic or testicular surgery
- Chronic stress and poor sleep
When to see a doctor immediately
- After 12 months of trying without conceiving, if the woman is under 35
- After 6 months, if the woman is over 35 — waiting the full year costs valuable time
- Straight away if the woman is over 40, or if periods are absent or very irregular
- Straight away if the tubes are known to be blocked or have been removed
- After two or more miscarriages
- If a semen analysis has shown a significant abnormality
- Before cancer treatment, to discuss freezing eggs, sperm or embryos
- If either partner has a family history of a genetic condition
- If you simply want your fertility assessed before deciding when to try
How it is diagnosed
Semen analysis
The first test that should be done, in every couple, before extensive investigation of the woman. It is cheap, quick and non-invasive, and male factors account for around 40 to 50% of infertility. It is repeated after a few weeks if abnormal, since results vary between samples.
Ovarian reserve testing
AMH from a blood sample and antral follicle count on ultrasound together estimate how many eggs remain. This predicts how the ovaries will respond to stimulation and guides the drug protocol. Important caveat: reserve tests measure egg <em>quantity</em>, not quality — and it is age that governs quality.
Hormone profile
FSH, LH, oestradiol, prolactin, TSH and androgens, timed to the cycle. These identify ovulation disorders, PCOS, thyroid dysfunction and raised prolactin — several of which are treatable in their own right and may not need IVF at all.
Tubal assessment
Hysterosalpingography or a saline sonography assesses whether the fallopian tubes are open. Blocked tubes are a direct indication for IVF, since no amount of ovulation induction will help if egg and sperm cannot meet.
Transvaginal ultrasound and uterine assessment
Examines the uterus and ovaries for fibroids, polyps, adenomyosis, endometriomas and adhesions. Correcting a cavity abnormality before transfer measurably improves implantation, so this is done before rather than after a failed cycle.
Infection screening and general health checks
HIV, hepatitis B and C, and rubella immunity for both partners, alongside blood counts, sugar and vitamin D. Optimising thyroid function and blood sugar before starting genuinely affects outcomes.
Genetic testing where indicated
Karyotyping for recurrent miscarriage or very low sperm counts, and carrier screening where there is a family history or consanguinity — a relevant consideration in parts of India.
How the options compare
| Feature | IUI (Intrauterine Insemination) | IVF (In Vitro Fertilisation) |
|---|---|---|
| Where fertilisation happens | Inside the body | In the laboratory |
| Requires open tubes | Yes | No |
| Sperm requirement | Reasonable count and motility needed | Works with very low counts using ICSI |
| Success per cycle | Roughly 10–15% | Strongly age-dependent, up to 40–50% under 35 |
| Medication | Mild stimulation | Full stimulation, daily injections |
| Egg retrieval procedure | Not needed | Needed, under sedation |
| Embryo freezing possible | No | Yes |
| Genetic testing of embryos | Not possible | Possible |
| Cost per cycle | Considerably lower | Considerably higher |
| Typically used for | Mild male factor, unexplained infertility, young couples | Blocked tubes, severe male factor, older age, failed IUI |
Types of treatment
Before IVF — simpler options where appropriate
Lifestyle optimisation
Weight normalisation, stopping smoking and alcohol, treating thyroid disease and controlling blood sugar. Unglamorous, and genuinely effective — weight loss alone restores ovulation in a substantial proportion of women with PCOS.
Ovulation induction
Letrozole or clomiphene tablets to trigger ovulation, with timed intercourse. First-line for PCOS with open tubes and a normal semen analysis, and far cheaper and simpler than IVF.
Intrauterine insemination (IUI)
Prepared sperm placed directly into the uterus around ovulation. Suits mild male factor and unexplained infertility in younger couples with open tubes. Usually attempted for three to four cycles before moving on, since success is roughly 10 to 15% per cycle.
Corrective surgery
Removing polyps, submucosal fibroids or intrauterine adhesions, or treating endometriosis. Correcting the cavity before an embryo transfer improves the chance of that transfer working.
IVF and its variations
Conventional IVF
Eggs and prepared sperm are placed together in a dish and fertilisation happens on its own. Suitable where sperm parameters are adequate.
ICSI — intracytoplasmic sperm injection
A single sperm is injected directly into each egg. Essential for severe male factor, for previous fertilisation failure, and where sperm has been retrieved surgically. Now used in a majority of cycles — though it is worth asking whether you actually need it, since it adds cost and offers no benefit where sperm parameters are normal.
Blastocyst culture
Embryos are grown to day five rather than transferred on day three. This allows better selection of the strongest embryo and improves implantation rates, though not every embryo survives to that stage.
Frozen embryo transfer (FET)
Embryos are frozen and transferred in a later, unstimulated cycle. Success rates are comparable to or better than fresh transfer, it avoids the risk of ovarian hyperstimulation, and surplus embryos give further attempts without repeating the whole stimulation and retrieval.
PGT-A — genetic testing of embryos
Screens embryos for chromosomal abnormalities before transfer. Most useful for older women and for recurrent miscarriage or repeated implantation failure. It adds significant cost, and it does not create good embryos — it only selects among those you already have.
Surgical sperm retrieval (TESA / PESA / micro-TESE)
Sperm collected directly from the testis or epididymis where there is none in the ejaculate. Combined with ICSI, it allows biological fatherhood in many men previously considered infertile.
Donor eggs, sperm or embryos
Where a partner's own gametes cannot achieve a pregnancy. Donor egg IVF has notably high success rates, because success then follows the donor's age rather than the recipient's. It carries real emotional considerations and counselling is part of the process, not an add-on.
What happens, step by step
- 1
Assessment and planning
2 to 6 weeks- Full assessment of both partners, starting with a semen analysis
- Ovarian reserve, hormone profile, tubal and uterine assessment
- Your realistic chance discussed in terms of your age and your results, not a clinic average
- The full cost of a two-to-three-cycle plan explained in writing, including medication
- Counselling support offered before you begin, not only if a cycle fails
- 2
Ovarian stimulation
10 to 14 days- Daily hormone injections stimulate multiple follicles to develop
- Ultrasound scans and blood tests every two to three days monitor the response
- Doses are adjusted as you go — this is why the monitoring visits matter
- A trigger injection is given at exactly the right time to mature the eggs
- Signs of ovarian hyperstimulation are watched for throughout
- 3
Egg retrieval
20–30 minutes- Performed 34 to 36 hours after the trigger injection, under sedation or short general anaesthesia
- A fine needle is passed through the vaginal wall under ultrasound guidance to collect the eggs
- No incision anywhere; you go home a few hours later
- Your partner provides a semen sample the same day, or frozen or surgically retrieved sperm is used
- Mild cramping and spotting afterwards are normal
- 4
Fertilisation and embryo culture
3 to 6 days- Eggs and sperm are combined, or ICSI is performed
- Fertilisation is confirmed the following day
- Embryos are cultured in a controlled incubator and graded daily
- You are updated on numbers and quality as the days progress
- Genetic testing is performed at this stage where planned
- 5
Embryo transfer
10–15 minutes- A fine catheter passes the embryo through the cervix into the uterus under ultrasound guidance
- No anaesthesia is needed and it feels much like a smear test
- Usually a single embryo, to avoid the risks of a twin pregnancy
- Surplus good-quality embryos are frozen for later attempts
- Progesterone support is started and continued
- 6
The two-week wait and pregnancy test
12 to 14 days- A blood test for beta-hCG rather than a home urine test, which can mislead
- Progesterone and any other support medication continues until advised
- Normal activity is encouraged; strict bed rest does not improve outcomes
- A scan at six to seven weeks confirms an ongoing pregnancy
- Where the cycle is unsuccessful, a review appointment plans what to change next time
How to prepare
- Both partners should stop smoking completely — it affects egg quality, sperm quality and implantation
- Work towards a healthy BMI; both obesity and being underweight reduce success
- Start folic acid at least three months before, and vitamin D if you are deficient
- Get thyroid function, blood sugar and prolactin optimised before starting
- Stop alcohol, and men should avoid hot baths, saunas and laptops on the lap
- Ask for the complete cost in writing, including medication, freezing and storage
- Plan time off around the retrieval, and lighter commitments during the two-week wait
- Arrange counselling support at the start rather than waiting for a difficult moment
- Discuss how many embryos to transfer before the day, when the decision is easier to think about clearly
Why patients choose this procedure
The most effective fertility treatment there is
IVF gives the highest chance of pregnancy per cycle of any treatment, and it works where simpler approaches cannot.
It bypasses blocked tubes entirely
Where the fallopian tubes are blocked, damaged or absent, IVF sidesteps the problem completely rather than trying to correct it.
It overcomes severe male factor
With ICSI, a single viable sperm can fertilise an egg. Combined with surgical retrieval, many men once told fatherhood was impossible now have biological children.
Surplus embryos can be frozen
Good-quality embryos not transferred are frozen, giving further attempts without repeating stimulation and retrieval — which lowers both the cost and the physical burden of a second try.
Embryos can be genetically screened
Where there is recurrent miscarriage, advanced maternal age or a known genetic condition, embryos can be tested before transfer.
Fertility can be preserved
Eggs, sperm and embryos can be frozen before cancer treatment or for medical reasons, preserving options that would otherwise be lost.
Possible risks and side effects
The cycle may not work
The most common outcome to prepare for, and the hardest. Even in the best circumstances a single cycle fails more often than it succeeds, and success is strongly governed by age. This is not usually a reason to stop — cumulative success across two or three cycles is substantially higher than any single one.
Ovarian hyperstimulation syndrome (OHSS)
An excessive response to stimulation causing abdominal swelling, pain, nausea and, in severe cases, fluid accumulation and clotting risk. Modern protocols, careful monitoring and freezing all embryos rather than transferring fresh have made severe OHSS much less common. Severe abdominal pain, breathlessness or reduced urine output must be reported immediately.
Multiple pregnancy
Transferring more than one embryo raises the twin rate, and twin pregnancies carry materially higher risks of prematurity, growth restriction and complications for both mother and babies. This is why single embryo transfer is now standard practice, even though it feels counter-intuitive to patients hoping to improve their odds.
Complications of egg retrieval
Bleeding, infection or injury to nearby structures. Uncommon, but it is a procedure under sedation and carries a small procedural risk.
Ectopic pregnancy
Slightly more common after IVF than after natural conception, particularly with damaged tubes. This is why an early scan is arranged rather than relying on a positive test alone.
Emotional and psychological strain
Genuinely one of the significant risks, and the least discussed. The injections, the monitoring, the two-week wait and the possibility of a negative result take a real toll on individuals and relationships. Counselling helps measurably and should be arranged early rather than in crisis.
Financial strain
Most couples need more than one cycle, and most Indian policies exclude infertility treatment. Planning finances for two to three attempts from the beginning avoids being forced to stop mid-way through a process that was working.
What recovery looks like
There are two recoveries in an IVF cycle. The physical one after egg retrieval is short. The emotional one, through the two-week wait and beyond, is the part that actually needs support.
Day of retrieval: you rest for a few hours and go home the same day. Expect cramping like a period, mild bloating and light spotting. Take it easy for the rest of the day and drink plenty of fluids. Most women feel largely normal within 24 to 48 hours.
Days 1 to 5 after retrieval: bloating and mild discomfort settle. Watch specifically for the warning signs of ovarian hyperstimulation — rapidly increasing abdominal swelling, severe pain, breathlessness, vomiting or reduced urine output — and report any of them immediately rather than waiting for the next appointment. You will be receiving daily updates on how the embryos are developing.
Embryo transfer day: the transfer itself takes ten to fifteen minutes, needs no anaesthesia and feels much like a smear test. You can go back to normal activity the same day. Strict bed rest afterwards does not improve the chance of success, despite how instinctive it feels.
The two-week wait: continue progesterone exactly as prescribed. Normal activity, gentle exercise and work are all fine — avoid only heavy lifting and high-impact activity. Do not test early at home: an early urine test can pick up the trigger injection and give a false positive, or miss a real pregnancy and cause needless distress. Wait for the blood test.
The result: a positive test is followed by continued progesterone and a scan at six to seven weeks. If the cycle has not worked, take the time you need before deciding anything. A review appointment goes through what the cycle showed and what would be adjusted next time — a failed cycle usually yields genuinely useful information about how you respond.
Contact your clinic immediately for severe abdominal pain, rapidly increasing swelling, breathlessness, heavy vaginal bleeding, fever, or passing very little urine.
What to eat and what to avoid
Recommended
- A Mediterranean-style pattern — whole grains, vegetables, fruit, olive oil, fish and pulses — which has the best evidence in fertility
- Protein at every meal for both partners
- Folic acid from at least three months before conception, plus folate-rich foods
- Vitamin D, supplemented where deficient
- Antioxidant-rich foods: berries, amla, nuts, seeds and green leafy vegetables
- Omega-3 from fish, walnuts and flaxseed
- Plenty of water, particularly around the time of egg retrieval
Best avoided
- Smoking by either partner — it damages egg quality, sperm quality and implantation
- Alcohol, for both partners, throughout the treatment cycle
- Excess caffeine, ideally kept below 200 mg a day
- Highly processed food, trans fats and excess refined sugar
- Unregulated fertility supplements and herbal products, which can interact with your medication
- Hot tubs, saunas and prolonged heat exposure for men, which reduce sperm quality
Post-operative care, at no extra cost
- Diet and lifestyle consultation with a nutritionist
- Scheduled follow-up calls until you are fully recovered
- Free cab for the follow-up visit
- 24×7 access to your care coordinator for any concern
IVF treatment cost
₹1,50,000 – ₹3,50,000
Per cycle, and the figure people are quoted is often only part of it. Ask specifically whether the quote includes the stimulation medication — which alone can be ₹60,000 to ₹1,20,000 and varies with your dose — as well as ICSI, embryo freezing, annual storage, and each frozen embryo transfer. Genetic testing (PGT-A) is extra again. Since most couples need more than one cycle, ask for the cost of a realistic two-to-three-cycle plan rather than a single headline number. Most Indian health insurance policies exclude infertility treatment entirely; a small number of newer and corporate group policies now include limited cover, so it is worth checking your specific document rather than assuming either way.
Inside the care journey
IVF — your questions answered
It depends overwhelmingly on the woman's age, and any clinic quoting a single number without saying which age band it applies to is not being straight with you. Per cycle, live birth rates are roughly 40 to 50% under 35, 30 to 35% in the late thirties, 15 to 20% at 40 to 42, and under 5% above 43 using your own eggs. These are per-cycle figures. Cumulative success across two or three cycles is considerably higher, which is exactly why planning for more than one attempt matters.