Milann | The Fertility Specialist




World IVF Day 2023: Doctor Answers 11 Most Asked Questions On Infertility And IVF

What is infertility?

Infertility is defined as the inability of a couple to conceive after one year of unprotected intercourse in a woman under the age of 35 years, or after six months when the women’s age is over 35 years. It affects around 10-15% of couples in India.

Is it true that as a female’s age advances her chances of getting pregnant decrease?

As the age of a female advances there is a decrease in her egg numbers and egg quality and so her chances of conceiving per cycle  or her fertility decreases with age. If you are 20-25 years old, your chance per cycle is about 25%. At 30-35 years, it is about 15%. After 35 years of age, it may be about 10% per ovulatory cycle, and the chances continue a downward trend.

When does a couple need to visit a fertility consultant? 

Couples are generally advised to seek medical help if they are unable to achieve pregnancy after a year of unprotected intercourse or after 6 months if a woman’s age is more than 35 years due to the age-related decline in fertility . If however a woman has a history of painful or irregular periods or a known cause like endometriosis it might be prudent to seek help sooner. If the male partner has a known or suspected low sperm count, then he should  also seek help sooner rather than waiting a year.  Evaluation of both partners should begin at the same time

What should a couple expect on their first visit?

The doctor interviews and examines both partners to determine their general state of health and to evaluate disorders that may be causing infertility. If no cause can be determined at this point, more specific tests are recommended. For women, these include an assessment of ovulation, testing of the fallopian tubes , uterine cavity evaluation and a basic hormonal profile. For men, initial tests focus on semen analysis. Advice on management is given based on the test results.

What are the common causes of infertility in a couple?

The most common factor causing infertility in women is ovulation disorders e.g. PCOS. Other factors include  blocked fallopian tubes, endometriosis, uterine causes. In males, it  could range from  low to absent sperm count (azoospermia).


By what all methods can a fertility expert help in achieving a pregnancy?

After initial history taking and investigations you are offered a series of treatment options based on your workup ranging from simple treatments to more advanced options.

Timed Intercourse/Ovulation induction (TI) – In this we monitor a woman’s cycle and the correct time to try is told to the couple. Many couples conceive if monitored properly till the documentation of ovulation .

IUI: Intrauterine insemination (IUI) is a procedure in which a husband’s  processed semen sample is placed in the woman’s uterus, at the time of ovulation with a sterile flexible catheter. The aim is to help a good number of motile sperms reach the Fallopian tube where fertilisation of the egg takes place. It is a simple procedure that requires no admission or anaesthesia.

IVF-ICSI: IVF means in vitro fertilisation, which is the fertilisation of an egg outside the body. This fertilised egg is called an embryo and after 3-5 days of development in an incubator, it is transferred into the womb/uterus of the patient.

We also offer services like Blastocyst transfer,Preimplantation Genetic Testing, Endometrial Receptivity assay for patients who have had previous failed IVF cycles.

Is infertility treatment very costly?

Not all patients visiting a fertility centre require IVF/ICSI(test tube baby) which is the most expensive form of treatment. A good fertility specialist helps you conceive in the most cost-effective and natural way moving towards IVF only when indicated. IVF / ICSI is advised only in those cases who have no or minimal chances to conceive otherwise.

How do you choose a good fertility specialist or IVF centre?

There are many centres in the market run by people who are either not infertility specialists or many times not even doctors. They simply act as mediators and most of the technical work is done by a team which visits them once a month. They have to club all patients on the dates when the team is expected to visit, which hampers the pregnancy rates. However, in a good fertility centre, the   procedure is performed by in-house doctors throughout the year.

What are the success rates for IVF treatment?

 The success rates for IVF treatment depends on the individual patient profile, the quality of oocytes and embryos after fertilisation and many other factors. The maternal age plays a very important role in the success of the treatment. As a woman ages, her ovarian reserve is depleted and the probability of obtaining good quality oocytes and embryos reduces. In these cases we offer genetic testing of the embryos before transferring them or give them the option of a donor egg cycle to improve the pregnancy rates.

Why should I seek treatment from a Reproductive Endocrinologist rather than from my gynaecologist?

Infertility is a distressing moment for any couple to go through and finding a fertility specialist can be quite stressful. Reproductive medicine specialists treat Reproductive disorders that affect women & men in a more specialised & scientific manner. It is important to find a doctor who is responsive and well matched to your needs and diagnosis.

Can we freeze our embryos if we are not planning to have a baby soon and are well aware of our advancing age?

Yes, in today's world women are giving preference to their careers over motherhood not realising that their biological clock is ticking. For them we have an option in which they can freeze their embryos/oocytes for later use. 

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