The fertility guide
Plain explanations, from "are we worrying too early?" to "what does IVF involve?". Written for everyone, medically reviewed, with sources you can check.
New to the terms? Start with the glossary.
All guides
Thyroid, prolactin and fertility
Thyroid problems and high prolactin can both disturb periods and ovulation. They are checked with simple blood tests, and both are usually treatable. Medicines should only be started, changed or stopped with a doctor.
Reviewed 16 Oct 20264 min read
IUI or IVF? How doctors decide which to suggest
There is no single rule for choosing between IUI and IVF. Doctors weigh the state of the fallopian tubes, sperm results, age, how long you have been trying, ovulation, any previous treatment, and your own priorities, including cost.
Reviewed 16 Oct 20264 min read
Blocked fallopian tubes: causes, tests and options
The fallopian tubes carry the egg towards the uterus, and are where sperm usually meet it. Tubes can be blocked or damaged by infection, surgery or endometriosis. Tests can check them, and there are options even when both tubes are blocked.
Reviewed 16 Oct 20264 min read
Fibroids, polyps and the uterus: which ones matter for fertility
Fibroids and polyps are common, non-cancerous growths in the uterus. Many have no effect on fertility. Whether one matters depends mostly on where it is, especially whether it bulges into the cavity where an embryo implants.
Reviewed 16 Oct 20264 min read
What counts as infertility, and how common is it?
Doctors use the word infertility when a pregnancy has not happened after 12 months or more of regular sex without contraception. It affects about 1 in 6 people worldwide at some point, it can involve either or both partners, and it is a medical condition, not anyone's fault.
Reviewed 16 Oct 20265 min read
Understanding your cycle and fertile window
Pregnancy is possible on about six days of each cycle: the five days before ovulation and the day of ovulation itself. Sex every two to three days covers this window without needing exact timing, and ovulation kits and apps can help but have limits.
Reviewed 16 Oct 20264 min read
Preparing for your first fertility appointment
A first fertility appointment is mostly a conversation about your health, cycles and how long you have been trying. Bringing period dates, previous reports and a list of medicines, and coming together as a couple where possible, helps the doctor plan the right next steps.
Reviewed 16 Oct 20264 min read
Common fertility myths, and what the evidence says
Many beliefs about fertility are passed on with good intentions but are not supported by evidence. Infertility is not only a woman's issue, relaxing is not a treatment, and both partners deserve a fair, simple check.
Reviewed 16 Oct 20265 min read
Choosing a fertility clinic in India: what to look for
A good fertility clinic is registered under the ART (Regulation) Act, 2021, has a qualified team, explains your plan clearly, gives itemised costs in writing and talks honestly about add-ons and uncertainty. Be cautious of guarantees and pressure to decide quickly.
Reviewed 16 Oct 20264 min read
Reading a semen analysis report
A semen analysis measures volume, sperm count, movement and shape. Results vary from one sample to the next, so one unusual result is rarely the whole story and is usually repeated before decisions are made.
Reviewed 16 Oct 20265 min read
What causes male infertility, and how is it checked?
Male fertility can be affected by how sperm are made, how they travel, ejaculation and erection, hormones, genes, infections and some medicines. Often no single cause is found. A semen analysis and a careful history are the usual starting point, with referral to a urologist or andrologist when needed.
Reviewed 16 Oct 20265 min read
Male fertility and lifestyle: what the evidence says
Smoking, heavy drinking, a high body weight, heat, anabolic steroids, recreational drugs and some workplace exposures can all affect sperm. Because sperm take about two to three months to develop, changes take time to show. Evidence for fertility supplements is limited.
Reviewed 16 Oct 20265 min read
Talking to your partner about a semen test
A semen analysis is a simple, private test and a normal part of checking a couple, not a test of manhood. Bringing it up gently, explaining why both partners are tested from the start, and knowing what the test involves can make the conversation easier for both of you.
Reviewed 16 Oct 20265 min read
Hormone blood tests for fertility: what each one shows
Hormone blood tests can show whether ovulation is happening and whether another hormone, such as thyroid or prolactin, may be getting in the way. Several of them depend on the day of your cycle, and each lab has its own normal range, so results need to be read in context.
Reviewed 16 Oct 20265 min read
Pelvic ultrasound and antral follicle count, explained
A transvaginal ultrasound gives a close view of the uterus and ovaries, and can show fibroids, polyps and cysts. Early in the cycle it can also count small follicles, the antral follicle count, which is a rough guide to egg reserve but says nothing about egg quality.
Reviewed 16 Oct 20264 min read
How to tell if you are ovulating
Regular periods are a good first sign that ovulation is happening. Doctors can confirm it with a mid-luteal progesterone blood test or follicle-tracking scans. Home ovulation kits can help with timing, but you do not need them, and temperature charts are not reliable for confirming ovulation.
Reviewed 16 Oct 20265 min read
IUI and IVF, step by step
IUI places prepared sperm in the uterus around ovulation; IVF collects eggs, fertilises them in a laboratory and transfers an embryo. They suit different situations, and in India both must be carried out at a clinic registered under the ART Act, 2021.
Reviewed 16 Oct 20265 min read
AMH: what it does and doesn't tell you
AMH is a blood test that gives a rough idea of how many eggs remain in the ovaries. It helps doctors plan treatment, but it does not measure egg quality and is not a prediction of whether you can conceive naturally.
Reviewed 16 Oct 20264 min read
The HSG test: what it checks and what to expect
An HSG is an X-ray test that checks whether the fallopian tubes are open and shows the shape of the inside of the uterus. It takes a few minutes and often causes period-like cramps. It is done after a period and before ovulation, with steps to lower the small risk of infection.
Reviewed 16 Oct 20264 min read
Ovulation induction: medicines to help you ovulate
Ovulation induction uses tablets such as letrozole or clomifene, or hormone injections, to help the ovaries release an egg. It is often a first treatment for people who do not ovulate regularly, such as many with PCOS, and it needs monitoring because of the risk of multiple pregnancy.
Reviewed 16 Oct 20264 min read
Frozen embryo transfer: what happens and why
In a frozen embryo transfer, an embryo frozen during an earlier IVF cycle is thawed and placed in the uterus. The lining of the uterus is prepared either with your natural cycle or with hormone medicines, and freezing and storage need your written consent.
Reviewed 16 Oct 20264 min read
IVF risks, including OHSS: what to know
Most IVF cycles go without serious problems, but there are real risks. The main ones are ovarian hyperstimulation syndrome (OHSS), multiple pregnancy, complications of egg collection, and ectopic pregnancy. Knowing the warning signs helps you get help early.
Reviewed 16 Oct 20264 min read
IVF add-ons: what the evidence says
Add-ons are optional extras offered alongside IVF, often at extra cost. Expert reviews, including ESHRE in 2023, found that for most add-ons there is not enough good evidence that they improve the chance of having a baby. It is reasonable to ask for the evidence before agreeing to any.
Reviewed 16 Oct 20264 min read
When an IVF cycle doesn't work: next steps
A cycle that doesn't lead to a pregnancy is painful, and grief is a normal response. When you feel ready, a review with your doctor can look at what happened in the cycle and whether anything should change. Second opinions are reasonable.
Reviewed 16 Oct 20264 min read
PCOS and fertility: what's known, and what isn't
PCOS often makes ovulation irregular, which is the main reason it can affect fertility. Many people with PCOS conceive, some without treatment and others with simple first steps. Both partners should still be checked.
Reviewed 16 Oct 20265 min read
Handling family pressure and questions about having a baby
Questions like "Any good news?" and advice from relatives can be hard to hear when you are trying to conceive. You decide what to share and with whom. A few ready answers, clear boundaries and a united front as a couple can make family time easier.
Reviewed 16 Oct 20264 min read
Getting through the two-week wait
The days between ovulation, IUI or embryo transfer and a pregnancy test are often the hardest part of trying. Testing early can mislead, and early symptoms are not a reliable sign either way. Planning how you will spend the wait, and knowing when to call your clinic, can make it easier.
Reviewed 16 Oct 20265 min read
Grief after a pregnancy loss
Losing a pregnancy, at any stage, can bring deep grief, and both partners can feel it. Most early losses are not caused by anything either of you did. Recovery takes time, physically and emotionally, and support is available.
Reviewed 16 Oct 20264 min read
Supporting your partner through fertility treatment
When your partner is the one having most of the tests and procedures, it can be hard to know how to help. Listening, sharing the practical load and coming to appointments matter a lot. Your own feelings matter too.
Reviewed 16 Oct 20264 min read
Deciding when to pause or stop fertility treatment
Taking a break from treatment, or deciding to stop, is a valid choice and one many people face. There is no right answer and no deadline. Reviewing your options with your doctor, and knowing the other paths to a family or a full life, can help you decide.
Reviewed 16 Oct 20264 min read
Unexplained infertility: when the tests are normal
Unexplained infertility means the standard tests for both partners are normal but a pregnancy hasn't happened yet. It is common and frustrating. Options range from continuing to try to IUI or IVF, and the choice depends mostly on your age and how long you have been trying.
Reviewed 16 Oct 20264 min read
Are we worrying too early? When to see a fertility doctor
Many people conceive within a year of trying, and taking longer is common. Doctors usually suggest an evaluation after 12 months of trying, or after about 6 months from the mid-30s. From 40, or if there is a known reason to look, it makes sense to ask without waiting.
Reviewed 16 Oct 20265 min read
Azoospermia: when no sperm are found in the sample
Azoospermia means no sperm were seen in a semen sample. It needs a repeat test to confirm, and then tests to find out whether sperm are being made but blocked, or not being made in normal numbers. Depending on the cause, options can include treatment, surgical sperm retrieval or donor sperm.
Reviewed 16 Oct 20265 min read
The first fertility tests, for each partner
A first fertility evaluation usually checks three things: whether ovulation is happening, whether the tubes and uterus look healthy, and the sperm. Each test answers a specific question, and none of them predicts whether you will conceive.
Reviewed 16 Oct 20265 min read
Is IVF painful? What each step can feel like
Most of IVF involves discomfort rather than severe pain, and egg collection is done under sedation. People experience it differently, so it helps to know what is common at each stage and which symptoms need a doctor straight away.
Reviewed 16 Oct 20264 min read
Looking after yourself while trying to conceive
Trying to conceive can be stressful, and it can strain relationships and work. Those feelings are common and valid. Small habits, honest conversations and the right support can make the process easier to carry.
Reviewed 16 Oct 20265 min read
Endometriosis and fertility: what it means for trying to conceive
Endometriosis is a common condition where tissue similar to the lining of the uterus grows elsewhere in the pelvis. It can make conceiving harder for some people, but many with endometriosis conceive. Treatment is decided case by case, and pain deserves care in its own right.
Reviewed 16 Oct 20264 min read
Planning for the costs of fertility treatment
Fertility treatment costs are made up of many parts, from consultations and tests to medicines, procedures, laboratory work and embryo storage. Asking for an itemised written quote, and checking what is and isn't included, helps you plan and compare.
Reviewed 16 Oct 20265 min read
Medically reviewed
Every guide is reviewed by Dr Shesha Sinha and shows its review date.
Sourced
Numbered references to guidelines and published research, at the end of every guide.
General information
Guides explain; they can't account for your history. Medical disclaimer