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Everything you need to know about In Vitro Fertilisation — from your first consultation to your positive pregnancy test — explained clearly by Dr. Devikarani V.
When both tubes are blocked or severely damaged, natural conception is impossible. IVF bypasses the tubes entirely by fertilising the egg in the lab.
Very low sperm count, poor motility, or abnormal morphology makes natural fertilisation unlikely. IVF with ICSI (injecting one sperm into one egg) can overcome this.
Women with PCOS who have not conceived after ovulation induction and IUI cycles may benefit from IVF to achieve a pregnancy.
Severe endometriosis that damages the ovaries or tubes, or reduces egg quality, can significantly impair fertility. IVF is often the most effective solution.
When all standard investigations are normal yet pregnancy has not occurred after 2–3 years, IVF is recommended to improve the chances of conception.
Women with low AMH or advanced maternal age benefit from IVF's controlled stimulation, which maximises the number of eggs retrieved in one cycle.
Couples with repeated miscarriages may opt for IVF with Preimplantation Genetic Testing (PGT) to select chromosomally normal embryos before transfer.
If 3–4 IUI cycles have not resulted in pregnancy, IVF is the natural next step — offering significantly higher success rates through direct egg–sperm fertilisation.
Couples who carry genetic disorders can use IVF with PGT-M (Preimplantation Genetic Testing for Monogenic disorders) to select unaffected embryos for transfer.
Each IVF cycle is unique, but the core steps are consistent. Here is a detailed walkthrough of every stage — from your very first consultation to your pregnancy test result.
Your IVF journey begins with a thorough consultation with Dr. Devikarani V. This is one of the most important appointments — we take the time to understand your complete medical history, previous treatments, and personal goals before forming any treatment plan.
In a natural cycle, the body develops just one egg per month. In IVF, we use hormonal injections to stimulate the ovaries to produce multiple eggs simultaneously — increasing the number of embryos available and improving the chances of a successful pregnancy.
The stimulation injections (gonadotropins — FSH and/or LH) are given daily under the skin, usually in the abdomen or thigh. Most women self-administer these injections at home after a simple demonstration from our nursing team.
Throughout the stimulation phase, you will visit Vivaa Hospitals every 2–3 days for monitoring. These visits are essential to assess how your ovaries are responding to the medication and to make timely adjustments to the dose.
When monitoring confirms your follicles are mature (typically 18–20mm in diameter), a "trigger" injection of hCG (human Chorionic Gonadotropin) or a GnRH agonist is administered. This injection mimics the natural LH surge that causes the final maturation of the eggs and prepares them for retrieval.
Egg retrieval is a minor surgical procedure performed under intravenous sedation — you will be comfortably asleep and will not feel any pain during the procedure. It takes approximately 20–30 minutes and is performed in our advanced operation theatre.
Using a thin needle guided by transvaginal ultrasound, the doctor gently aspirates fluid from each follicle. This fluid is immediately passed to our embryologist, who identifies and isolates the eggs.
On the same day as egg retrieval, the male partner produces a semen sample by masturbation in a private collection room. If the male partner is unable to produce a sample or has azoospermia (no sperm in semen), surgically retrieved sperm (TESA/PESA) from a previous procedure can be used.
The semen sample undergoes a specialised laboratory preparation called "sperm washing" — which separates the healthiest, most motile sperm from the semen. These prepared sperm are then used for fertilisation.
After egg retrieval and sperm preparation, fertilisation takes place in our embryology laboratory. There are two methods of fertilisation used in IVF:
Conventional IVF: A large number of prepared sperm are placed in a dish with each egg and left overnight. The healthiest sperm naturally penetrates the egg.
ICSI (Intracytoplasmic Sperm Injection): A single selected sperm is directly injected into each mature egg using a micromanipulation needle under a high-powered microscope. ICSI is recommended when sperm quality is poor, when previous IVF fertilisation has failed, or when there are few eggs available.
After fertilisation, the embryos are placed in a special incubator that maintains ideal conditions of temperature, humidity, and gas concentration — mimicking the environment of the fallopian tube. The embryologist monitors their development daily.
Embryos are graded at key developmental stages:
The embryo transfer is one of the simplest yet most emotionally significant steps in the IVF journey. The best-quality embryo (or embryos) is loaded into a thin, soft catheter and gently placed into the uterine cavity under ultrasound guidance. The procedure takes just 10–15 minutes and is usually painless — no anaesthesia is required.
After embryo transfer, the next 14 days are known as the "Two-Week Wait" — the time for the embryo to implant in the uterine lining and for hCG hormone levels to rise to detectable levels. This waiting period is emotionally challenging for most couples.
On Day 14 after embryo transfer, a blood beta-hCG test is done to confirm whether a pregnancy has occurred. A blood test is far more accurate than a urine home test at this early stage.
If the result is positive: Congratulations — an early pregnancy has been established. A viability scan is scheduled 2 weeks later (at approximately 6–7 weeks gestation) to confirm a heartbeat and the number of embryos implanted. Progesterone and other support medications are continued through the first trimester.
If the result is negative: We understand this is deeply painful. Your medications will be stopped, and your period will usually return within a week. A follow-up consultation will be scheduled to review the cycle, understand what happened, and plan the next steps — whether a frozen embryo transfer or a new stimulation cycle.
Both IVF and IUI are effective fertility treatments — the right choice depends on your diagnosis, medical history, and how long you've been trying.
| Feature | IUI | IVF |
|---|---|---|
| How it works | Sperm placed directly in uterus; fertilisation occurs naturally inside the body | Eggs retrieved from ovaries; fertilised outside the body in the lab |
| Invasiveness | Non-invasive; similar to a smear test | Minor surgical procedure (egg retrieval under sedation) |
| Success Rate (per cycle) | 10–20% per cycle | 50–70% per cycle (age-dependent) |
| Stimulation Injections | Mild — 3–5 days (or tablets only) | Intensive — 8–14 days of daily injections |
| Suitable for blocked tubes | ✗ Not suitable | ✓ Ideal — bypasses tubes |
| Suitable for severe male factor | ✗ Not suitable | ✓ With ICSI — highly effective |
| Cost (approximate) | ₹10,000 – ₹30,000 per cycle | ₹1.2 – ₹2.5 lakh per cycle |
| Embryo freezing possible | ✗ No | ✓ Yes — frozen embryo transfer option |
| Genetic testing of embryos (PGT) | ✗ Not possible | ✓ Possible — helps select healthy embryos |
| Recommended when | Mild infertility, open tubes, normal sperm, early treatment | Blocked tubes, severe male factor, failed IUI, poor ovarian reserve, older age |
The single most important factor. Success rates are highest under 35 and decline progressively after 37. Age affects egg quantity and quality significantly.
A good AMH level and high antral follicle count predict better ovarian response and more eggs — giving more embryos to choose from.
Good sperm count, motility, and morphology ensure higher fertilisation rates. Sperm DNA fragmentation also plays an important role in embryo quality.
A healthy uterine lining (endometrium) of 8–12mm at transfer, free from polyps, fibroids, or adhesions, is essential for successful implantation.
Grade A blastocysts (Day 5 embryos) have significantly higher implantation rates. Our expert embryology lab focuses on optimal culture conditions.
Maintaining a healthy weight, eating a balanced diet rich in antioxidants, avoiding smoking and alcohol, and managing stress all positively impact IVF outcomes.
The experience of the treating doctor, the quality of the embryology laboratory, and the protocols used all have a direct bearing on success rates.
Taking all prescribed medications on time — especially progesterone support after transfer — is critical. Missing doses can jeopardise implantation.
Have more questions? Our comprehensive FAQ page covers 42 questions across all fertility topics.
Visit Full FAQ PageEvery journey to parenthood is unique. Dr. Devikarani will evaluate your individual case and guide you through the most appropriate treatment — with complete honesty, compassion, and expertise.
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