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Doctors generally suggest a fertility check-up if you have been trying for a year without success, or after six months if the woman is 35 or older. You do not have to wait that long if there is an obvious reason, such as very irregular periods, known endometriosis, previous tubal surgery or a known sperm problem.

In IVF, hormone injections help the ovaries produce several eggs, which are collected in a short procedure under sedation. The eggs are fertilised in the lab, the embryos grow for three to five days, and usually one embryo is placed in the uterus. A pregnancy test follows about two weeks later. Extra good-quality embryos can be frozen for later use.

ICSI (intracytoplasmic sperm injection) is done as part of an IVF cycle. Instead of mixing eggs and sperm in a dish, the embryologist injects a single sperm into each mature egg. It is the usual choice when the sperm count or movement is low, or when sperm has to be retrieved surgically.

IUI is a simpler first-line treatment. The woman may take tablets or low-dose injections to help ovulation, and on the right day, washed and concentrated sperm is placed inside the uterus with a thin tube. It takes a few minutes and needs no anaesthesia.

In a frozen embryo transfer, an embryo saved from an earlier IVF cycle is thawed and placed in the uterus, without another round of egg collection. The uterine lining is prepared with tablets or in a natural cycle and monitored with scans before the transfer.

AMH (anti-Müllerian hormone) is a blood test that gives an idea of how many eggs are left in the ovaries. A low AMH means fewer eggs are likely to be collected in IVF. It does not measure egg quality, and it does not mean natural pregnancy is impossible.

PCOS (polycystic ovary syndrome) is one of the most common reasons for irregular periods and difficulty conceiving, because ovulation does not happen regularly. Many women with PCOS conceive with ovulation tablets such as letrozole, lifestyle changes and timed intercourse or IUI, without needing IVF.

A male factor is involved in a large share of couples who struggle to conceive, so a semen analysis should be one of the first tests, not the last. The report looks at volume, sperm count, movement (motility) and shape (morphology). One abnormal result is usually repeated before drawing conclusions.

A failed IVF cycle is hard, emotionally and financially. Before trying again, it helps to understand what happened: how many eggs were collected, how many fertilised, how the embryos developed and how the transfer went. A second opinion can point to changes that are worth making, and those that are not.

Egg freezing lets a woman store eggs at a younger age for use later. It works best before 35. Donor eggs are an option when a woman’s own eggs are unlikely to result in a pregnancy. In India, egg donation is regulated under the ART (Regulation) Act, 2021 and must go through a registered ART bank and clinic.