Most infertility results from physical problem in either man or woman`s reproductive system. Some causes includes

1. Problems with man`s reproductive system.
2. Problem with woman`s fallopian tubes.
3. Problem with woman`s uterus and / or cervix.
4. Problems with woman`s ovulation.
5. Unknown reason.

Conception occurs when the male's sperm meet the woman's egg and successfully penetrates it. This typically takes place in one of the woman's fallopian tube and the fertilized egg then travels to the uterus and implants in the uterine lining. For pregnancy to take place, fertilization of the egg must be followed by a successful impanation. Only one egg is released for fertilization in each menstrual cycle. If this egg is not fertilized, conception will not be possible again until the next cycle.

Most infertility problems are not hereditary. If your grand mother, mother or sister conceives late or had difficult in conceiving, it is not a rule that you will not conceive.

Improvements in medication, surgery and ART make pregnancy possible for a majority of the couples pursuing treatments. Success rates have drastically improved for couples taking treatment under ART.

No, many couples are successful in their attempts to conceive using simple and “low-tech” procedure. ~10-20% couples seeking infertility treatment will undergo ART procedure. All ART procedures are established medical treatment .

All available data indicates that frozen semen does not increase the risk of birth defects. In fact, the freezing process tends to kill off weaker sperm, and may thus lead to survival of best sperm.

Single women, couple with male partner has no sperm or very poor semen analysis and cannot afford expensive treatment like ICSI, donor IUI is an option. Some time, it is also used when there is an inheritable genetic problem which could be transferred from the male.

1. Spermatogenesis or sperm production cycle takes about 3 months time. Sperm quality on the egg retrieval day is often related to what happened in the male's body 3 months ago. Listed below is guide lines to help ensure that semen specimen on oocyte pickup day is of best possible quality.
2. A fever more than 101°C within 3 months prior to ART treatment may adversely affect sperm quality, sperm count and motility may appear normal, but fertilization may not occur. Body temperature should be maintained below 100o C with medicine during or before ART cycle.
3. Keep the use of alcohol or cigarettes to a minimum before and during ART cycle. Do not use any 'recreational' drugs.
4. Any other medicine use should be brought into notice of fertility specialist doctor.
5. Avoid hot tubs, spas, jacuzzis, or saunas during 3 months prior to ART cycle.
6. Avoid heavy exercise, physical activity at a moderate level is acceptable and encouraged.
7. Refrain from ejaculation for 2-3 days, but not more than 5 days prior to semen collection on oocyte pick up day.

Following are the indication for egg donation

1. Poor egg quality
2. Premature ovarian failure
3. Age
4. Previous multiple IVF failure
5. Genetic cause

In this procedure eggs are retrieved from recipients either known or unknown donor, fertilized with husband's sperm and resultant embryos are transferred to recipient's uterus. Success rates are extremely high with this process.

A single healthy pregnancy is the goal of any fertility clinic. The multiple birth rate is depend on age, uterine condition, embryo implanted and quality of embryos. Generally 30% is twin pregnancy rate and 3% higher order birth rate.

1. Age more than 40 years
2. High level of FSH hormone
3. No ovaries
4. Premature ovarian failure
5. previous IVF failure
6. Benign or malign formation on ovaries [increased level of oncomarker Ca-125]
7. Genetic disease

Pre cycle tests are some of blood test, and scanning which can be done with minimal discomfort. Injections are administered subcutaneous with a short needle and discomfort should be tolerable. Only progesterone injection given intra muscularly. The main procedure involved in IVF is the egg retrieval, it is done under anesthesia to avoid pain The embryo transfer procedure is again a very simple one. Anaesthesia is generally not required for this procedure

Uterine polyps are benign [99%] out growths of the endometrial lining. The polyp acting as a ''foreign body'' in the cavity may cause chronic irritation and interfere with embryo implantation . Hysteroscopic polyectomy [removal of poly p] improves pregnancy outcome in infertile women and should be considered prior to IVF.

Polycystic ovarian syndrome is a problem caused by abnormal levels of certain hormones in woman's body. In PCOS, ovaries are larger than normal and there are series of underdeveloped follicles that appear in clumps. These cysts cause a hormonal imbalance, and a pattern of symptoms may develop, which is called syndrome. PCOS is the name given to a metabolic condition in which a woman will have symptoms that reflect imbalances in reproductive and other hormones.

Endometriosis is a condition where cells, that usually remain confined to the cavity of the uterus, grow outside of the uterus, usually on or in the ovaries and also on the surface of the pelvic organs. It also decreases the chances of natural conception. Patients having endometriosis require IVF as treatment option for conception.

Fibroids are benign tumors consisting of fibrous tissue and muscle which grow in the uterus. The significance of fibroids relates, to not only their size but also their location. Even small fibroids located inside the cavity of the uterus, where embryos need to implant, may interface with success and need to be removed. Fibroids that do not encroach on the cavity of the uterus are generally not significant unless, they are larger than 5 cm in diameter and also if there are many fibroids causing significant uterine enlargement.