When a couple is diagnosed with infertility, they see IVF as their only ray of hope. There are multiple stages at which couples have the question, “When to do IVF?” But it’s very important to understand that not every infertile couple needs an IVF.

In fact, 60% of couples can conceive naturally with just minor treatments. It’s obvious to feel distracted and stressed when diagnosed with infertility. Couples often start taking advice from the people around them. The worst part is that such couples consider themselves a patient. We would like to make it clear that infertility is not a disease. You are a fit and healthy human being, and just one of your systems is a bit weakened. It does not have any bad effect on your body. So you have to keep up the positive attitude. You can surely conceive with the help of technology and medical science.

Now, let’s understand what the prerequisites to conceiving a baby are.

Prerequisites to conceive

• Healthy Uterus: The uterus is where the baby will grow. So having a healthy uterus with a good inner lining and blood flow is important. It’s also important to remember that 1 out of 5,000 girls is born without a uterus. They do not have a uterus at birth, and this condition is known as Mullerian agenesis.
• Good quality sperm and egg: Quality sperm and egg are vital for conceiving a baby. Good quality sperm means sperm that has good count, motility, morphology and normal DNA fragmentation. Similarly, a healthy egg that ovulates between the period cycle is also required. Women with irregular periods believe their eggs are of not good quality. This is an absolutely wrong belief. Irregular periods do not indicate the bad quality of the egg. Instead, irregular periods indicate that there is some obstruction in the ovulation of the egg.
• Healthy and functional Fallopian tube: Once the egg is ready in the ovary, it has to travel to the uterus. For this, it requires a healthy and functional fallopian tube. These fallopian tubes act as a bridge between the ovaries and the uterus. So the fallopian tubes should be open and must be in working condition.But to ensure all the above factors are normal, we have to perform some blood tests, sperm count and ovulation time, and examine the uterus’s inner lining. An X-ray test is also required to check the internal structure of the fallopian tube.

Results of the tests

These tests have two outcomes:

1. All the reports are normal
2. There is some issue in one or more reports

Depending on the issue, we start the treatment. If there is an issue with the formation of the egg, we give injections for ovulation which can help the woman conceive.

Similarly, if there is an issue with the uterus, like the presence of the polyp, the septum or fibroid, their removal can help the woman conceive.

If there is a problem with the fallopian tube, like the blocked tube, we try to open it via an endoscopy. Once the tubes open, the woman can conceive naturally.

When there is an issue with the sperm, i.e. poor motility or low sperm count, we prescribe some medications to correct the issue. But remember, no medicine can guarantee an increase in motility and sperm count.

So, infertile couples should not waste their time. When you cannot conceive, you should immediately contact the IVF specialist. This will minimize the wastage of time, and you can conceive a baby rather quickly.

When you reach out to an IVF consultant, it’s not necessary that the doctor will suggest the IVF procedure mandatorily. The doctor will perform multiple tests and will try to address all the issues with the necessary treatments. As we mentioned earlier, 60% of couples will be able to conceive naturally. Doctors will perform your follicular study, will determine your ovulation time and will recommend you do timed intercourse. In some cases, the doctor might recommend an IUI procedure. IUI is a procedure in which the doctor collects the sperm, washes them and inserts them into the woman’s uterus. Similarly, they might recommend a Laparoscopy if there is an issue with the fallopian tube. And if there is an issue with the sperm, lifestyle modifications are suggested along with some medicines.

When is the IVF procedure recommended?

When all the above-mentioned steps fail, then a doctor might recommend you get an IVF procedure. If your sperm count is very low, your IUI is failing again and again, motility is low, or the morphology of the sperm is poor, then IVF might be recommended.

Moreover, if the male partner has Azoospermia (nil sperm count), then we can perform an AESA procedure to extract the sperm and perform IVF or ICSI with the collected sperm.

Sometimes, everything is alright, but the female partner has PCOS. In almost 60% of cases, PCOS can be fixed with medications and lifestyle changes. But in some cases, injections become necessary for the formation of the eggs. In this case, too, a couple needs an IVF procedure.

IVF is also recommended if the couples are above 35 and their low AMH levels. In such cases, IVF is recommended because couples have very limited time to conceive.

If any partners have cancer and are planning to undergo radiation therapy, we recommend preserving their eggs or sperm. We later use them to help these individuals conceive a baby via IVF.

There are a few cases where either the uterus is not present, or if it’s present, it’s being damaged severely due to infections like TB or Asherman’s syndrome. In such cases, the couple might have to take the help of surrogacy. Even in this case, conceiving one’s own genetic baby is possible with the help of IVF.

Consulting IVF specialists at the right time

The very first thing that infertile couples need to understand is that their inability to conceive naturally is not their fault. It’s not a disease. Technological advancements will ensure you can conceive your own genetic child with multiple procedures.

In some cases, it happens that the couples wait far too long before reaching out to the IVF specialists. This delay can be very dangerous because, in many cases, the time to conceive, even with IVF, has passed. Either there are no more eggs left in the female, or the sperm of the male is damaged severely. So it’s very important to consult an IVF specialist at the right time.

Wrapping up

It’s very important to understand for infertile couples that the more time you waste consulting an IVF specialist, the more will be a generation gap between you and your child.

We hope this comprehensive guide has cleared all your doubts about when to do an IVF procedure. Remember, the quicker decisions you make, the better your chances of conceiving a baby through IVF. Still, if you have some doubts or questions, you can feel free to ask us. Our experts will definitely get back to you.

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• About Author

  Dr. Supriya Puranik

  Gynaecologist & IVF Specialist

Often known as the last glimmer of hope for people who have lost all hope for conceiving a child, Dr. Supriya Puranik is a leading gynaecologist, high risk obstetrician and Head of IVF & Gynaecology department at Ankura Hospital for Women & Children.