Frequently Asked Questions:

Q. My periods are irregular & come once in 2 months. Could this be a reason for my infertility ?

As long as the periods are regular, this means ovulation is occurring. Some normal women have menstrual cycle lengths of as long as 40 days. Of course, since they have fewer cycles every year, the number of times they are "fertile" in a year is decreased. Also, they need to monitor their fertile period more closely, since this is delayed (as compared to women with a 30 day cycle).

Q. How successful is infertility treatment ?

When talking of success rates for any type of infertility treatment, one should bear in mind that the average chance to conceive for a normally fertile couple having regular unprotected intercourse is around 25% during each menstrual cycle. It is estimated that 10% of normally fertile couples fail to conceive within their first year of attempt and 5% after two years. Comparable to normal fertility rates, effective treatments can be expected to have, on average, up to a 25% success rate per cycle of treatment, and may therefore need to be repeated several times before a pregnancy is achieved. Simple ovulation induction to compensate for hormonal imbalances has a very high success rate; more than 80% of women suffering from such disorders are likely to conceive after several cycles of treatment with drugs such as clomiphene citrate or gonadotrophins.  

Q. My husband's blood group is B positive and I am A negative. Could this blood group "incompatibility" be a reason for our infertility ?

There is no relation between blood groups and fertility.  

Q. After having sex, most of the semen leaks out of my vagina. How can we prevent this ? Should we change our sexual technique ? Could this be a reason for our infertility ?

Loss of seminal fluid after intercourse is perfectly normal, and most women notice some discharge immediately after sex. Many infertile couples imagine that this is the cause of their problem. If your husband ejaculates inside you, then you can be sure that no matter how much semen leaks out afterwards, enough sperm will reach the cervical mucus. This leakage of semen ( which is called effluvium seminis) is not a cause of infertility. In fact, this leakage is a good sign - it means your husband is depositing his semen normally in your vagina ! Of course, you cannot see what goes in - you can only see what leaks out - but the fact that some is leaking out means enough is going in !

Q. Are there particular health risks for women undergoing infertility treatment ?

Along with their intended benefits, drugs used to treat infertility may on occasion cause side effects. In ovulation induction, close monitoring of follicular growth is crucial to ensuring successful treatment. Monitoring techniques (such as ultrasound scan and blood tests) and adequate use of treatment protocols help the physician to avoid ovarian hyperstimulation syndrome (OHSS) and minimize the risk of multiple pregnancy. Current treatment protocols have been designed to reduce the risk of multiple births and OHSS.

Q. My husband refuses to get his semen tested. He says the fact that it is thick and voluminous means it must be normal !

: Semen consists mainly of seminal fluid, secreted by the seminal vesicles and the prostate. The volume and consistency of the semen is not related to its fertility potential, which depends upon the sperm count. This can only be assessed by microscopic examination.

Q. Local side effects  (OHSS-Multiple Birth)

Common local side effects experienced by patients who receive gonadotrophins by intramuscular injection include skin redness, swelling and bruising. Pain and discomfort sometimes reported after intramuscular injections are now likely to be lessened with the availability of gonadotrophins produced by recombinant DNA - or genetic engineering - techniques which are administered by subcutaneous injection.

26. Can ovulation induction increase the risk of ovarian cancer ?

Ovarian cancer is a rare disease; the chance of a young woman developing an ovarian malignancy during her lifetime is lower than 1.5%. A number of factors have been found to increase the risk of ovarian cancer, including genetic predisposition and dietary habits. Scientific studies carried out in the last few decades have demonstrated that infertility itself is a risk factor for ovarian cancer. There is evidence that each pregnancy reduces the risk of a woman contracting ovarian cancer (this risk could be reduced by more than 25% by a first pregnancy). No epidemiological study has ever established a causal link between ovulation promoting drugs and ovarian cancer. An extensive study on this issue, reporting on more than 2,600 women treated between 1964 and 1974 and followed for an average of twelve years, found no association between ovulation inducing drugs and ovarian cancer.

Q. What about the health risks for children born following infertility treatment ?

Regarding children born following treatment with ovulation promoting drugs, the incidence of birth defects has never been found to be higher than that in the normal population.

Q. My mother feels I am too tense, and that if I just relax, I'll get pregnant.

Yes. But to a certain extent only we have seen in our IVF patients that the ones who are mentally relaxed, who do yoga etc. conceive faster but sitting ideally at home & relaxing wouldn’t solve any problem.

Q. PCOS Polycystic ovary syndrome or PCOS, is an ovulation disorder which affects 4-6% of all women. Several factors contribute to the disease. At this moment researchers think that the cause of the disease is genetic. The major features of this syndrome are irregular or no menstruation, hirsutism and acne due to high levels of male hormones, obesity (40-50%), high insulin levels with risk for developing diabetes and large polycystic ovaries shown on ultrasound. Women with PCOS usually present at fertility clinics for counseling. To increase fecundity the treatment possibilities are mostly focussed on regulation of the menstrual cycle. For this, several drugs are used (clomiphene citrate, bromocriptine, gonadotrophins) and weight loss is strongly advised. In many cases the cycle will be ovulatory and regulated by these treatments. Furthermore at this moment it is being investigated whether electrocoagulation of the large ovaries can give (long-term) regulation of the cycles.


Q. I have no problems having sex. Since I am virile, my sperm count must be normal.

There is no correlation between male fertility and virility. Men with totally normal sexdrives may have no sperms at all.

Q. I don't think infertility treatment should not be offered in India, because there are too many babies in this country already. Why should we exacerbate the population problem by producing more? In any case, IVF treatment is too expensive for India to be able to afford.

The right to have children is a fundamental right of every human being and a very basic biological urge. Just because a neighbour has too many children should not deprive the infertile couple of their right to have their own. IVF and related technologies are undoubtedly expensive, but, then, so is heart surgery. Yet, no one objects when over Rs 1 lakh are spent to try to salvage the heart of a 70 year old man (whose life expectancy in any case is only about 5 years and is not extended by the surgery). Why then should medical technology not be used to help couples in their thirties (with their whole lives ahead of them) have their own baby? In fact, IVF is a much more cost-effective use of medical resources than a number of other accepted surgical procedures (such as joint replacement surgery or kidney transplants).  

Q. My semen analysis report shows I have no sperm in the semen ( azoospermia ). Is this because I used to masturbate excessively as a boy ?

Masturbation is a normal activity which most boys and men indulge in. It does not affect the sperm count. You cannot "run" out of sperms, because these are constantly being produced in the testes.

Q My wife is frigid and does not enjoy having sex. Could this be the reason for her infertility ?

There is no connection between sexual pleasure and fertility. Don't forget that even a woman who gets raped can get pregnant ! And don't forget that the commonest reason women do not enjoy sex is because their husbands are unskilled lovers ! Maybe you should improve your sexual technique, and spend more time in foreplay and in pleasuring your wife !

Q. What is endometriosis?

Tissue hitologically identical to endometrium (the inner lining of the uterine wall) outside the uterine cavity. Usually, endometriosis is confined to the pelvic and lower abdominal cavity; however, it has occasionally been reported to be in other areas, as well. Endometriosis is one of the most common problems that gynaecologists currently face. It is one of the most complex and least understood diseases in our field and, despite many theories, we still do not have a clear understanding of the cause or of its relationship to infertility. Since this disorder is primarily a human disease and rare in other animal species, accumulation of the facts has been slow. Although endometriosis has been considered a pathological or separate disease entity, it may not be a disease at all. It may actually be the clinical manifestation of a more basic underlying disorder, such as a basic chemical or physiological abnormality that affects the tubal motility or immune system which could be responsible for the initiation or progression of endometriosis in patients with retrograde menstrual flow. By the same token, endometriosis may not be the cause of infertility, but the result of it. Further technological developments may be necessary in order for us to fully understand this problem.