The desire to start a family is among the most profound of human experiences. Yet for an estimated one in six couples globally, the journey to parenthood is marked not by joy alone, but by quiet heartbreak and unanswered questions. At Genova Clinic in Malviya Nagar, South Delhi, every couple that walks through the door carries a story — and that story is heard fully before a single test is ordered.
This guide answers the questions most commonly asked by patients, demystifies a deeply personal subject, and maps the path ahead clearly.
What Causes Female Infertility?
Female infertility accounts for approximately 40% of all infertility cases. Understanding the cause is the essential first step — because treatment follows diagnosis, not assumption.
1. Ovulation Disorders (PCOS)
Polycystic Ovary Syndrome (PCOS) is responsible for the majority of ovulation-related infertility, affecting an estimated 15–20% of Indian women of reproductive age. When eggs are not released regularly, conception becomes impossible without intervention. (FOGSI Consensus on PCOS, 2022)
2. Blocked or Damaged Fallopian Tubes
Scarring from previous pelvic infections, endometriosis, or prior surgery can block the fallopian tubes, preventing egg and sperm from meeting. A hysterosalpingogram (HSG) is used to evaluate tube patency and is routinely offered at Genova Clinic. (Cleveland Clinic, Fallopian Tube Disorders, 2023)
3. Endometriosis
Tissue similar to the uterine lining growing outside the uterus affects an estimated 10% of women of reproductive age globally and is a significant, often under-diagnosed cause of infertility. Pain during periods or intercourse may indicate its presence. (Johns Hopkins Medicine, 2024)
4. Uterine Abnormalities
Fibroids that distort the uterine cavity, polyps, congenital malformations, or scar tissue from prior procedures (Asherman's syndrome) can all interfere with implantation and must be evaluated in a thorough fertility workup.
5. Age-Related Decline in Egg Quality
Both the quantity and quality of eggs decline with age — a process that accelerates meaningfully after 35. The AMH (Anti-Müllerian Hormone) test and antral follicle count on ultrasound are used to assess ovarian reserve at Genova Clinic. (Mayo Clinic, Female Infertility, 2024)
6. Thyroid and Hormonal Imbalances
Hypothyroidism, hyperthyroidism, elevated prolactin levels, and insulin resistance are all screened as part of the standard fertility evaluation. These conditions are highly treatable when identified early.
Recognising the Symptoms of Infertility
Infertility rarely announces itself with dramatic symptoms. However, certain signs suggest that a fertility evaluation should be sought sooner rather than later:
- Irregular or absent periods — cycles shorter than 21 days or longer than 35 days may signal an ovulation disorder
- Painful periods — severe, worsening dysmenorrhoea may indicate endometriosis
- Abnormal bleeding — mid-cycle spotting or heavy periods may reflect uterine pathology
- Pain during intercourse — a potential marker of endometriosis or pelvic inflammatory disease
- Signs of hormonal imbalance — unexplained weight gain, acne, excessive hair growth, or hair loss may point to PCOS or thyroid dysfunction
- Recurrent miscarriage — two or more pregnancy losses warrant specialist evaluation
- History of pelvic infections — prior STIs or pelvic inflammatory disease increase the risk of tubal factor infertility
How Is Infertility Diagnosed?
A fertility evaluation is always a couple's evaluation — not only the woman's. At Genova Clinic, both partners are assessed from the outset.
For Women
- Day 2–3 hormone blood panel — FSH, LH, AMH, oestradiol, prolactin, TSH, fasting insulin
- Transvaginal ultrasound — assesses the uterus, ovaries, antral follicle count; detects PCOS, fibroids, or cysts
- HSG (hysterosalpingogram) — confirms tubes are open and the uterine cavity is normal
- Laparoscopy — where endometriosis or significant pelvic adhesions are suspected
For Men
- Semen analysis — evaluating count, motility, morphology, and volume
- Hormonal assessment — testosterone, FSH, LH where indicated
How to Conceive: Your Treatment Pathway
Treatment is always personalised to the diagnosis, the couple's age, their prior history, and their preferences. The steps below outline the most commonly followed approach — from simple to advanced.
Step 1 — Lifestyle Optimisation
A healthy BMI, a low-glycaemic-index diet rich in folate and antioxidants, quitting smoking, limiting alcohol, and moderate exercise have all been shown to meaningfully improve natural fertility. For women with PCOS, dietary changes alone can restore ovulation in many cases. (JAMA Internal Medicine, Lifestyle and Female Fertility, 2023)
Step 2 — Ovulation Induction
Oral medications — most commonly letrozole or clomiphene citrate — are prescribed to stimulate the ovaries to develop and release eggs. Ultrasound monitoring tracks follicle growth, allowing the timing of intercourse or insemination to be precisely guided. (Cleveland Clinic, Ovulation Induction, 2023)
Step 3 — Intrauterine Insemination (IUI)
A minimally invasive procedure in which prepared, concentrated sperm is placed directly into the uterus at ovulation. IUI is recommended for mild male-factor infertility, unexplained infertility, or after 3–6 cycles of ovulation induction without success. Success rates range from 10–20% per cycle. (FOGSI Assisted Reproduction Guidelines, 2022)
Step 4 — In Vitro Fertilisation (IVF)
The ovaries are stimulated to produce multiple eggs, which are retrieved under sedation and fertilised in a laboratory. The resulting embryos are transferred to the uterus after 3–5 days of culture. IVF is indicated when simpler treatments have not succeeded, when both tubes are blocked, in severe male-factor infertility, or when age or ovarian reserve demands a proactive approach. Success rates for women under 35 can reach 40–50% per cycle at experienced centres. (Johns Hopkins Medicine, IVF Overview, 2024)
10 Questions Patients Ask Most About Infertility
PCOS is the single most common cause, responsible for the majority of ovulation-related infertility in Indian women. Other major causes include blocked fallopian tubes (often from prior infections), endometriosis, uterine fibroids or polyps, and age-related decline in egg quality. A proper investigation identifies the cause in most cases — and most causes are treatable.
Under 35: 12 months of regular, unprotected intercourse. Age 35 or older: 6 months. If there is a known condition — PCOS, irregular periods, endometriosis, or prior pelvic infections — seek evaluation earlier. Earlier answers mean earlier treatment and better outcomes. (Mayo Clinic, Infertility, 2024)
Yes — absolutely. PCOS is the most common cause of anovulatory infertility, but it is also one of the most effectively treated. Lifestyle changes, ovulation induction medication, and careful monitoring are successful for the vast majority of women with PCOS. Many patients at Genova Clinic with PCOS have gone on to conceive with minimal intervention.
A detailed history, transvaginal ultrasound, and a hormonal blood panel (Day 2–3 FSH, LH, AMH, TSH, prolactin) form the core workup. A semen analysis for the male partner is requested at the same time. Depending on findings, an HSG (to check tube patency) may be arranged. Not all tests are needed for every patient — the workup is guided by the individual history.
IUI is a simple outpatient procedure taking under five minutes. A thin, soft catheter deposits prepared sperm directly into the uterus. Most patients experience only mild period-like cramping, if anything at all. No anaesthesia is required, and patients leave the clinic immediately afterwards. (Cleveland Clinic, IUI, 2023)
Stress alone is rarely a primary cause of infertility, but chronic severe stress can disrupt the hormonal signals that regulate ovulation. Stress management, mindfulness, and psychological support are valuable parts of holistic fertility care — they complement, but never replace, medical investigation.
A diet rich in whole grains, leafy vegetables, legumes, healthy fats (nuts, avocado, olive oil), and antioxidant-rich foods (berries, tomatoes) is associated with better fertility outcomes. Adequate folic acid (400 mcg daily) is recommended before and during early pregnancy. Processed foods, refined sugars, and trans fats worsen hormonal balance. (Harvard T.H. Chan School of Public Health, 2023)
Female fertility declines gradually from the early 30s, more steeply after 37, and significantly after 40. This reflects decreasing egg quantity and increasing chromosomal abnormalities in older eggs. Conception is not impossible after 35 — but prompt evaluation and proactive planning are particularly important. (Johns Hopkins Medicine, 2024)
It depends on their size and location. Most fibroids do not affect fertility. Submucosal fibroids (protruding into the uterine cavity) can impair implantation and increase miscarriage risk. When fibroids are found to be causative, surgical removal (myomectomy) is an effective option. (Mayo Clinic, Uterine Fibroids, 2024)
Basic fertility workup: ₹3,000–₹8,000. Ovulation induction cycle with monitoring: ₹5,000–₹15,000. IUI: ₹8,000–₹18,000 per cycle. IVF: ₹1.2–2 lakh per cycle. At Genova Clinic, pricing is fully transparent and discussed at the first consultation — there are no hidden costs.
Ready to Take the First Step?
A single consultation with Dr. Nilotpala Mohanty can replace months of uncertainty with a clear, personalised plan. Genova Clinic welcomes patients from across Delhi — Saket, Green Park, Hauz Khas, CR Park, GK I & II, Chattarpur, Vasant Kunj, Lajpat Nagar, and beyond.