Infertility is classified into two main types based on a woman’s pregnancy history:

• Primary Infertility: When a woman has never been pregnant despite trying for at least 12 months (or 6 months if over 35).
• Secondary Infertility: When a woman is unable to conceive again after having at least one prior pregnancy, regardless of the outcome.

Fact: Both primary and secondary infertility can affect men and women, requiring timely evaluation and treatment.

Infertility can result from issues in either partner or a combination of factors. Common causes include:

• Female factors: Ovulation disorders, blocked fallopian tubes, endometriosis, PCOS, uterine abnormalities, or age-related decline in egg quality
• Male factors: Low sperm count, poor sperm motility, abnormal sperm shape, hormonal imbalances, or testicular problems
• Combined factors: Both partners having underlying reproductive health issues
• Unexplained infertility: No identifiable cause despite thorough evaluation

Tip: Early diagnosis of the root cause is crucial for effective treatment and higher success rates.

Certain lifestyle and health conditions can increase the risk of infertility in both partners. Common risk factors include:

• Weight issues: Being underweight or overweight affects hormonal balance and ovulation
• Advanced age: Women over 35 and men over 40 have reduced fertility potential
• Sexually transmitted diseases (STDs): Infections can damage reproductive organs
• Chronic stress: Affects hormonal balance and sexual health
• Medical conditions: Diabetes, hypertension, hypothyroidism, and autoimmune disorders
• Unhealthy habits: Smoking, alcohol consumption, and substance abuse lower fertility
• Environmental toxins: Exposure to chemicals like lead and pesticides can impair reproductive health

Tip: Maintaining a healthy lifestyle, managing stress, and treating infections early can reduce infertility risk.

Several gynecological and hormonal conditions can increase infertility risk in women. Common factors include:

• PCOD (Polycystic Ovarian Disease): A leading cause of ovulation disorders
• Ovarian cysts: May interfere with egg release and hormonal balance
• Uterine fibroids: Can block implantation or cause miscarriages
• Endometriosis and chocolate cysts: Affect egg quality and tubal function
• Uterine polyps: Obstruct embryo implantation
• Hypothyroidism: Disrupts menstrual cycles and ovulation
• PID (Pelvic Inflammatory Disease): Leads to scarring and tubal blockages
• Blocked fallopian tubes: Prevents egg and sperm from meeting
• Uterine malformations or septum: Increases miscarriage risk
• Low AMH or ovarian failure: Indicates poor egg reserve
• Menstrual irregularities: Suggest underlying hormonal imbalance
• Past ectopic pregnancy or abortions: May cause scarring or damage
• Asherman’s syndrome: Uterine adhesions affecting implantation
• Chronic medical conditions: Kidney disease, sickle cell anemia, celiac disease
• Pituitary gland disorders: Affect hormone production and ovulation

Tip: Regular gynecological check-ups and early intervention can help manage these risks effectively.

Male infertility is often linked to sperm health, hormonal imbalances, or structural issues. Common risk factors include:

• Low sperm count or low testosterone (hypogonadism): Affects fertility and overall reproductive health
• Varicocele: Enlarged veins in the scrotum impair sperm production
• High heat exposure: Tight clothing or working in hot environments damages sperm quality
• Undescended testes: A congenital condition affecting sperm production
• Misuse of anabolic steroids: Lowers testosterone and sperm count
• Premature or retrograde ejaculation: Prevents sperm from reaching the egg
• Injury to scrotum or testes: Trauma can reduce fertility potential
• Genetic disorders: Such as Klinefelter syndrome affecting sperm development
• Testicular cancer: Can impair sperm production and hormone balance

Tip: Early evaluation and lifestyle changes can significantly improve male fertility outcomes.

Infertility diagnosis requires a combination of history, physical exams, and specialized tests to identify the root cause. Common diagnostic steps include:

• Semen analysis (Men): Evaluates sperm count, motility, and shape
• Hormonal profile: Checks estrogen, progesterone, FSH, LH, and thyroid levels in women; testosterone in men
• Pelvic ultrasound (Women): Detects ovarian cysts, PCOS, or uterine abnormalities
• Hysterosalpingography (HSG): X-ray with contrast dye to check if fallopian tubes are open
• Sonohysterogram or Hysteroscopy: Evaluates uterine cavity for fibroids, polyps, or adhesions
• Genetic tests: Identifies chromosomal or inherited conditions affecting fertility

Tip: Early and accurate testing ensures the right treatment plan and higher chances of conception.

Infertility often shows no obvious signs other than the inability to conceive, but certain symptoms may indicate underlying issues:

• In Women: Irregular or absent periods, painful periods, pelvic pain, or symptoms of PCOS (weight gain, acne)
• In Men: Low libido, erectile dysfunction, pain or swelling in the testes, reduced facial or body hair
• Both: Inability to conceive after 12 months of regular, unprotected intercourse (6 months if the woman is over 35)

Tip: If you notice these symptoms, consult a gynecologist or fertility specialist early for evaluation.

If medications and basic therapies fail to achieve pregnancy, advanced treatment options are available. Common infertility treatments include:

• Intrauterine Insemination (IUI): A procedure where processed sperm is placed directly into the uterus using a thin, soft catheter to increase chances of fertilization.
• IVF (In Vitro Fertilization): An assisted reproductive technique where eggs are retrieved and fertilized with sperm in a lab dish. The resulting embryo is transferred into the uterus (Embryo Transfer or ET).
• ICSI (Intracytoplasmic Sperm Injection): Similar to IVF, but a single healthy sperm is injected directly into each harvested egg before embryo transfer, useful for severe male infertility.
• Third-Party ART: Involves donor eggs, donor sperm, or donor embryos. Some couples may require surrogacy, where another woman carries the pregnancy.

Tip: Your gynecologist will recommend the most suitable option based on age, fertility test results, and medical history.

Ovulation induction is a first-line infertility treatment where medications stimulate the ovaries to release eggs for fertilization. It is recommended for:

• Women with irregular or absent ovulation: Common in PCOS or hormonal imbalance
• Unexplained infertility: Improves the chances of natural conception
• Before IUI or timed intercourse: Increases the number of mature eggs available

Medications: Clomiphene citrate, Letrozole, and Gonadotropin injections are commonly used under medical supervision.

ART involves advanced methods to help couples conceive when natural methods fail. Common techniques include:

• IVF (In Vitro Fertilization): Eggs and sperm are fertilized in a lab, and embryos are placed in the uterus
• IUI (Intrauterine Insemination): Sperm is directly placed inside the uterus to enhance fertilization chances
• ICSI (Intracytoplasmic Sperm Injection): A single sperm is injected into an egg, ideal for severe male infertility

Third-party ART: Includes donor eggs, sperm, embryos, and surrogacy for specific cases.

Surgical procedures are recommended when structural abnormalities affect fertility. Common surgical options include:

• Laparoscopy: Removes endometriosis, ovarian cysts, and clears blocked fallopian tubes
• Hysteroscopy: Treats uterine polyps, fibroids, adhesions, and septum
• Microsurgical procedures: Repair of fallopian tubes or removal of pelvic adhesions

Benefit: These minimally invasive surgeries improve natural conception chances or enhance ART outcomes.

Hormonal therapy is essential for treating endocrine-related infertility. It helps restore normal ovulation and improve conception chances. Common scenarios include:

• PCOS: Medications like Metformin and ovulation stimulants correct hormonal imbalance
• Thyroid disorders: Thyroxine for hypothyroidism or anti-thyroid drugs for hyperthyroidism
• High prolactin levels: Dopamine agonists help normalize menstrual cycles
• Luteal phase defect: Progesterone supplements support implantation

Tip: Correcting hormonal imbalances early can often avoid the need for advanced fertility treatments.

Nearly 90% of couples achieve pregnancy after undergoing infertility treatment. However, success rates vary based on the cause of infertility, age, and treatment type:

• ART (Assisted Reproductive Techniques): About 50% of women under 35 conceive, while the rate drops to 30% for women over 40
• IUI (Intrauterine Insemination): Success rate is 20–30%, usually within 3 cycles if it’s going to work

Tip: Never lose hope. With timely intervention, advanced techniques, and expert care at a trusted center, success is achievable.

While not all infertility cases are preventable, adopting healthy habits can significantly reduce the risk for both men and women. Steps to prevent infertility include:

• Maintain a healthy weight: Eat a balanced diet and stay active to support hormonal balance
• Avoid harmful habits: Quit smoking, alcohol, and recreational drug use as they impair fertility
• Practice safe sex: Prevent sexually transmitted infections (STIs) that can damage reproductive organs
• Reduce toxin exposure: Limit contact with environmental toxins such as pesticides, lead, and chemicals
• Manage stress: Chronic stress affects hormone levels and reproductive health

Tip: Regular health check-ups and early treatment of medical conditions like thyroid disorders or diabetes can also help preserve fertility.

The cost of infertility treatment in Mumbai varies depending on the treatment type, diagnostic tests, and individual health needs. Here’s an approximate breakdown:

• Consultation: ₹800 – ₹1,500 per visit
• Ovulation Induction: ₹5,000 – ₹10,000 per cycle
• IUI (Intrauterine Insemination): ₹10,000 – ₹20,000 per cycle
• IVF (In Vitro Fertilization): ₹1,50,000 – ₹2,50,000 per cycle
• ICSI (Intracytoplasmic Sperm Injection): ₹1,80,000 – ₹3,00,000 per cycle
• Surgical treatments (Laparoscopy/Hysteroscopy): ₹50,000 – ₹1,20,000

Factors influencing cost: Age of the couple, complexity of infertility, hormonal medications, number of cycles, and hospital facilities.

Tip: Always confirm the final estimate during your consultation to avoid hidden costs and choose a center with transparent pricing.

ICD-10 Codes for Infertility

CPT Codes for Infertility Treatment and Procedures

Q1. How can secondary infertility be treated?

Q2. Can infertility be cured permanently?

Q3. How to conceive fast with infertility issues?

Q4. How to improve egg quality naturally?

Q5. How to improve sperm quality naturally?

Q6. What is the best fertility drug to get pregnant?

Q7. How to conceive twins naturally or through treatment?

Q8. Can I get pregnant at 42 with infertility?

Q9. Why can’t I get my wife pregnant even after trying?

Q10. Can two females have a baby without sperm?

Q11. How to increase fertility quickly?

Q12. How to get pregnant fast at 40?

Q13. Is it possible to get pregnant with secondary infertility?

Q14. How to make peace with secondary infertility emotionally?

Q15. How many years is secondary infertility defined as?

Q16. How does lifestyle impact infertility?

Q17. What is the role of diet in infertility treatment?

Q18. Can stress alone cause infertility?