Location:
Call: 080 6556 1000
[email protected]

Doctors

photo of Dr. Lavanya Kiran

Dr. Lavanya Kiran

Director & Lead Consultant – Obstetrics, Gynecology, Robotics, Regenerative Medicine, Cosmetic Gynaecology & Fertility

photo of Dr. Angel Lucy James

Dr. Angel Lucy James

Consultant - Obstetrics & Gynecology

photo of Dr. Arjun Ajayaghosh

Dr. Arjun Ajayaghosh

Attending Consultant – Obstetrics and Gynaecology

photo of Dr. Rajeswari Nellipudi

Dr. Rajeswari Nellipudi

Attending Consultant – Obstetrics and Gynaecology

photo of Dr. Madhumithaa N

Dr. Madhumithaa N

Attending Consultant – Obstetrics & Gynaecology

photo of Dr. Harika Chikkam

Dr. Harika Chikkam

Senior Specialist – Obstetrics & Gynaecology

Doctor Videos


Dr. Lavanya Kiran, 9 Months Full Term Care, Antenatal Care, Caesarean, Colposcopy, Companionship in Labor, Fertility Preservation, Fertility Services, Fetal Medicine, Fitness & Care, Gynaecology Services, Hi-Risk Pregnancy, HSG, Hysteroscopy, ICSI, Instrumental Delivery, IUI, IVF, Laparoscopic and Robotic Procedures, Maternity services, Menopause clinic, Obstetrics, Oocyte Freezing, Ovarian Tissue Preservation, Ovulation Induction, Painless Delivery, PCOD Specialty centre, PMOS Specialty Centre, Postnatal care, Preconception, Pregnancy Nutrition, Preventive Womens Healthcare, Semen Analysis, Vaginal Delivery, VBAC, Woman Health Services, Women's Vaccination

Health Blogs

image

31 August, 2026

Common Causes of Infertility

Authored By: Dr. Lavanya Kiran

Infertility is defined as the inability to conceive after twelve months of regular, unprotected intercourse, or six months when the woman is above 35. It affects a significant proportion of couples trying to conceive, and yet it remains a condition many people approach with assumptions that do not reflect the clinical reality. The most persistent of these assumptions is that infertility is primarily a female problem. It is not.The male factor substantially contributes to about 50% of all cases of infertility. The male is solely responsible in about 20% of cases and is a contributing factor in another 30 to 40% of all cases. As male and female causes often coexist, it is essential that both partners are investigated and managed together.Understanding the most common causes on both sides is the starting point for anyone navigating a fertility evaluation.Female infertility causesOvulation disordersMost cases of female infertility are caused by problems with ovulation. Without ovulation, there are no eggs to be fertilised. PCOS is a hormone imbalance problem which can interfere with normal ovulation and is the most common female infertility causes.The most common overall cause of female infertility is failure to ovulate, which occurs in 40% of women with infertility. Polycystic ovary syndrome produces irregular or absent ovulation through insulin resistance and elevated androgen levels. Primary ovarian insufficiency, where the ovaries stop functioning before the age of 40, is another cause of ovulatory failure and carries additional implications for hormonal health and bone density.Tubal diseaseBlocked or damaged fallopian tubes prevent sperm from reaching the egg or prevent a fertilised egg from travelling to the uterus. The most common causes of tubal damage include previous pelvic inflammatory disease, often from chlamydial infection, previous ectopic pregnancy, and endometriosis affecting the tubes. Sexually transmitted infections such as chlamydia can damage the fallopian tubes, and some other STIs may also cause infertility.EndometriosisEndometriosis is a disease in which tissue identical to the lining of the uterus grows outside the uterus, on the ovaries, tubes and other pelvic structures. This causes inflammation, adhesions, and sometimes direct injury to the tubes and ovaries. Specifically, even moderate endometriosis can disrupt fertility through inflammatory mechanisms, which can damage the quality of the egg and the implantation of the embryo. Endometriosis is one of the more difficult causes of female infertility to diagnose and treat. Uterine factorsStructural problems such as the presence of abnormal tissue in the fallopian tubes or uterus are another common reason for female infertility. Structural issues prevent the egg from meeting the sperm or prevent the embryo from implanting.Fibroids, polyps, a septate uterus, or intrauterine adhesions from previous procedures or infections can all interfere with implantation and early pregnancy maintenance. These are usually identified during a uterine assessment as part of the fertility workup.Diminished ovarian reserveA woman's ovarian reserve, representing the quantity and quality of eggs remaining, declines with age and can be reduced prematurely by genetics, previous ovarian surgery, or autoimmune conditions. Low ovarian reserve reduces the number of eggs available for stimulation and retrieval, and the eggs that remain are more likely to carry chromosomal abnormalities.Male infertility causesSperm abnormalitiesThe most common findings in male infertility relate directly to the sperm itself. These include:Low sperm count, where the number of sperm in the ejaculate falls below the threshold needed for reliable fertilisationPoor sperm motility, where sperm cannot swim effectively enough to reach and penetrate the eggAbnormal sperm morphology, where the shape of the sperm impairs its ability to fertiliseAzoospermia, the complete absence of sperm in the ejaculate, which occurs in around 10 to 15% of infertile men and may reflect either a production problem or an obstruction in the reproductive tractVaricoceleVaricocele is a swelling of the veins that drain the testicle. It is the most common reversible cause of male infertility and may lead to reduced sperm quantity and quality. The enlarged veins raise scrotal temperature, impairing sperm production. Surgical repair of a varicocele can improve semen parameters in a meaningful proportion of men.Hormonal imbalancesThe hormonal axis regulating sperm production involves signals from the brain and pituitary gland to the testicles. Disruption at any level, whether from a pituitary tumour, thyroid dysfunction, or conditions affecting testosterone production, can reduce sperm output significantly. Exogenous testosterone, including anabolic steroids used for body building, suppresses this axis and can cause severe reductions in sperm count.Genetic causesKlinefelter syndrome, Y chromosome microdeletions, and cystic fibrosis gene mutations are among the genetic causes of male infertility. Klinefelter syndrome occurs when a boy is born with an extra copy of the X chromosome and often is not diagnosed until adulthood. Men with congenital bilateral absence of the vas deferens, linked to cystic fibrosis mutations, produce sperm in the testicles but cannot deliver it through ejaculation.Unexplained infertilityEven after a thorough investigation of both partners, a proportion of couples are given a diagnosis of unexplained infertility, where no specific cause can be identified with current diagnostic tools.One third of infertility cases in heterosexual couples are due to male infertility, one third to female infertility, and one third to both partners or entirely unknown causes. Unexplained infertility does not mean nothing is wrong. It means the cause has not yet been identified. These couples are typically offered assisted reproductive treatment with the expectation that many will achieve pregnancy through IUI or IVF.TakeawaysThe causes of infertility are distributed roughly equally between female infertility causes, male infertility causes, and unexplained factors. Female causes include ovulation disorders, tubal disease, endometriosis, uterine abnormalities, and diminished ovarian reserve. Male causes include sperm abnormalities, varicocele, hormonal imbalances, and genetic conditions. Both partners should be investigated simultaneously from the outset, as causes frequently coexist. Unexplained infertility affects a significant proportion of couples and does not preclude successful treatment. Anyone who has been trying to conceive for twelve months without success, or six months above the age of 35, should seek a fertility evaluation without further delay.

Read More
image

31 August, 2026

When Should Couples Seek Fertility Help?

Authored By: Dr. Lavanya Kiran

Most couples who decide they want to start a family assume conception will happen relatively quickly. When it does not, the months of trying can bring a mix of confusion, frustration, and worry, along with a question that many are unsure how to answer: at what point does this become something to investigate medically? The answer depends on age, medical history, and a few specific circumstances that should prompt earlier rather than later action.Waiting too long to seek help is one of the most consistently documented patterns in fertility care. Most couples attempt to conceive for 22.3 months before presenting for fertility evaluation, almost a year beyond the recommended threshold. This delay can impair quality of life, impact treatment outcomes, and increase overall healthcare costs.The standard timelines for seeking helpFor a healthy couple in which the woman is under 35, infertility is typically defined as no pregnancy after 12 months of regular, unprotected intercourse. If the woman is 35 or older, the recommendation is to seek help after six months of trying without conceiving, since female fertility declines with age.If a woman is over 40, or a condition known to cause infertility is present, evaluation should not be delayed at all.These timelines reflect the biology of fertility decline. A 32-year-old and a 39-year-old are not in the same biological situation, and treating their situations identically by defaulting to the same twelve-month threshold before seeking help does not serve the older patient well.When to seek help sooner regardless of how long you have been tryingCertain circumstances should prompt a fertility consultation without waiting for the standard twelve or six-month period to elapse. These include situations where a known or suspected cause of infertility already exists.For women, earlier evaluation is appropriate when:Menstrual cycles are consistently irregular, very infrequent, or absent, as this usually reflects an ovulation problemThere is a known diagnosis of PCOS, endometriosis, premature ovarian insufficiency, or uterine fibroidsThere is a history of previous pelvic infections or sexually transmitted infections that may have affected the fallopian tubesThere has been previous pelvic or abdominal surgery that may have caused adhesions or tubal damageThere have been two or more miscarriages, which warrants investigation for recurrent pregnancy loss causesCancer treatment involving chemotherapy or radiation has been received, as these can affect ovarian reserveA woman may wish to see a fertility specialist sooner if she has a history of irregular menstrual cycles, miscarriage, pelvic inflammatory disease, endometriosis, PCOS, uterine fibroids, or other gynaecological problems.For men, earlier evaluation is appropriate when:There is a known history of testicular injury, surgery, or undescended testesPrevious chemotherapy or radiation has been receivedThere is a history of sexually transmitted infections affecting the reproductive tractThere are current symptoms including difficulty with ejaculation or a known varicoceleBoth partners need to be evaluated from the startThis is one of the most important and most frequently overlooked points in fertility care. For initial infertility evaluation, clinicians should initiate concurrent assessment of both the male and female partners. Both the female and male are equal stakeholders in both diagnosis and treatment.Despite male factors contributing to approximately half of all infertility cases, male partner evaluation is disproportionately bypassed, with an estimated 860,000 male partners not evaluated at the time of fertility consultation. This is a significant clinical gap. Delaying the male evaluation by months while focusing exclusively on the female partner wastes time that is clinically meaningful.A semen analysis is a simple, non-invasive test that provides immediate information about sperm count, motility, and morphology. It should be among the first investigations requested, not an afterthought.What the initial fertility evaluation involvesThe first fertility consultation is typically with a reproductive endocrinologist or a gynaecologist with a subspecialty interest in fertility. It covers the reproductive history of both partners, including the duration of trying, any previous pregnancies, menstrual pattern, relevant medical and surgical history, and lifestyle factors.The preliminary investigations recommended for the infertile couple are focused on semen analysis, detection of ovarian function through hormonal assay, and evaluation of tubal patency through hysterosalpingography. These three investigations cover the most common causes of infertility and can be completed within a single menstrual cycle, giving the specialist enough information to begin directing further assessment or treatment.Recurrent pregnancy lossCouples who have had two or more consecutive miscarriages occupy a specific and important category. In couples with recurrent pregnancy losses of two or more, clinicians should evaluate the male partner. Recurrent pregnancy loss has its own set of potential causes including chromosomal abnormalities in one or both partners, uterine structural problems, blood clotting conditions, and immunological factors. It warrants investigation as a distinct clinical problem rather than being managed as repeated episodes of ordinary miscarriage.The emotional dimensionThe decision to seek fertility help carries emotional weight that the clinical timeline does not fully capture. Infertile couples are at greater risk of marital stress, sexual dysfunction, and decreased quality of life, which may extend even to the initial twelve-month period before evaluation is recommended. Couples who are struggling emotionally during the trying period do not need to wait until a clinical threshold is reached before reaching out to a specialist for a conversation. An early consultation does not commit a couple to treatment. It provides information, reassurance where appropriate, and a plan if investigation reveals something that needs addressing.TakeawaysWhen to seek fertility help depends on the woman's age and whether either partner has a known condition that affects reproductive function. The standard thresholds are twelve months of trying for women under 35, six months for women above 35, and no delay for women above 40 or anyone with a known fertility-related diagnosis. Fertility evaluation should involve both partners from the outset, as male factors contribute to roughly half of all infertility cases. Earlier infertility specialist consultation is appropriate whenever irregular cycles, recurrent miscarriage, previous pelvic infection, or relevant medical history is present. Fertility testing when to start is a question best answered in conversation with a specialist, who can take the full clinical picture into account.

Read More
image

28 August, 2026

IVF Journey: A Step-by-Step Guide

Authored By: Dr. Lavanya Kiran

For couples who have been trying to conceive without success, or for individuals building families through assisted reproduction, the decision to pursue IVF often comes after a long and emotionally demanding period. In vitro fertilisation is one of the most well-established forms of assisted reproductive technology available, and yet the process itself remains opaque for many people who are just beginning to explore it.Understanding what actually happens at each stage, and what to expect emotionally and physically along the way, makes the journey considerably less daunting.What IVF is and who it is forIn vitro fertilisation is a medical process where eggs are collected from the ovaries, fertilised with sperm in a laboratory, and then transferred back into the uterus with the hope of achieving a pregnancy.In vitro fertilisation treatment is recommended when there are blocked or damaged fallopian tubes, severe male factor infertility and unexplained infertility after other treatments have been unsuccessful. Other situations include diminished ovarian reserve, genetic conditions where preimplantation testing is needed, and for single individuals or couples pursuing parenthood. Step 1: Initial consultation and fertility assessmentThe first step is for the doctor to understand the patient’s fertility story. It may involve coming in two to three different times during the menstrual cycle for blood tests, ultrasounds and studies. These tests assess the way reproductive organs are functioning. Doctors can also confirm fitness for pregnancy. Blood tests are done to check the ovarian reserve by noting AMH levels and antral follicle count on ultrasound in women. A uterine check-up is also done using a hysteroscopy or saline sonogram, and baseline hormone levels are checked.Semen analysis for men checks sperm count, motility, and morphology. Both partners may also undergo genetic carrier screening depending on their history. Step 2: Ovarian stimulationOnly one egg matures and is released each month in a natural menstrual cycle, but doing ovarian stimulation encourages the ovaries to produce multiple eggs.Ovaries produce more mature eggs after hormonal medications are injected. However, not all eggs fertilise or develop normally after fertilisation. So, retrieving more than one egg improves the chances of implantation in the later stage.This phase lasts eight to fourteen days, so a patient is required to attend regular appointments for blood tests and ultrasound scans. This way, the fertility team can track follicle development and adjust medicines as needed. Step 3: Egg retrievalAnother injection is given to help the follicles reach the appropriate size and to help eggs mature. These eggs are retrieved approximately 36 hours later under sedation or light anaesthesia. The whole process takes around 20-30 minutes. A thin needle is passed through the vaginal wall using ultrasound to aspirate fluid from each follicle and collect the eggs within it. Mild cramping and bloating in the days following the procedure are quite common in patients.Step 4: Fertilisation Eggs are checked for maturity in the laboratory. This is so that they can be fertilised with sperm. There are two ways to do it, either insemination or intracytoplasmic sperm injection (ICSI). ICSI is helpful when sperm quality is poor or when previous fertilisation efforts did not succeed. The fertilised eggs form embryos, and are cultured in the laboratory for five to six days, after which they reach the blastocyst stage. It is the most advanced stage in the development of an embryo before transfer. It is associated with higher implantation rates than earlier-stage embryos. The embryologist monitors development and gives the information to the team about the number of normally progressing embryos. Step 5: Preimplantation genetic testing (if required)Some couples struggle with a known genetic condition, older maternal age or repeated implantation failure, so preimplantation genetic testing can be helpful for them. A small number of cells from the blastocyst are biopsied to rule out any abnormality in chromosomes. This process can add an extra two weeks for results. But it helps in transferring only chromosomally normal embryos to improve the implantation rate and reduce the risk of loss.Step 6: Embryo transferThe transfer of embryos is painless, so it does not require sedation. A patient needs to lie down on an examination table so the embryo can be guided through the cervix into the uterine cavity using a fine catheter. The whole procedure takes under 15 minutes to complete and is done through ultrasound guidance.The number of embryos transferred is usually one, particularly in younger patients with good prognosis embryos, to minimise the risk of multiple pregnancy while maintaining a high chance of success. Any remaining good-quality embryos are vitrified, a rapid freezing technique, and stored for future use if the current cycle does not result in a pregnancy or if the couple plans further pregnancies.Step 7: The two-week wait and pregnancy testThe period between embryo transfer and the pregnancy blood test is the most emotionally demanding part of the IVF process. The body needs time for the embryo to implant and begin producing the pregnancy hormone hCG. A blood test at the clinic provides a definitive and quantified result, and a positive test is then followed by an early ultrasound to confirm the location of the pregnancy and assess the heartbeat.IVF success factorsThe likelihood of a successful outcome depends on many factors.Age of the woman, as egg quality declines with age, is the single most important predictor of IVF success.The number and quality of embryos available for transferThe underlying cause of infertilityThe woman's uterine health and receptivityWhether a fresh or frozen embryo transfer is usedTakeawaysThe IVF process includes several steps from fertility assessment through ovarian stimulation, egg retrieval, fertilisation, embryo development, and finally, transfer. Understanding IVF steps reduces anxiety in patients. It helps them engage with their care team throughout the treatment. IVF success factors are age, embryo quality, and uterine health, which means that outcomes are not the same for everyone. The entire process can be quite overwhelming, so emotional support from family or friends can help the people embarking on this journey.

Read More
Loading booking..