IVF treatment in India

Read this before you compare clinics

Fertility is the branch of medicine where marketing and evidence diverge most, so this page starts where the sales pitch usually ends.

A clinic's advertised success rate tells you about the patients it treated, not about you. A centre that mainly treats women in their early thirties will publish better numbers than one that takes on difficult cases, and neither figure predicts your outcome. The variables that actually matter are your age, your ovarian reserve measured by AMH and antral follicle count, the sperm analysis, and whether there is a specific blockage or condition in the way.

So the question worth asking is not "what is your success rate" but "given my age and my AMH, what would you expect per cycle, and how many cycles does your plan assume?" A specialist who answers that with a range and a caveat is being straight with you. One who answers with a single impressive percentage is quoting a brochure.

Age is the single largest factor and it is not negotiable by any technology. If you are being told that a particular add-on will overcome it, be sceptical. The most valuable thing an honest consultation can do is tell you early, while you still have options, rather than after three cycles.

What a cycle actually involves

1. Testing first. Hormone blood tests, an ultrasound to count follicles, a semen analysis, and checks of the uterus and tubes. This can largely be done at home and sent for review.
2. Ovarian stimulation. Around ten to twelve days of daily injections to grow multiple eggs, with scans every few days to watch the response. This is the part that ties you to one place.
3. Egg collection. A short procedure under sedation, taking about twenty minutes.
4. Fertilisation in the laboratory. Either standard IVF, where eggs and sperm are placed together, or ICSI, where a single sperm is injected into each egg.
5. Embryo culture. Three to five days of growth under observation before transfer or freezing.
6. Transfer. One embryo, usually, placed into the uterus in a quick outpatient procedure. Remaining good embryos are frozen.
7. The wait. A blood pregnancy test about two weeks later.

How long you have to be in India

This is where fertility travel most often goes wrong in the planning, because the timeline is not a single appointment. A fresh cycle from the start of stimulation to embryo transfer runs roughly three to four weeks, and the middle of it involves scans every two or three days that cannot be skipped or moved.

There is an alternative worth asking about: split the treatment. Do stimulation, egg collection and fertilisation on one trip, freeze the embryos, and return later for a frozen embryo transfer, which needs far less time. For someone travelling from abroad with work and family commitments, two shorter trips are often more practical than one long one, and freezing does not reduce the chance of success in the way people fear.

ICSI, donor eggs and the add-ons

• ICSI injects a single sperm directly into an egg, and is the right answer where sperm count, movement or shape is the problem, or where standard IVF has failed to fertilise. It is not automatically better for everyone, and it should be recommended for a reason.
• Donor eggs or sperm substantially change the odds where the problem is egg quality or a very low sperm count. Indian law regulates donation and surrogacy tightly and the rules have changed in recent years, so anything in this area must be confirmed with the clinic against current regulation rather than against what a website said last year.
• Add-ons such as embryo glue, assisted hatching and various immune treatments are widely offered and the evidence behind many of them is weak. Ask what each one costs, what evidence supports it in your specific situation, and what happens if you decline it.
• Genetic testing of embryos has real uses, particularly with recurrent miscarriage or a known inherited condition, and is oversold outside those situations.

Insurance

This came up more than any other question in our research, and the answer is usually disappointing: most health insurance policies exclude fertility treatment, in India and in most other countries. Some employer schemes and a small number of policies now include it, often with conditions on age, on the number of cycles, and on waiting periods.

Ask your insurer in writing, before you travel, naming the specific procedures. A verbal yes from a call centre is worth nothing when the claim is assessed. If you are covered, a written estimate from the hospital is what your insurer will need to see.

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