Many couples are told IVF is the answer. First, ask why.

IVF is a treatment where eggs are collected from the ovaries, fertilised with sperm in a laboratory, and an embryo is placed in the womb.

Daily injections help several eggs grow instead of one. The eggs are collected in a short procedure under sedation. In the lab, each egg meets sperm, either around it (conventional IVF) or with one sperm injected into it (ICSI). Embryos grow for 3 to 6 days, and one is transferred, fresh or in a later cycle. At Jananam, IVF treatment in Chennai happens at our Neelankarai hospital, where the embryology lab is on site.

IVF's real benefit is that it gets around problems the body can't: blocked tubes, low sperm count, and ovulation that won't happen on its own.

It also lets embryos be tested for a known genetic condition, lets spare embryos be frozen for a brother or sister later, and makes donor eggs or sperm possible. What IVF cannot do is make eggs or sperm healthier. It works with what is there, which is why age and egg reserve shape what it can do for you. IVF babies are not different: once the embryo implants, the pregnancy is like any other.

People do IVF when simpler treatment can't work or hasn't worked, and many couples who are told they need IVF don't.

IVF is usually right for blocked or removed tubes, severe male factor, severe endometriosis, low egg reserve where time matters, a known genetic condition, or after IUI has had a fair try. If tubes are open and both of you test normal, tablets or IUI often come first. A treatable problem, like thyroid, a polyp or weight, should be fixed before anything else.

Most of our transfers are frozen because the womb lining can be prepared more calmly in a later cycle than during stimulation.

Stimulation injections push hormone levels well above normal, which in some women may affect how ready the lining is. Freezing all embryos also protects women at risk of over-response (OHSS), such as some with PCOS, and is needed when embryos are genetically tested. A fresh transfer is still an option when the response, hormones and lining all look right.

We transfer the smallest number that gives a good chance of pregnancy, and never more than two.

Two embryos do not double the chance of a baby. They raise the chance of twins, and twins carry more risk of miscarriage, high blood pressure, diabetes in pregnancy and early birth. With a tested normal embryo, one is enough at any age. Spare embryos are frozen for later.

A cycle can stall at any step, and it is easier to hear this now than to meet it unprepared.

Fewer eggs may grow than hoped, or too many (OHSS). Not every egg is mature, not every mature egg fertilises, and not every embryo grows to day 5. Sometimes there is no embryo to transfer. After a cycle that doesn't work, we review each step so the next one is different for a reason, not a repeat.