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Depressed Woman - NU Fertility

ERA Test for Repeated Failure of Pregnancy

Endometrial Receptivity Analysis or ERA test is a test used to assess the uterine lining receptivity in women who have experienced multiple unsuccessful attempts to conceive. By analyzing the optimal time with maximum chances of embryo implantation during IVF,, this test can help to determine the optimal timing for embryo transfer, thus increasing the likelihood of successful pregnancy in women with recurrent miscarriage.

Understanding the cause for repeated failure of pregnancy

Causes For Repeated Failure of Pregnancy - NU Fertility


Couples who experience repeated pregnancy failures can find themselves in a difficult and emotionally taxing situation. Repeated failure of pregnancy can be attributed to a variety of factors such as:

Chromosomal abnormalities: Chromosomal abnormalities in the egg or sperm can result in early miscarriages, as well as structural problems in the uterus, including fibroids and polyps, which may impede implantation or result in complications during pregnancy. Furthermore, hormonal imbalances, such as thyroid disorders or Polycystic Ovary Syndrome (PCOS), can affect fertility and lead to recurrent pregnancy loss.

Autoimmune disorders: In autoimmune disorders, the immune system mistakenly attacks the embryo. In conditions such as thrombophilia, the risk of blood clot formation increases and the blood supply to the placenta is impaired, leading to miscarriage.

Lifestyle factors: Factors including smoking, heavy drinking, and being overweight or underweight can have a negative effect on fertility and increase the likelihood of having multiple unsuccessful pregnancies. Advanced maternal age plays an important role as women over 35 have a higher incidence of chromosome abnormalities in their eggs.

Genetic factors and familial predisposition: Genetic mutations may also influence the occurrence of repeated abortions.

What is The Window of Receptivity?

Woman Hands Holding Female Uterus - NU Fertility


The uterine receptivity window is a brief period of time in the menstrual cycle during which the lining of uterus is optimally prepared for receiving the embryo, leading to successful pregnancy.

During this window, the endometrium undergoes certain changes to become more receptive to the incoming embryo. The blood flow to the uterus increases and the inner lining of the uterus produces certain chemicals which favor successful pregnancy.

Window of implantation is around day 20 of a 28 day cycle. It lasts for 3-4 days.. It may, however, vary for women with longer or shorter cycles.If the uterus is exposed to a healthy embryo at this time, pregnancy happens.

In IVF, the embryo is transferred back into the uterus at this time with maximum chances of successful implantation. Endometrial Receptivity Analysis (ERA) test has revolutionized the process of determining the time of maximum implantation potential of the uterus, thus enhancing the likelihood of successful pregnancy for couples with fertility issues.

How does the ERA test work?

Technician Doing ERA Test Work - NU Fertility


The Endometrial Receptivity Analysis (ERA) test is used to assess the optimal window of endometrial receptivity for embryo implantation during assisted reproductive procedures, such as in vitro fertilization (IVF).  

The ERA test involves a series of steps:

Endometrial biopsy: A uterine biopsy is performed during a woman’s natural cycle or hormone replacement cycle. A thin catheter is used to collect a small sample of the uterine lining. The collection of the uterine biopsy occurs 7 days after the luteinizing hormone (LH) surge during a natural cycle.

Molecular analysis: The tissue sample collected is then analyzed for the expression of 248 genes that are involved in the development of endometrium receptivity. The gene expression profile is used to determine if the endometrium is “receptive” or “not-receptive” at that particular time.

Personalized timing: The ERA test utilizes gene expression data to determine when the endometrium is most receptive for each individual.

Treatment adjustment: Embryo transfer during assisted reproductive procedures can now be tailored to the patient’s particular window of receptivity, thus increasing the likelihood of successful pregnancy. This personalized approach ensures that the embryo is inserted into the uterine lining at its most receptive point.

The ERA test represents a significant advancement in assisted reproductive technology, offering a personalized approach to time the embryo transfer, correctly. By analyzing the molecular status of the endometrial lining, it helps identify the precise window of implantation for each individual. This tailored approach holds promise for couples facing recurrent pregnancy failures, as it maximizes the chances of a successful pregnancy.

NU Fertility at NU Hospitals, based in Bangalore, provides modern treatment options for women suffering from recurrent pregnancy loss. The doctors at NU Fertility have many years of experience in the field of reproductive health and are trained to handle even the most sensitive cases with expertise and precision. If you want to know more about ERA testing, get in touch with NU fertility specialists.


  1.     Mahajan N. (2015). Endometrial receptivity array: Clinical application. Journal of human reproductive sciences, 8(3), 121–129.
  2.  Recurrent pregnancy loss. UCLA HEALTH.
  3.   Understanding Repeated Pregnancy Loss. Stanford Medicine.
  4.  Liu, Z., Liu, X., Wang, M., et al. (2022). The Clinical Efficacy of Personalized Embryo Transfer Guided by the Endometrial Receptivity Array/Analysis on IVF/ICSI Outcomes: A Systematic Review and Meta-Analysis. Frontiers in physiology, 13, 841437.

Author: Dr. Sneha J

Doctor Preparing Growing Embryos - NU Fertility

How to Prepare for an Embryo Transfer

An embryo transfer is the first step of in vitro fertilization (IVF). Embryo transfer involves the fertilization of eggs outside the body and the transfer of the embryos into the uterus to achieve a pregnancy. Preparing for embryo transfer is a crucial step in the journey of assisted reproductive technology (ART). Proper preparation is essential to maximize the chances of a successful pregnancy. In this blog, we will explore the steps to prepare for embryo transfer, covering various aspects to ensure a smooth and successful procedure.

Indications for Embryo Transfer

Disappointed Couple Sitting on The Floor - NU Fertility


Embryo transfer is a critical procedure in the field of reproductive medicine, typically recommended for various conditions that hinder natural conception or pose risks during pregnancy. Common indications for embryo transfer include:

Infertility: When couples struggle to conceive due to factors such as male or female infertility, embryo transfer can help by placing healthy embryos into the woman’s uterus.

Recurrent Pregnancy Loss: For individuals experiencing multiple miscarriages, embryo transfer may increase the chances of a successful pregnancy by selecting the healthiest embryos.

Medical Conditions: Certain medical conditions, such as uterine abnormalities or previous surgeries, can affect a woman’s ability to conceive or maintain a pregnancy. Embryo transfer can overcome these obstacles.

Single Parent: Embryo transfer allows women to have biological children by using donor sperm.

Age-Related Fertility Decline: As women age, their fertility decreases. Embryo transfer with younger, healthier embryos can improve the chances of a successful pregnancy in older women.

Preparation for Embryo Transfer

Healthy Diet for Embryo Transfer - NU Fertility


Preparing for embryo transfer involves a combination of physical, emotional, and logistical considerations. Here are the steps you need to take to get ready for an embryo transfer:

Consultation and Planning: Start your preparation by choosing a reputable fertility clinic or ART centre having experienced professionals. Schedule a consultation with a fertility specialist to discuss your individual situation and treatment plan. The specialist will review your medical history and assess any potential factors affecting fertility.

Preparing your Body: Begin adopting a healthy lifestyle by eating a balanced diet, exercising regularly, and avoiding alcohol and smoking. Follow your doctor’s advice on taking specific prenatal vitamins and supplements, such as folic acid, to support pregnancy. Comply with prescribed medications, such as hormonal injections, to prepare the uterine lining for embryo implantation.

Synchronization of Cycles: If you are using a donor egg or sperm, ensure synchronization of cycles with the donor. Take hormonal medications as per your doctor’s instructions to align your menstrual cycle with the embryo’s development.

Psychological Readiness: Consider seeking counselling or psychological support to manage the emotional stress associated with fertility treatments. Lean on your support network, including friends and family, to provide emotional assistance during this process.

Pretransfer Tests: Undergoing an ultrasound to evaluate the uterine lining’s thickness and structure and blood tests may be required to check hormone levels and overall health before proceeding.

Lifestyle Adjustments: Practice stress reduction techniques such as yoga, meditation, or deep breathing exercises to help relax your body and mind. Consider adjusting your work schedule to accommodate medical appointments and potential rest periods after the transfer.

Pretransfer Instructions: Stay well hydrated in the days leading up to the embryo transfer. Avoid or limit caffeine and alcohol consumption. Refrain from sexual activity a few days before the embryo transfer. Maintain good personal hygiene to prevent infections and wear loose, comfortable clothing on the day of the transfer. Make sure you have reliable transportation to and from the clinic on the day of the transfer. Consider having a companion accompany you for support and assistance.

Understanding the Procedure: Take time to understand the embryo transfer procedure, what to expect, and any potential risks or complications involved. Ask your doctor any questions or concerns you may have about the process.

The day of the Embryo Transfer: Arrive at the clinic on time, allowing for any necessary paperwork and preparation. Listen carefully to the medical team’s instructions and explanations of the procedure.

Post Transfer Care


Plan to rest for the remainder of the day following the transfer. Avoid strenuous activities and lifting heavy objects. Continue any prescribed medications and follow-up appointments. The two-week waiting period after the transfer can be challenging. Stay patient and avoid taking home pregnancy tests prematurely. Follow-up appointments to check for pregnancy are essential during this phase.

To summarize briefly, embryo transfer is a versatile and effective method for overcoming various reproductive challenges, enabling individuals and couples to achieve their dream of parenthood. With proper planning and working closely with your fertility specialist, you can increase your chances of a successful embryo transfer and, ultimately, a healthy pregnancy.  

NU Fertility Hospitals in Bangalore, India is renowned as one of India’s premier infertility centres, excelling in embryo transfers. With cutting-edge technology, a highly skilled medical team, and a strong track record of successful pregnancies, it stands out as the first choice of individuals and couples seeking advanced reproductive solutions.


  1.    Embryo Transfer. American Pregnancy Association.
  2.    Embryo Transfer. Cambridge IVF.
  3.    Embryo Transfer. Stanford Medicine.     induction.

Author: Dr. Sneha J

Woman Suffering Pelvic Pain - NU Fertility

Why You Should Try Ovulation Induction Prior to IVF and IUI

Infertility Problems in Indian Couples - NU Fertility


Infertility in women may be caused due to several reasons. Many a times, it is caused by ovulation problems. Ovulation is the process of release of a mature egg from the ovary. Under normal circumstances, the released egg travels to the fallopian tube where it gets fertilized by a sperm. Over a period of several days, the fertilized egg travels to the uterus, where it gets implanted. When this happens, a woman is said to be pregnant.

What is ovulation induction (OI)?

Negative Result in Pregnancy Test Kit - NU Fertility

Ovulation induction is a method of assisted reproduction, useful for treating fertility issues in women who either do not have a normal ovulation or have no ovulation at all owing to hormonal disorders or a condition called Polycystic Ovary Syndrome (PCOS). In OI, fertility medications are used to stimulate the release of one or more eggs from the ovary.

Need for OI

Ovulation Induction Concept - NU Fertility

Generally, OI is done in one of two particular situations. Firstly, it is brought to use in conditions where the woman has irregular menstrual cycles and does not release an egg on her own to ovulate. With the help of these medications, the woman is able to release a single egg. Secondly, OI is helpful even if the woman is ovulating regularly on her own. In such a situation, these medications are used with an aim to release several eggs at a time. The idea behind this is that a couple who is unable to achieve pregnancy with the woman just releasing one egg per month, the chances of getting pregnant will increase if 2-3 eggs are released at a time.

How does OI work?

Ovulation Induction Medications - NU Fertility


Ovulation-inducing medications are often the first line of treatment your healthcare provider will try in order to achieve pregnancy. These medications belong to a class called gonadotropins and work by stimulating the release of hormones that facilitate egg production. Basically, there are two types of OI medications:

  1.     Oral medications: Often treated as the first line of treatment, these medications help women who do not ovulate or ovulate infrequently. As part of the treatment, first an ultrasound and some blood tests are carried out on the second or third day of the menstrual cycle. Starting from day 2-5 of the cycle,, you will be given oral medications such as clomiphene or letrozole for 5 days . Following this, a vaginal ultrasound will be performed on the 10th or 11th day to check how well the egg has developed. With the help of an ultrasound and blood tests, your healthcare provider would be able to monitor the development of follicles, based on which you may start attempting to conceive naturally or through intrauterine insemination (IUI).
  2. Injectable medications: In case oral medications are unsuccessful in giving the desired results, injectable medications containing hormones such as follicle-stimulating hormone (FSH) and Leutenizing hormone (LH) may be administered. As with oral medications, the treatment cycle begins with an ultrasound and blood tests on day 2-3 of the menstrual cycle. The injectable medications are then administered in the first half of the menstrual cycle, depending upon the response. When the lead follicle/s measure at least 16-18mm in diameter, you will be injected with human chorionic gonadotropin (hCG) to trigger ovulation. At this juncture, intercourse or IUI can be performed. This fertility medication (hCG) can be used with both IUI and IVF.

Success rate of ovulation induction

Woman Expecting Baby Through Ovulation Induction - NU Fertility

The rate of success of OI depends on the woman’s diagnosis and other factors, particularly her age. Up to 20-25% of success rate of pregnancy per cycle can be achieved in young, healthy couples with no fertility issues. 

Keeping in mind the various advancements that have taken place in the field of fertility medicines, a couple need not lose hope of achieving pregnancy. With the right approach and medical aid, the dream of becoming parents can be fulfilled. Ovulation induction is the answer for many childless couples who are dealing with infertility issues.

NU Fertility @NU Hospitals offers the best treatments available to deal with infertility issues. It is the best ovulation induction fertility treatment hospital in Bangalore. The team of fertility experts here work day in and day out to help you achieve pregnancy at the earliest. As a couple who is facing fertility issues, you can visit NU fertility center and get yourself treated for the same. Giving a new lease of hope and life is the motto of NU Fertility @ NU Hospitals, Bangalore.



  1.   Ovulation induction. Northwestern Medicine.
  2.   Ovulation induction (OI). Stanford Medicine Children’s Health.
  3. Ovulation induction. Patient education. University of California San Francisco (UCSF Health).
  4. Ovulation Induction and Intrauterine Insemination. Yale Medicine.

Author: Dr. Sneha J

Couple Expecting Baby - NU Fertility

From Sudden Halt In Periods To Assured Pregnancy at NU Fertility

In this case study, we witness a case of a 33-year-old woman who despite having a birth defect, was still able to conceive. Surgical removal of the defect almost stopped her menstrual cycle. Later, she was counseled for fertility treatment and after undergoing it, she cherished the much-desired pregnancy.

Two years ago, 33-year-old Kavita (name changed for privacy) had undergone surgery for a septate uterus at another hospital.

A septate uterus is a layer of fibrous tissue splitting the uterine cavity into two halves. Some people are born with a septate uterus, and they may not know it until they undergo a test for infertility, frequent abortions, or occasionally while doing a caesarean section, as an incidental finding. This is a birth defect seen in 2-3% of women.

Impact of PCOS on Fertility

Uterine Septum Comparison - NU Fertility

Owing to this surgery, her menstrual bleeding declined drastically. Before surgery, there were 4-5 days of bleeding every month, which after surgery got reduced to only spotting on the first day of periods.

She explained this worrisome situation to Dr. Sneha, a Fertility Specialist at NU Fertility, Bengaluru, which stressed her out as she desired to become a parent. So, a diagnosis of “Asherman Syndrome” was made as it is seen in 2% of women after this kind of surgery.

Asherman Syndrome is a condition wherein dense adhesions inside the uterus cause decreased space and blood flow for the prospective fetus to grow.

Further, in view of the severely decreased sperm count in her husband (Oligoasthenoteratospermia), she was counselled for Intracytoplasmic Sperm Injection (ICSI) as well as In-vitro Fertilization (IVF).
Medications for stimulation of follicle growth in the ovaries were given, egg retrieval was done, and 6 good-quality embryos were frozen on day 4.

Soon, she had to undergo treatment for the adhesions in the uterus if IVF/ICSI had to work. She underwent hysteroscopy (introduction of a camera to inspect the inside of the uterus) and removal of adhesions inside in 2 sittings, 1 month apart.

The menstrual blood flow improved to 1-2 days of decreased flow in the subsequent cycle. She was happy that she was bleeding again during her cycle, though not like before.

Her embryo transfer was planned in a natural cycle after 5 months, giving adequate time for the uterus to heal to harbor a healthy pregnancy. The uterine lining was not adequate and embryo transfer had to be cancelled for two consecutive months.

We used the latest technique of injecting Platelet-rich plasma (PRP) into the uterine cavity to improve the uterine lining to house the embryo and allow its successful growth. PRP acts by increasing growth factors in the uterus. The uterine lining grew to 5mm which is still below the standard proposed- 7mm. After explaining the chances of embryo implantation, we transferred 2 embryos into the uterus.

Platelet Rich Plasma - NU Fertility

A good thick uterine lining is required for success in an IVF /ICSI cycle as this provides space and nutrition to the developing embryo.

The biggest surprise was when her pregnancy test turned positive. Scanning at 6 weeks showed that both the embryos implanted in the uterus, and one had a heartbeat too. The other fetus stopped growing, confirmed on the 8-week scan.

Subsequent follow-up sessions showed that she was 10 weeks pregnant with a normal-growing fetus inside.
If you have a septate uterus and you desire to have a baby, you should talk to your infertility specialist about the possible treatment options.

Having a septate uterus does not mean you cannot have a baby. It just means you may need some extra care and support along the way. With proper treatment and guidance, you can have a successful pregnancy and a healthy baby.

Key Takeaway:

  • Septate uterus is a congenital malformation that shows no symptoms most of the time. Further, it does not always have an effect on fertility.
  • However, if it causes hindrance to fertility or pregnancy, it may be surgically removed after a thorough diagnosis by a fertility doctor.
  • Septal resection is a commonly performed procedure with good results. About 60% of women conceive naturally after septal resection if this is the cause of infertility.
  • Complications can happen with any procedure in medicine, and there are ways to tackle them.
Woman Suffering Pelvic Pain - NU Fertility

PCOS and Fertility: Everything You Need to Know

Polycystic ovarian syndrome (PCOS) is a health condition that affects women of childbearing age. In this condition, the ovaries tend to produce excess androgens, a male sex hormone that is usually present in small amounts in women. The name, polycystic ovarian syndrome, describes numerous small cysts (fluid-filled sacs) in the ovaries. However, these are different from the other ovarian cysts which require surgery. PCOS can have an impact on a woman’s overall health as well as their physical appearance. Although common, PCOS is often a treatable condition.


Impact of PCOS on Fertility

Missed Period Marking on Calender - NU Fertility

Hormonal imbalances in women may result in excessive amounts of androgens, the formation of cysts in the ovaries, the thickening of the outer well of the ovaries, and insulin resistance. All these changes can interfere with the process of ovulation in women. One of the common signs to understand this is missed or irregular periods.

Signs and symptoms

Lady Squeezing her Pimples - NU Fertility
The symptoms of PCOS may include:

  • Missed or irregular periods
  • Infertility
  • Skin tags
  • Acne or oily skin
  • Ovaries that are large or have several cysts
  • Excess body hair (hirsutism)
  • Male pattern baldness or thinning of hair
  • Dark or thick skin patches at the back of the neck, in the armpits, and under the breast


Blood Samples for Testosterone Test - NU Fertility

The exact cause of PCOS still remains unclear. However, it has been shown that most women with PCOS have insulin resistance, which means their bodies cannot utilize insulin effectively. Accumulated insulin levels in the body lead to potential rise in androgen levels. Obesity can also raise insulin levels, worsening PCOS symptoms.


Ultrasound Examination of Women's Pelvic - NU Fertility

PCOS is diagnosed in the following ways:
To begin with, your healthcare provider will take your complete medical history along with your symptoms. Following that, you will have to undergo a thorough physical examination, especially of the pelvic region. This includes checking the reproductive organs closely.
A few additional tests may also be ordered to confirm the diagnosis. These include:
Pelvic ultrasound: This test creates images of blood arteries, tissues, and organs using sound waves and a computer. It examines the size of the ovaries as well as the presence of cysts in them. It also provides information on the thickness of the endometrium (inner lining of the uterus).
Blood tests: These tests provide information on the levels of androgen and other hormones in women. Additionally, it may provide information on blood glucose, cholesterol, and thyroid levels.


Woman Taking Pills for PCOS - NU Fertility

There is no treatment available for PCOS as such. However, the symptoms can be treated and managed well. Infertility treatment caused by PCOS involves correcting ovulation issues and tackling metabolic problems, such as insulin resistance. If you have a BMI of 30 or above, your healthcare professional may advise you to lose weight by adopting a healthy eating pattern and regular exercise.
If you don’t wish to become pregnant, hormonal birth control pills may be helpful. However, a few treatments that may help you ovulate and conceive include:
Medicines that stimulate ovulation (releasing an egg)
These medications work by stimulating the ovary to grow eggs. These are taken once a day for five days at the start of your menstrual cycle.
These drugs work quite effectively in helping women with PCOS to ovulate. However, these are started at the lowest possible dose and increased as needed, by your healthcare practitioner.
Insulin-sensitizing drugs
These medications are effective in women with insulin resistance – a condition where insulin fails to act in the body. These drugs aren’t first-line treatments for PCOS but can be used to encourage regular periods and ovulation. They may not be as effective as other treatments of PCOS in helping women to become pregnant but can stimulate ovulation.
Hormone injections
These are injectable hormones that facilitate ovarian stimulation and ovulation. This treatment may require frequent doctor visits to monitor your body’s response to the drug.
Surgery in the form of laparoscopic ovarian drilling is recommended for patients who do not respond to medications. Although rare, it may be an option.

Complications of PCOS
Depressed Woman Awaked at Night - NU Fertility
If left untreated, women with PCOS may be likely to develop serious health conditions such as

  • Type 2 diabetes mellitus
  • High blood pressure
  • Heart diseases
  • Sleep disorders
  • Depression and anxiety
  • Infertility
  • Uterine cancer

PCOS is a common hormonal problem in women of childbearing age these days. It affects the menstrual cycle and causes many symptoms. It is best to speak with a healthcare provider if you believe you are experiencing any PCOS-related symptoms. You can control the symptoms, reduce risk factors, and increase your chances of getting pregnant with the help of medical interventions and lifestyle modifications.
NU Hospitals located in Bangalore, India provides special effective treatment for PCOS by well-trained doctors to handle even the most delicate cases with expertise. If you are suffering from PCOS, or have any queries related to infertility, consult the specialist at NU Hospitals today!


1. PCOS and fertility. Tommy’s. Accessed on 28 September 2023.
2. Polycystic ovarian syndrome. OASH | Office on Women’s Health.,you%20can’t%20get%20pregnant. Accessed on 28 September 2023.
3. PCOS and pregnancy. Pregnancy birth & baby. Accessed on 28 September 2023.

Author: Dr. Sneha J

In Vitro Fertilization - NU Fertility

FAILED IVF: Reasons and What to Do Next?

In-vitro fertilization is the process of fertilization where an egg is combined with a sperm under in vitro or laboratory conditions. This technique is a boon for all those childless couples who have failed to conceive and give birth to a baby through the natural process. IVF is especially beneficial in case of PCOS, blocked uterine tubes, fibroids, endometriosis, low ovarian reserve, and poor egg or sperm health. However, sometimes this procedure may not work out as planned and result in a failed IVF.

Common reasons for IVF failure

Dressed Asian Women - NU Fertility

This section talks about the many reasons that can contribute to a failed IVF procedure. Each of these causes of failure are dealt with in detail as mentioned below:

  • Age of female:

Women above the age of 35 often find it difficult to conceive. The quality and quantity of the egg also deteriorate with advancing age, making your chances of becoming pregnant less. It is noted that live birth rates for IVF are only 40% for women above the age of 35 years.

  • Quality of embryo:

This is one of the leading causes of IVF failure. The embryos may appear to be healthy under laboratory conditions but they fail to get implanted into the uterus as they do not get the right environment to grow.

  • Ovarian response:

IVF treatment requires a woman to daily inject a fertility hormone called follicle stimulating hormone (FSH). This hormone is responsible for increasing egg production. Sometimes, the woman’s ovaries do not respond in the way expected and thus, fail to produce multiple eggs for collection. Older women are more prone to have this condition of low ovarian reserve.

  • Implantation failure:

If the egg fails to get implanted in the uterus, the IVF fails. Several reasons could contribute to the failure of implantation including a premature increase in progesterone levels, infection of the uterus, presence of uterine polyps, or an endometrial lining that is too thin.

  • Autoimmune disorders:

An autoimmune disorder can also cause the embryo implantation to fail as the antibodies may start attacking healthy cells or tissues. In the case of IVF (embryo implantation), the immune system may mistakenly recognize the embryo as invading tissues and attack it.

  • Chromosomal issues:

It is characterized by the presence of an extra or missing chromosome and is often, one of the major causes for IVF implantation failures. Women in their mid or late 30s are most likely to develop chromosomal abnormalities. Therefore, women who have had multiple implantation failures, are generally advised to undergo preimplantation genetic screening.

  • Sperm abnormality:

Any irregularity in the structure of the sperm will lead to an unfertilized egg as the sperm fails to penetrate the egg’s outer membrane. This results in the failure of the IVF procedure.

  • Lifestyle:

Unhealthy lifestyle practices such as smoking that fertility specialists advise to get rid of in case of natural pregnancies, also apply to women who undergo an IVF. Consumption of alcohol and having a bad nutritional diet are also contributing factors to multiple conception failures. IVF cycle outcomes can also be affected if the woman undergoing IVF is underweight or overweight.

After IVF failure: What next?

 In Vitro Fertilization Process - NU Fertility
If your first IVF cycle has failed, it may be useful to find out the reason behind its failure. It may have been due to the woman’s maternal age, cause and duration of infertility, history of previous pregnancies, male factor (sperm count and quality), and lifestyle influence. The younger the age of the woman, the greater is the possibility of an IVF to succeed. A woman in her 20s has 60-70% higher chances of conceiving in the very first in-vitro cycle. In case of a first-time IVF failure, your fertility specialist would generally recommend you to undergo another cycle because with every cycle, the chances of a woman to conceive become more.
In case of two failed in-vitro cycles, the couple needs to undergo another cycle, after determining the cause of failure during the previous two cycles. However, a third-time IVF failure can only mean an underlying condition that is disrupting the in-vitro implantation, leading to repeated failure. In such cases, it is advisable to opt for a more specific and advanced pregnancy treatment.

Advanced treatments after multiple IVF failures

Prefilled Pen Syringe - NU Fertility

Despite having recurrent IVF failures, there is still hope of conceiving with the other advanced treatment options now available. These pregnancy procedures can be carried out once your fertility specialist has analyzed your previous cycles to rule out the reason behind the IVF failure.

  • Frozen embryo transfer:

FET is a procedure in which healthy embryos (blastocysts) from a previous in-vitro cycle are frozen and preserved for use at a later time. This technique is fast gaining popularity over conventional in-vitro cycles.

  • Intracytoplasmic sperm injection:

Often abbreviated as ICSI, this is an advancement in the conventional IVF procedure. During this procedure, the egg is directly fertilized by injecting with a single live sperm. ICSI is a good option for couples where the male suffers from male factor infertility.

  • Intracytoplasmic morphologically-selected sperm injection:

IMSI is another advancement in the traditional IVF procedure. It is similar to ICSI except that in IMSI, the sperm is first analyzed under high magnification to select only the sperm which has the best morphology. This procedure is helpful in case the male partner’s sperm has quality issues.
Treatment of immunological causes of infertility before proceeding with the next cycle.
Preimplantation genetic testing of embryos for chromosomal abnormalities before embryo transfer.

With the latest medical advancements in the field of fertility treatment, it is now possible for a woman to conceive in spite of multiple IVF failures. However, it is important to let your fertility specialist run a battery of tests on you and your partner to ascertain the cause behind IVF failure. Your desire to become parents is no longer a dream!
NU Fertility at NU hospitals is the best place for IVF failure treatment in Bangalore, India. The fertility specialists here not only make it possible for you to conceive using IVF, but also rule out IVF failure reasons. Once the reason is known, they take you through the best possible treatment so that your wish of becoming a parent turns true. Visit NU Fertility in case you have any issues in conceiving through IVF as this is the best place for infertility treatment in Bangalore.

Diagnosis of vaginismus

Your healthcare provider will ask you questions about your symptoms, medical, and sexual history. A pelvic examination can help determine if there are any other issues or the presence of muscle spasms. A topical numbing cream may be applied on the outside of your vagina prior to the pelvic exam to reduce discomfort.



1. Failed IVF Cycles: Reasons, What to Do Next, and Tips for Success. Grace Fertility. Accessed on 5 October 2023.
2. IVF Failure- Why Did My IVF Fail? The Fertility Foundation. Accessed on 5 October 2023.
3. Weathering the Storm: What to Do After Your First Failed IVF-When and How to Try Again? India IVF. Accessed on 5 October 2023.
4. WHY DOES IVF FAIL? The Fertility & Gynaecology Academy. Accessed on 5 October 2023.

Author: Dr. Sneha J

Gynecologist Demonstrating Model of Female Reproductive System - NU Fertility

Vaginismus Treatment: All You Need to Know

Vaginismus refers to a condition when muscles around your vagina get tensed up or contract involuntarily. The vagina is a part of the female reproductive system and connects the lower part of the uterus (cervix) with the outside of your body. These involuntary muscle spasms happen when something like a penis, a finger, a tampon, or a medical instrument tries to penetrate your vagina. These spasms can be mild or very painful.

Vaginismus symptoms may appear during the late teen years or early adulthood, when a woman has sex for the first time. The condition can also happen the first time a woman tries to insert a tampon or has a pelvic exam at a healthcare provider’s office.
Some women develop vaginismus later in life. This can occur after years without any problems. Spasms or discomfort may occur anytime there’s vaginal penetration or they may happen at certain times, such as during sex or pelvic exams.

Vaginismus can lead to infertility and can have a negative impact on a woman’s sense of femininity, her ability to become pregnant, and on the maternal and fetal prognosis during pregnancy.

Causes of vaginismus

Depressed Sad Women - NU Fertility

Vaginismus is a condition that can lead to physical, psychological, relationship and sexual problems. The underlying cause of this condition is not fully understood. Vaginal pain can be exacerbated by bladder infections, urinary tract infections, and yeast infections.
A variety of factors may cause vaginismus, including:

  • Anxiety
  • Vaginal tears caused due to childbirth
  • Previous surgery
  • Fear of intercourse
  • Previous sexual abuse / unpleasant sexual experience

Signs and symptoms of vaginismus

Women Suffering from Pain - NU Fertility
Common symptoms of vaginismus include:

  • Pain or discomfort during vaginal penetration.
  • Inability to have sexual intercourse or pelvic examination due to vaginal muscle contractions or pain.
  • Pain during intercourse.

Diagnosis of vaginismus

Vaginal Examination Device - NU Fertility

Your healthcare provider will ask you questions about your symptoms, medical, and sexual history. A pelvic examination can help determine if there are any other issues or the presence of muscle spasms. A topical numbing cream may be applied on the outside of your vagina prior to the pelvic exam to reduce discomfort.

Management and treatment of vaginismus

Pelvic Floor Muscles Exercise - NU Fertility

The primary objective of vaginismus treatment is to reduce the reflex of the muscles that cause them to contract. Additionally, the treatment is designed to address the underlying fears or anxieties that may be contributing to the condition.
Your healthcare provider may suggest one or a combination of the following treatments:
1. Counselling:
Women participate in a limited number of counselling sessions, either alone or with a partner, in which they are provided with information on sexual disorders. Additionally, sessions are conducted in which doctors assist women in overcoming their psychological fear of vaginal penetration in order to better respond to it. Women are provided with comprehensive information on female anatomy, pelvic floor muscles, and sexual intercourse. Furthermore, patients are given insight into vaginismus and the treatment options available for them, based on the nature of the disorder. Husband/ male partner is also involved in the process.

2. Topical therapy:
The use of topical creams may be beneficial in relieving the symptoms of vaginismus.

3. Vaginal dilator therapy:
A vaginal dilator is a tube-shaped device that is available in a range of sizes. The primary purpose of a vaginal dilator is to relax the muscles around the vagina. Patients with vaginismus use a dilator to become more receptive and less sensitive to vaginal penetration. A local numbing cream may be applied to the external surface of the vagina prior to insertion of the vaginal dilator.

4. Kegel exercises:
Kegel exercises involve the contraction and relaxation of the pelvic floor muscles. These exercises are highly beneficial and in addition to the treatment of vaginismus, are also used to treat various other conditions, such as urinary incontinence. To perform this exercise, one must contract the muscles of the pelvic floor and release them repeatedly. Depending on the individual’s health, a doctor may recommend performing these exercises for a certain number of times daily.

5. Botox injections:
The use of Botox injections has been demonstrated to be a highly effective treatment for vaginismus. These injections have been found to reduce the intensity of the most painful spasms and their effects remain long-lasting, even after Botox has worn off.

6. Cognitive behavioural therapy (CBT):
The purpose of cognitive behavioural therapy (CBT) is to help understand how the thought processes influence one’s emotional state and behaviour. This therapy can be used to alleviate symptoms of anxiety, depression, and post-traumatic stress disorder (PTSD).

7. Relaxation techniques:
Relaxation techniques, such as breathing exercises and hypnosis, can also be employed to reduce stress and manage vaginismus.

8. Sex therapy:
Trained sex therapists assist individuals and couples in finding a sense of pleasure in their sexual relations.

If you’ve been diagnosed with or are experiencing symptoms of vaginismus, it is important to know what treatment options are available to help you manage the condition. Getting timely help to treat this condition can help you lead a more fulfilling life.

NU Fertility at NU Hospitals, based in Bangalore, provides modern treatment options for women suffering from The doctors at NU Fertility have many years of experience in the field of reproductive health and are trained to handle even the most sensitive cases with expertise and precision. If you’re suffering from vaginismus or have any questions regarding female reproductive health, get in touch with NU fertility specialists.

1. Vaginismus. NHS. Accessed on 4 October 2023.
2. Vaginismus. MedlinePlus. . Accessed on 4 October 2023.
3. Vaginismus. Cleveland Clinic. Accessed on 4 October 2023.
4. Vaginismus. Mount Sinai. Accessed on 4 October 2023.

Author: Dr. Sneha J

Depressed Woman Holding Pregnancy Test Kit - NU Fertility

5 Ways Laparoscopic Surgery Can Help with Infertility

Infertility is defined as the inability to conceive despite having one year of unprotected, regular intercourse. Women may face infertility issues due to various reasons, including ovulation disorders, tubal infections, cervical and uterine complications, and endometriosis. In males, it is predominantly due to decreased sperm count or motility. With timely diagnosis and treatment, there is hope for couples who have infertility issues to still conceive.

Causes of Female Infertility

1. Ovulation disorder: Certain ovulation disorders such as premature ovarian failure (ovaries stop working at age 40), polycystic ovary syndrome (PCOS), and thyroid disorders (underactive or overactive thyroid gland) inhibit the release of egg in some women while in others, ovulation may not occur in every cycle, lowering the chances of conception.
2. Endometriosis: A medical condition in which the inner lining (tissue) of the womb starts growing in other parts (e.g. ovaries/ abdomen wall), causing damage.
3. Scarring due to surgery: Sometimes, the uterus and fallopian tubes can get damaged and scarred after pelvic or cervical surgery.
4. Fibroids: These are non-cancerous growths that prevent the attachment of the fertilized egg in the womb by altering the structure and blood flow in the uterus.
5. Pelvic inflammatory disease (PID): This is a bacterial infection of the upper genital tract in females that can damage and scar the fallopian tubes.

Cause of Male Infertility

Doctor Hand Reassuring Male Patient - NU Fertility
Male factor infertility is the leading cause of infertility in males. Men with male factor suffer from:

  • Low sperm count
  • Low sperm motility
  • Obstruction in the tubes which transit the sperms to the outside
  • Testicle disorders arising due to infection, cancer, or surgery
  • Ejaculation disorders that restrict semen release


Diagnosis of Female Infertility

Diagnosis of Female Infertility - NU Fertility

The normal process of fertilization involves the release of healthy eggs from the ovaries, which pass into the fallopian tubes to fertilize with the sperm. The fertilized egg must then travel and attach itself to the uterus (implantation). Diagnosis of female infertility includes trying to find out problems in any of these steps of fertilization.

One prominent method of infertility testing in women is called laparoscopy. Laparoscopy has become an integral part of gynecologic surgery as it helps in the diagnosis and treatment of various abdominal and pelvic disorders of the female reproductive system. In this procedure, a small incision is made around the navel, through which a thin, viewing device is inserted to examine the fallopian tubes, ovaries, and uterus. This procedure is helpful in ruling out endometriosis, scarring, blockages, or other problems with the fallopian tubes. It may also be useful in detecting issues with the ovaries and uterus. With the help of laparoscopy, certain infertility conditions can also be treated. For instance, it can remove growths called fibroids or endometriosis tissue.

5 Ways Laparoscopic Surgery is Useful in Infertility

 Laparoscopic Instruments - NU Fertility

1. Easy identification of abnormalities: While there are other indirect methods of diagnosis of fibroids and endometriosis, laparoscopy is the only sure way of direct visualization of internal structures to confirm the presence of these abnormalities. Mild endometriosis and scarring in the uterus can be diagnosed with the help of laparoscopy.
2. Diagnosis of blockage or scarring of the fallopian tubes: Both blockage and scarring of the fallopian tubes are hard to diagnose and treat using other methods of diagnosis. With the help of a laparoscope, your healthcare provider can view and rectify these abnormalities to increase the chances of conception.
3. Detection of pelvic pathologies: Sometimes, pelvic pathologies go unnoticed, causing repeated in vitro fertilization failures. The answer to these problems lies in laparoscopy, which helps detect and treat these pathologies and enhances conception.
4. Removal of pelvic adhesions and endometrial tissue: With the help of laparoscopic surgery, pelvic adhesions and endometrial tissue can be removed. Once this is done, the chances of a natural way of conception are increased. Any unexplained causes of infertility can be determined using laparoscopy.
5. Less invasive and technologically improved method: Laparoscopy is a minimally invasive procedure when compared to conventional open surgery. Not only does the person get discharged within a day to resume her normal, daily activities, but it is also a less painful procedure, with minimal blood loss due to a smaller incision.

Keeping the above-mentioned benefits of laparoscopy in mind, more and more women are opting for it as the choice for diagnosis of infertility in them. The results of a laparoscopy performed for infertility testing usually show abnormalities such as blocked fallopian tubes, endometriosis, adhesions, fibroids, and cysts. Most of these conditions can be corrected during the same procedure. Laparoscopy is a boon for finding out the cause and treating infertility problems in females, giving hope of a new life to many!

Among the infertility treatment hospitals in Bangalore, a name that stands out is that of NU hospitals. In recent times, this institution has witnessed numerous laparoscopic procedures because of the technological improvements in instrumentation. The doctors here are adept at performing laparoscopy to help in the management of infertility issues of all the women who come here as a last resort and go back with a new lease of life! Visit NU hospitals today to allay all your fears of conception.

1. Infertility. Mayo Clinic. 54322 . Accessed on 28 September 2023.
2. Role of laparoscopic surgery in infertility. Middle East Fertility Society Journal. Berker et al . . Accessed on 28 September 2023.
3. Role of laparoscopy in treating infertility. MAX Healthcare. . Accessed on 28 September 2023.

Author : Dr. Sneha J

Nitrogen Bank Containing Sperm - NU Fertility

Social Egg Freezing: Benefits, Risks, and Other Considerations

What is social egg freezing?

 Happy Pregnant Woman - NU Fertility
Social egg freezing is the process of obtaining the eggs of a healthy and fertile woman, followed by the freezing and preservation of these eggs to have a pregnancy later on in life, typically after 35 years when fertility potential decreases. Ideally, it is performed on women aged 25 to 35 to increase the likelihood of a future pregnancy. Egg freezing can be performed using slow-frozen or flash-frozen protocols; however, the latter method has been found to enhance oocyte survival after thawing and has been associated with an increase in pregnancy rates. It is, therefore, the recommended method of egg freezing as certified by the medical associations.

Suitable candidates for egg freezing

Women Working on Laptop - NU Fertility
If you’re a woman between the age of 25 and 35 who wants to start a family but can’t do it right now, egg freezing might be a good option for you. If you’re undergoing any invasive treatments, such as chemotherapy, that can reduce the fertility of your eggs, egg freezing might be the best option. It’s also a good option for women whose ovaries have been removed or other diseases have affected their reproductive health.

Benefits of social egg freezing

Women Working on Laptop - NU Fertility

    The process of social egg freezing followed by IVF and embryo transfer provides significant advantages for women who expect to become pregnant in their later years of life. These include:

  • Fertility preservation: By freezing eggs, individuals can increase their chances of conceiving a healthy baby in the future and provide them with the possibility of becoming a genetic parent.
  • Giving birth to a healthy child: The earlier eggs are retrieved, particularly up to 35 years of age, the greater the likelihood of the fertilised egg developing into a healthy embryo, thus reducing the risk of chromosomal abnormalities.
  • Peace of mind: Egg freezing is not a guarantee of future pregnancy, but it significantly increases your chances of becoming pregnant in the later stages of life, ensuring peace of mind.
  • Preventive step: Egg freezing can also be used as a preventative measure before an invasive treatment or operation, allowing individuals to prepare for assisted reproduction treatments in the event of a natural conception being compromised.

Risks associated with social egg freezing

Pregnant Women Monitor Blood Pressure - NU Fertility
It is important to know about the health risks associated with ovarian stimulation or egg retrieval. Ovarian hyperstimulation syndrome may be the most significant medical risk associated with egg freezing. Mild to moderate ovarian hyperstimulation symptoms may include tiredness, nausea, headache, abdominal discomfort, tenderness, and irritability. These side effects are usually managed conservatively. Ovarian hyperstimulation syndrome can be prevented by careful monitoring of the egg stimulation cycle and when done by experienced specialists.
Women who attempt to conceive through the use of their frozen-thawed eggs usually have healthy children. The risk of abnormality in the baby is almost similar to a child conceived naturally.

Societal implications of social egg freezing

 Egg Freezing - NU Fertility
The increased visibility of social egg freezing in the media may lead to an increase in the number of young women opting to freeze their eggs to secure the possibility of having a genetically related child.
Social egg freezing is often presented as a ‘back-up’ that provides young fertile women with the opportunity to pursue long-term relationships, finish their education, become financially secure, or progress in their careers without worrying about their fertility in the future. This can have a significant impact on the way some women think about their reproductive choices.
Changing the way women are seen in society requires a strategic shift in mindset to reduce the negative consequences. It takes a collective braided effort from all sides of society to make a big change, and social egg-freezing is one way to do that.

NU Fertility at NU Hospitals, Bangalore, India offers the best fertility treatment. We provide a wide range of fertility treatments including egg freezing, which is the process of harvesting a woman’s eggs and freezing them so that they can be used to become pregnant in the future. If you are planning to freeze your eggs or harvest them, please get in touch with our experienced fertility specialists. We offer affordable egg-freezing and fertility treatments and ensure complete privacy and confidentiality.

1. Social egg freezing. National Health Library.
Accessed on 4 October 2023.
2. Social egg freezing. National Health Library. Accessed on 4 October 2023.
3. Is egg freezing right for you? Yale Medicine.
Accessed on 4 October 2023.
4. Social egg freezing. BC Medical Journal.
. Accessed on 4 October 2023.

Author: Dr. Sneha J

5 Things You Need to Know About Endometriosis and Infertility

 Anatomy of Endometriosis Disease in Female Infertility - NU Fertility

Endometriosis is derived from the word “endometrium,” which is the uterine tissue. Endometriosis is a disorder in which tissue that resembles the lining of the uterus from the inside develops on the outside. Endometriosis causes the tissue lining the inside of the uterus to thicken, break down, and bleed during each period. However, new tissue growth on the uterine wall may retain blood, resulting in painful periods and pain while having intercourse. Therefore, endometriosis makes it harder for a woman to conceive.

Signs and symptoms of endometriosis:

 Woman suffering from Menstrual Cramps - NU Fertility

Endometriosis has a range of varied symptoms. These include:
● Long, heavy, and painful periods
● Difficulty conceiving a baby
● Pain during or after intercourse
● Pelvic pain
● Painful bowel movements
● Pain during urination
● Unexplained tiredness

Endometriosis and Fertility

Endometriosis in Infertility - NU Fertility

Endometriosis is linked to infertility in women. It is evaluated through the following stages:

Stage 1:

endometriosis (minimal): There are a few tiny endometriosis implants present, but no scar tissue.

Stage 2:

endometriosis (mild): There are more endometriosis implants present, but no scar tissue.

Stage 3:

endometriosis (moderate disease): It is characterized by the presence of extensive endometriosis in the abdomen, which may be deep and cause cysts in the ovaries. Scar tissue around the tubes or the ovaries may be present.

Stage 4:

endometriosis (severe): Large endometriotic cysts in the ovaries are observed, as well as probable scar tissue between the uterus and the rectum, around the ovaries or the fallopian tube.
Here are 5 things you should know about endometriosis

Things You Should Know About Endometriosis - NU Fertility

1. Endometriosis is not similar to infertility

Endometriosis may increase the risk of infertility due to several reasons. But, it is not in itself similar to infertility. Most of the time, AMH (anti-Müllerian hormone) levels due to endometriosis are linked with infertility. However, AMH is more of a marker of egg quantity rather than egg quality. For infertility, in addition to AMH levels, it is required to consider other hormone levels, regularity of periods, and age.

2. Women in their 30’s and 40’s are most likely to have it

Endometriosis can manifest itself as early as a girl’s first menstrual cycle, but it is most frequently seen between the ages of 30 and 40. Although the exact cause is unknown, the most likely variables are late pregnancies, menstrual periods lasting more than 7 days, or menstrual cycles shorter than 27 days. There could also be a family link through moms, sisters, or even aunts.

3. Egg freezing might be a good idea

Women who are not ready to have a baby in their early reproductive years can choose to freeze their eggs for future use. It is ideal to freeze your eggs in your 20s or before the age of 35. Freezing eggs at this age may provide the best quality of eggs. Having healthy eggs in a bank can increase your chances of conceiving through in vitro fertilization (IVF) if you ever need a baby.

4. Getting pregnant will not cure endometriosis

It is a common misconception that childbearing will treat endometriosis. Endometriosis is an oestrogen-dependent disorder. Progesterone levels rise during pregnancy, which helps improve endometriosis symptoms. Though the symptoms of endometriosis improve with this, it may not cure the disease. Exclusive breastfeeding may also relieve symptoms because it lowers oestrogen and progesterone levels in the body. The symptoms may reappear once the pregnancy or the breastfeeding is over if endometriosis is left undiagnosed and untreated.

5. Right treatment could preserve or even restore fertility

Endometriosis affects no two women in the same way. As a result, while recommending fertility treatment, it is critical to individualize the treatment method. Before beginning any treatment, a full fertility assessment is performed to obtain the
majority of the data and a clear image of how endometriosis is interfering with the woman’s ability to conceive. Intrauterine insemination (IU) may be an option if the disease is mild. However, in some instances, women may be recommended to try IVF (in-vitro fertilization). If the endometriosis is severe and has adversely destroyed the ovaries due to presence of ovarian cysts or surgery for treating ovarian cysts , impacting ovarian reserve and egg quality, donor eggs may provide you with the best chance of conceiving a child.
If you are diagnosed with endometriosis or experiencing symptoms of endometriosis, and finding it difficult to conceive a child, it is better to know the options available that could help you overcome the condition.
NU Hospitals, based in Bangalore, offers modern treatment options to women suffering from endometriosis and infertility. The doctors at NU Hospitals have years of experience treating women’s reproductive health issues and are well-trained to manage even the most delicate cases with expertise. If you are suffering from endometriosis or have any queries related to women’s reproductive health, consult the specialists at NU hospitals today!


1. 5 Things You Need to Know About Endometriosis. McLeod Health.

5 Things You Need to Know About Endometriosis

. Accessed on 29 September 2023.

2. Endometriosis and Infertility. Brigham and Women’s Health. etriosis/endometriosis-and-fertility

. Accessed on 29 September 2023.

3. 5 Things You Need to Know About Endometriosis. Mather Hospital Northwell Health.

5 things you need to know about Endometriosis

. Accessed on 29 September 2023.

4. Endometriosis. Johns Hopkins Medicine.

. Accessed on 29 September 2023.


Author : Dr. Sneha J