Infertility is clinically defined as the failure to achieve a clinical pregnancy after 12 months of regular, unprotected sexual intercourse for couples where the woman is under 35 years of age. For women aged 35 years and older, the threshold is reduced to 6 months before formal evaluation is recommended. Secondary infertility refers to the same difficulty occurring in a couple who have previously achieved at least one pregnancy. Infertility is a medical diagnosis, not a personal failing, and the majority of cases have identifiable causes that respond well to appropriate treatment.

Infertility affects approximately 10 to 15 percent of married couples in India, making it one of the most prevalent conditions in reproductive health. Studies suggest that between 27 and 30 million infertile couples exist in India, with the actual number likely higher due to widespread underreporting driven by social stigma. Globally, the World Health Organisation estimates that approximately one in six couples of reproductive age experiences infertility at some point in their lives.

No. This is one of the most damaging and persistent myths about infertility. Medical evidence is very clear that infertility is attributable to female factors in approximately 40 percent of cases, to male factors in approximately 40 percent of cases, and to a combination of both or unexplained causes in the remaining 20 percent. Despite this, in Indian medical practice, the female partner is frequently the only one investigated — leading to years of treatment directed at the wrong person. Dr. Krishnakumar evaluates both partners comprehensively from the outset of every couple’s investigation.

The decision about when to seek specialist evaluation depends on the woman’s age and whether there are known risk factors for infertility. For women under 35 with no known fertility risk factors, specialists generally recommend seeking evaluation after 12 months of trying without success. For women aged 35 to 39, the recommended threshold is 6 months. For women aged 40 and above, evaluation should be sought immediately, without waiting. Additionally, any of the following should prompt immediate evaluation regardless of age or duration of trying: irregular or absent periods, a known diagnosis of PCOS, endometriosis, fibroids, or thyroid disorder, two or more previous pregnancy losses, a history of pelvic infection or surgery, or a previous abnormal semen analysis in the male partner.

The relationship between psychological stress and fertility is genuinely complex and remains an area of active research. Acute, severe stress can temporarily disrupt ovulation by affecting hypothalamic-pituitary signalling. Chronic severe stress may also affect sperm parameters. However, the evidence does not support the idea that normal everyday stress or emotional worry — however significant it may feel — is a primary cause of infertility. Many couples who conceive naturally were under enormous stress throughout their trying period, and many couples in the most serene circumstances experience infertility with clear biological causes. The advice to ‘relax and it will happen’ is well-intentioned but medically inaccurate and can cause unnecessary guilt. Infertility has real biological causes that deserve real medical evaluation.

Unexplained infertility is a diagnosis of exclusion — it means that the standard investigation protocol (semen analysis, hormonal profile, ovulation assessment, uterine and tubal evaluation) has not identified a specific cause for the failure to conceive. It is diagnosed in approximately 15 to 25 percent of infertile couples. The term ‘unexplained’ does not mean ‘untreatable’ — couples with unexplained infertility have meaningful success rates with IUI and IVF. It does reflect the current limitations of available investigations in detecting all possible contributing factors. More advanced investigations — endometrial biopsy for receptivity, sperm DNA fragmentation testing, hysteroscopy — may reveal additional information in some couples with unexplained infertility.

IVF — in vitro fertilisation — involves several distinct phases. Ovarian stimulation uses injectable hormonal medications to encourage the ovaries to produce multiple follicles simultaneously, monitored by ultrasound and blood tests. Egg retrieval is performed under light sedation when follicles are mature, using ultrasound-guided aspiration through the vaginal wall. In the laboratory, the retrieved eggs are fertilised with the partner’s prepared sperm — either by conventional insemination or by ICSI (injection of a single sperm directly into each egg). Embryos are cultured for 5 to 6 days to blastocyst stage. The best-quality embryo is then transferred into the uterus through the cervix — a brief, painless procedure. Two weeks later, a blood pregnancy test is performed.

A fresh IVF cycle — from the start of ovarian stimulation to the embryo transfer — takes approximately 4 to 6 weeks. The stimulation phase typically runs for 10 to 14 days. The egg retrieval and subsequent embryo culture to blastocyst stage add another 5 to 6 days. After transfer, the 14-day wait until the pregnancy test completes the cycle. If good-quality embryos are frozen for a frozen embryo transfer (FET) cycle rather than a fresh transfer, the FET cycle itself typically takes 3 to 4 weeks from cycle start to transfer.

For most patients, IVF is significantly less uncomfortable than anticipated. The injectable stimulation medications are subcutaneous injections that most patients learn to self-administer — they feel like a small pinch. The egg retrieval is performed under intravenous sedation, so the patient is not aware of the procedure during it. Afterwards, mild abdominal cramping and bloating similar to period symptoms are common for a day or two. Embryo transfer is performed without sedation and is described by most patients as similar to or slightly more uncomfortable than a routine cervical smear. The two-week wait after transfer is often described as emotionally the most difficult part.

In conventional IVF, eggs and sperm are mixed together in a dish in the laboratory and fertilisation occurs naturally — sperm must swim to and penetrate the egg independently. In ICSI (intracytoplasmic sperm injection), the embryologist selects a single normal-looking sperm and injects it directly into the egg using a fine glass needle under a high-powered microscope. ICSI is used when sperm count is very low, when motility is severely reduced, when sperm have been surgically retrieved, or when previous IVF cycles have resulted in poor fertilisation. For most couples with normal sperm parameters, the pregnancy rates from conventional IVF and ICSI are equivalent.

There is no single answer because the number of viable eggs needed depends on the woman’s age, quality, and individual circumstances. Generally, retrieving 8 to 15 eggs would typically yield a good number of blastocysts for transfer and freezing. For a woman over 40, fewer eggs may be retrieved and the proportion developing to blastocyst stage may be lower. Dr. Krishnakumar will give each patient a personalised assessment based on her individual ovarian reserve parameters.

Surplus high-quality embryos are vitrified — flash-frozen using modern vitrification technology — and stored in the embryology laboratory at cryogenic temperatures. Vitrified embryos have a survival rate of greater than 95 percent on thawing and can be stored for several years. Frozen embryo transfer (FET) cycles allow couples to use their stored embryos in future treatment cycles, extending the value of a single egg retrieval.

A blastocyst is an embryo that has been cultured in the laboratory for 5 to 6 days. Blastocysts have a significantly higher implantation potential than cleavage-stage embryos (Day 2-3), and culturing to blastocyst allows the embryologist to select the best embryo from among those available, following contemporary standards in IVF practice.

PGT-A — Preimplantation Genetic Testing for Aneuploidies — is a technique in which a few cells are biopsied from the blastocyst and tested for chromosomal normality before transfer. It significantly improves the probability of successful implantation and reduces miscarriage rates. It is recommended for women over 37, for couples with recurrent miscarriage, and for those who have experienced multiple failed embryo transfers.

There is no universally correct answer. Multiple clinical variables determine when it is appropriate to pursue further cycles — including age, ovarian reserve, diagnosis, and quality of embryos. Dr. Krishnakumar believes each failed cycle is an opportunity to learn and adjust the protocol, and he does not close cases until every reasonable option has been considered.

Yes, most patients continue working normally. The stimulation phase requires morning monitoring appointments every 2-3 days, which most find compatible with a working schedule. The retrieval procedure requires one day off work. After embryo transfer, there is no medical requirement for bed rest — patients can resume normal light activity, though strenuous exercise is avoided during the two-week wait.

ECRES stands for European Certificate in Reproductive Endoscopic Surgery. It is awarded by ESHRE to surgeons who have demonstrated competence against rigorous international standards. Dr. Krishnakumar is the first and only Indian physician to hold this certification. For patients needing complex pelvic surgery, this certification is the most meaningful evidence of surgical excellence available.

NABH — the National Accreditation Board for Hospitals and Healthcare Providers — is the premier hospital accreditation body in India. It requires a hospital to demonstrate sustained compliance with standards covering all aspects of clinical and administrative quality. JK Women Hospital’s NABH status is an independently verified quality certification — not a marketing claim.

Every new patient consultation, monitoring scan, protocol decision, and surgical procedure is conducted by Dr. Krishnakumar personally. This is the standard of care at our clinic. You see Dr. Krishnakumar. Every time.

The clinic team communicates in English, Hindi, and Marathi. Medical information and treatment documentation can be provided in English or Hindi as preferred. For international or NRI patients, English is the primary language of communication.

Yes. Video consultations are available for NRI patients globally and patients outside Mumbai. Reports can be shared in advance by WhatsApp or email. Video consultations allow for detailed history-taking and diagnostic review before an in-person visit.

Yes, many women with PCOS conceive naturally, particularly those who ovulate semi-regularly. If ovulation is absent, ovulation induction is a highly effective first-line fertility treatment. The vast majority of women with PCOS who want to conceive ultimately do so, though some will require medical assistance.

No. While endometriosis can impair fertility, many women with mild to moderate stages conceive naturally. For others, laparoscopic surgical excision and IVF offer meaningful chances of pregnancy. The critical factor is seeking specialist evaluation early and being treated by a surgeon with advanced laparoscopic skills.

In many cases, yes. In obstructive azoospermia, sperm production is normal but blocked; surgical sperm retrieval (TESA/PESA) followed by ICSI has excellent success rates. In non-obstructive cases, micro-TESE can often recover sperm. Even in the most difficult cases, donor sperm remains an option.

An abnormal Pap smear does not mean you have cancer. Most results reflect precancerous changes that can be treated before they progress. The next step is typically a colposcopy (examination under magnification). Even high-grade changes are effectively treated with LEEP or cone biopsy, with cure rates exceeding 95%.

Asherman’s syndrome is the formation of intrauterine adhesions (scar tissue), often following a D&C or infection. It can cause light periods and infertility. Treatment involves hysteroscopic lysis — divisions of the adhesions under direct vision — which restores the normal cavity in most cases.

POI is the cessation of normal ovarian function before age 40. While conception with own eggs is difficult, Donor Egg IVF is the most effective treatment and offers very high success rates. Dr. Krishnakumar provides comprehensive care for both the fertility and hormonal health implications of POI.

We operate on a transparent pricing policy. A written cost estimate covering consultations, scans, labs, medication, and the procedure is provided at the first consultation. There are no hidden charges. Costs vary by complexity, so please contact the clinic at +91 7045947047 for an accurate estimate.

Yes. The clinic offers instalment arrangements and EMI options for IVF treatment cycles. Details are discussed during the consultation with our billing team to ensure that financial considerations do not prevent access to care.

Coverage varies significantly between policies. Some cover investigations and medications, while others may cover the procedure itself under updated IRDAI guidelines. Our billing team will assist in reviewing your policy and facilitating the TPA process for eligible claims.

Appointments are typically available within a few days to a week. Urgent cases — including women over 40 or those seeking oncofertility consultation before cancer treatment — are prioritised and scheduled as quickly as possible. Call +91 7045947047 to book.

Yes, and it is encouraged. Sharing previous reports via WhatsApp (+91 98200 67318) or email before the consultation allows Dr. Krishnakumar to review them in advance, leading to a more substantive discussion during your appointment.

JK Women Hospital (Dombivli): Mon-Sat, 9:00 AM to 7:00 PM. Fortis Hospital (Kalyan): Selected days (please confirm when booking). Emergency contact is available for established patients.

Yes. Injectable gonadotropins are synthetic versions of natural hormones and have an extensive safety record. The primary risk is OHSS, which is mitigated at our clinic through carefully personalised stimulation protocols and continuous monitoring.

OHSS (Ovarian Hyperstimulation Syndrome) occurs when ovaries over-respond to stimulation. Prevention includes lower stimulation doses for high-risk patients (like those with PCOS), regular monitoring, and “freeze-all” strategies if over-response is detected. Dr. Krishnakumar applies these strategies systematically.

Decades of research have not established a causal relationship between fertility medications and cancer. Current evidence does not support an increased risk of ovarian, breast, or other cancers from IVF stimulation itself.

Once established, an IVF pregnancy is managed the same as a natural one. IVF pregnancies are often monitored more closely in the early weeks due to the clinical history involved. Babies born through IVF have health outcomes equivalent to those naturally conceived.

Miscarriage rates after IVF reflect maternal age and embryo quality rather than the process itself. PGT-A significantly reduces this risk by ensuring only chromosomally normal embryos are transferred.

We follow the international standard of elective single embryo transfer (eSET) wherever possible. This reduces the twin rate to approximately 1-2%, comparable to natural rates, while maintaining high overall success rates.

It means your specific situation requires more careful monitoring and proactive management to address potential complications early. It does not mean something will go wrong; rather, it ensures you receive the specialised support needed for a safe delivery.

Management includes dietary modification, blood glucose monitoring, and tracking fetal growth with serial scans. If diet alone is insufficient, metformin or insulin is used to ensure blood sugar remains in a safe range for mother and baby.

Pre-eclampsia is new-onset high blood pressure after 20 weeks. Management involves close monitoring, blood pressure medication, and corticosteroids if preterm delivery is likely. Deciding the timing of delivery is a complex judgement call that benefits from Dr. KK’s extensive experience.

Keyhole surgery performed through small incisions (5-10mm). Benefits include significantly reduced pain, shorter hospital stays (often 1-2 nights), faster return to daily activities, and minimal scarring compared to open surgery.

Most return to light activity in 2-3 days and normal activities in 1-2 weeks. Complex procedures (like large fibroid removal) may take up to 3 weeks. Dr. Krishnakumar provides tailored recovery guidance for every patient.

Diagnostic hysteroscopy can often be performed under local anaesthesia or light sedation. Operative hysteroscopy (removing polyps or septa) typically requires general anaesthesia to ensure complete comfort. Dr. Krishnakumar will advise on the best option for your case.

This is likely perimenopause — the transition phase where ovaries produce less oestrogen. It can last several years before menopause occurs. Symptoms often include hot flushes, sleep disruption, and mood changes. A consultation can confirm this and discuss management options.

Current evidence shows HRT is safe and effective for most healthy women under 60 within 10 years of menopause. Modern transdermal preparations have a very favourable risk profile and significantly improve quality of life and bone health.

If periods interfere with your quality of life, require frequent pad changes, involve blood clots, or are not controlled by over-the-counter pain relief, you should see a specialist. These symptoms have treatable causes and should not be endured.