Fertility Procedures, Step-by-Step
Dr. Sharvari Mundhe
Medical Director
A walk-through of common fertility procedures — from ovulation induction and IUI to IVF, ICSI, FET, ERA, and surgical investigations.
Treatment is chosen based on diagnosis, age, and response. Here is what the common procedures actually involve, step by step.
Ovulation Induction (OI)
Who needs it?
Women who do not ovulate regularly (e.g., PCOS).
Steps
- 1Baseline ultrasound on Day 2–3 of cycle
- 2Fertility medications to stimulate egg growth
- 3Ultrasound monitoring to track follicle development
- 4Trigger injection when the follicle is mature
- 5Timed intercourse
This is usually the first-line treatment in selected patients.
IUI (Intrauterine Insemination)
Who needs it?
Mild male factor, unexplained infertility, ovulation issues.
Steps
- 1Cycle monitoring with medication (natural or stimulated cycle)
- 2Trigger injection to time ovulation
- 3Semen sample collection on procedure day
- 4Sperm processing in the lab
- 5Placement of prepared sperm directly into the uterus
- 6Pregnancy test after 14 days
The procedure is quick, simple, and usually painless.
IVF (In Vitro Fertilization)
Who needs it?
Blocked tubes, severe male factor, low ovarian reserve, failed previous treatments.
Steps
- 1Ovarian stimulation injections (8–12 days)
- 2Regular ultrasound and hormone monitoring
- 3Trigger injection for final egg maturation
- 4Egg retrieval (OPU) under short anesthesia
- 5Fertilization in the laboratory (IVF or ICSI)
- 6Embryo development (3–5 days)
- 7Embryo transfer into the uterus
- 8Pregnancy test after 12–14 days
ICSI (Advanced IVF Technique)
Used in severe male factor.
Additional step
A single sperm is injected directly into each egg in the laboratory to improve fertilization.
Frozen Embryo Transfer (FET)
If embryos are frozen:
- 1Prepare the uterine lining with medications
- 2Monitor endometrial thickness
- 3Thaw embryo
- 4Transfer into uterus
- 5Pregnancy test after 12–14 days
ERA (Endometrial Receptivity Analysis)
What is it?
ERA is a specialized test used to determine the optimal timing for embryo transfer in IVF.
Who may need it?
- Recurrent implantation failure
- Multiple failed IVF cycles despite good-quality embryos
How it works
- 1The uterus is prepared as in a mock embryo transfer cycle
- 2A small endometrial biopsy is taken
- 3The sample is analyzed to determine the window of implantation
- 4Future embryo transfer is timed accordingly
ERA is not required for every patient — it is advised selectively.
Hysteroscopy
What is it?
A minor procedure where a thin camera is inserted through the cervix to visualize the inside of the uterus.
Why is it done?
- To detect polyps, fibroids, septum, adhesions
- Recurrent miscarriage
- Repeated implantation failure
- Abnormal ultrasound findings
Procedure
- Usually day-care
- Short anesthesia
- Can be diagnostic or operative (if correction is needed)
It helps ensure the uterine cavity is optimal for implantation.
Laparoscopy
What is it?
A minimally invasive surgical procedure done through small abdominal incisions to examine pelvic organs.
Why is it done?
- Suspected endometriosis
- Blocked fallopian tubes
- Severe pelvic pain
- Adhesions
It allows both diagnosis and treatment in the same sitting.
About Dr. Sharvari Mundhe
Consultant – Gynaecology & Reproductive Medicine with over 12+ Years of experience. She believes in a patient-first approach, combining compassionate care with scientific excellence.
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