IVF and IUI in India: what each involves, what it costs, and how to choose a clinic

IUI: what it is and who it suits

Intrauterine insemination: the man's semen is washed and concentrated in the laboratory, and the best-moving sperm are placed directly into the uterus around ovulation, usually with tablets or injections to stimulate the ovaries and a scan to time it.

It suits: mild male-factor problems, unexplained subfertility, cervical problems, and couples using donor sperm. It requires at least one open fallopian tube and reasonable sperm numbers.

Success is modest — commonly in the range of 10 to 15 per cent per cycle, falling with age — and most clinics reassess after three or four cycles. It is far cheaper than IVF, which is why it is usually tried first where it is appropriate.

IVF and ICSI: the process

Roughly two to three weeks of hormone injections to grow multiple follicles, monitored by scans and blood tests; a trigger injection; egg collection under sedation through the vagina; fertilisation in the laboratory — either by mixing with sperm (IVF) or injecting a single sperm into each egg (ICSI, used for male-factor problems); embryo culture for three to five days; and transfer of one embryo (sometimes two) into the uterus, with any remaining embryos frozen.

Then a two-week wait and a blood pregnancy test. Fresh transfer or frozen transfer in a later cycle are both routine, and frozen transfers now often give equal or better results.

The main risks: ovarian hyperstimulation syndrome (largely preventable with modern protocols but occasionally serious), multiple pregnancy if more than one embryo is transferred — which is why single-embryo transfer is increasingly standard — and the emotional and financial toll of repeated cycles.

Success rates, cost and the law

Success depends overwhelmingly on the woman's age and the cause. Clinics quote widely varying figures, and the number that matters is live births per embryo transfer for women of your age at that clinic — not 'success rate', which can quietly mean positive pregnancy tests including those that later miscarry.

Cost in India varies by city and clinic: an IUI cycle typically runs into the tens of thousands of rupees, and an IVF cycle commonly runs from around one and a half to three lakh rupees or more, with medicines, ICSI, freezing and storage often charged separately. Ask for an itemised quote and what is excluded.

The ART (Regulation) Act 2021 and the Surrogacy (Regulation) Act 2021 govern this sector: clinics and banks must be registered on the national registry, records must be maintained, donor gametes are regulated, commercial surrogacy is banned (altruistic surrogacy is permitted under strict conditions), and age limits apply — broadly up to 50 for women and 55 for men.

Sex selection is a separate criminal offence under the PCPNDT Act. Any clinic that hints at gender selection is committing a crime, and the correct response is to leave.

Choosing a clinic and protecting yourselves

Ask: are you registered under the ART Act, and what is your registration number? What are your live-birth rates per transfer for my age group? What exactly does the quoted package include and exclude? How many cycles do you suggest before we reassess? Who performs the procedures, and is the embryologist full-time? Can I see the consent forms and the record of my embryos?

Warning signs: guarantees of success, pressure to start IVF before basic tests including a semen analysis, refusal to give written costs, packages sold on the phone, and any suggestion of sex selection.

Protect the finances: agree a limit as a couple before starting, in writing to each other if necessary. Loans taken for repeated cycles are a common and quiet source of long-term family debt in India. Some employer insurance policies now include fertility cover — check before assuming it is entirely out of pocket.

Protect the relationship: agree in advance how many cycles you will do, and what the alternatives are — a break, donor gametes, adoption through CARA, or a decision to stop. Counselling is offered by good clinics and is worth taking.

When to see a doctor

During treatment, seek urgent care for: severe abdominal pain and bloating, rapid weight gain, breathlessness, reduced urine output or vomiting after egg collection — these suggest ovarian hyperstimulation; heavy bleeding; fever; or fainting.

In an IVF pregnancy: any bleeding, one-sided pain (ectopic pregnancy can occur even after IVF), or severe abdominal pain needs same-day assessment.

This article is general information, not medical advice, and is no substitute for personal medical advice. For any decision about your or your child's health, please consult your doctor.

Frequently asked questions

Q: Are IVF babies at higher risk of health problems? — Slightly raised risks of preterm birth, low birth weight and some conditions have been reported, partly related to multiple pregnancy and to the underlying subfertility rather than the technique. In absolute terms the great majority of IVF babies are healthy.

Q: How many embryos should be transferred? — One, in most situations, particularly for younger women with good-quality embryos. Twin pregnancies carry substantially higher risks for mother and babies, and a clinic pushing multiple transfers to raise its headline numbers is not acting in your interest.

Q: Does IVF cause early menopause? — No. The stimulation recruits follicles that would have been lost in that cycle anyway; it does not deplete the reserve faster.

Q: Is surrogacy an option in India? — Only altruistic surrogacy, under the Surrogacy (Regulation) Act, with strict eligibility rules for the intending couple and the surrogate, and only through registered clinics. Commercial surrogacy is prohibited, and arrangements outside the Act are illegal.