Subarna and Sanchita (names changed) first visited our clinic in 2020. 

There was hope in their eyes, and a quiet hesitation in their voices: 

“We’ve been married for two years… we’re planning for a baby now. Is everything alright?” 

Many people assume that walking into an IVF clinic automatically means IVF is necessary. 

But medicine is not about technology alone — it is about choosing the right treatment based on actual need.

First Consultation: 

When There Was No Infertility 

After carefully reviewing their history, it was clear they had not yet tried naturally for 6–12 months. 

We reassured them: 

“You do not have infertility. There is no need for invasive tests right now. ” 

Instead, we focused on Preconception Care: 

  • Folic acid supplementation (to prevent neural tube defects) 
  • Rubella antibody testing (to avoid infection during pregnancy) 
  • Thalassemia screening 
  • Blood group testing
  • Advice on regular intercourse (2–3 times per week)

They asked, “Should we do fertility tests just to be sure?”

Our answer was simple:

  • Not every test is necessary.
  • Many fertility investigations are not perfect. 
  • Unnecessary testing can lead to false reports, anxiety, and added financial burden — without improving outcomes. 
  • In medicine, knowing what not to do is just as important as knowing what to do.

One Year Later: 

When Waiting Becomes Difficult 

After a year of trying, they returned. 

“We’ve been trying for a year… nothing has happened. ” 

Now we moved step by step: 

  • Semen analysis — normal 
  • AMH (Anti-Müllerian Hormone) — good ovarian reserve 
  • Ultrasound — normal ovaries 
  • We did not immediately test the fallopian tubes. 

There is no need to do everything at once. 

We started ovulation induction with oral medications. 

Follicular monitoring confirmed ovulation.

After 3–4 months — still no pregnancy.

Tube Testing & Unexplained Infertility 

HSG showed open fallopian tubes. 

All routine parameters were essentially normal.

So what was the problem?

This is what we call Unexplained Infertility — when standard investigations do not reveal a clear cause. 

I explained to them:

If 100 couples try regularly:

  • 10–15 conceive in the first month 
  • 60 within six months 
  • 80 within one year

Why don’t the others conceive in the first month?

We simply don’t know. That is the “chance factor.” 

There are biological elements we cannot directly measure:

  • Egg quality 
  • Functional sperm competence 
  • Subtle tubal function 
  • Embryo genetic potential

Some of these can only be evaluated or bypassed during IVF.

But that does not mean everyone needs IVF at the beginning.

Next Steps: Gonadotropins and IUI 

We proceeded with gonadotropin injections for ovulation induction. 

Three cycles — still no success.

Then we moved to IUI (Intrauterine Insemination). 

In IUI:

  • Semen is processed in the laboratory 
  • The most motile sperm are selected 
  • They are placed directly inside the uterus at ovulation 
  • This bypasses cervical barriers and shortens the distance sperm must travel, slightly increasing the chance of conception.

After 3–4 cycles — still no pregnancy.

They did not give up. 

The IVF Journey. 

Finally, they chose IVF. 

In IVF:

  • Multiple eggs are retrieved
  • Fertilization occurs in the laboratory 
  • Embryos are created 
  • An embryo is transferred into the uterus 

The first cycle was positive. 

There were tears of joy. 

But 48 hours later, hCG levels failed to rise appropriately. 

It was a biochemical pregnancy — implantation had begun but did not sustain.

They were devastated. 

Frozen embryos were available. 

However, during thawing, embryo quality was not adequate for transfer.

Many couples stop here. 

They did not. 

The Second IVF:

 Science and Faith Together

Another IVF cycle.Positive again. 

This time — twins. 

The pregnancy progressed well until 28 weeks, when Sanchita developed preeclampsia — high blood pressure with protein in urine, a potentially serious pregnancy complication. 

Close monitoring was initiated. 

At 34 weeks, we made the decision for delivery.

Premature — yes. 

Healthy — thankfully, yes.

The Real Message 

✔ Visiting an IVF clinic does not automatically mean IVF is required. 

✔ The right treatment should be given to the right patient at the right time.

✔ Unnecessary tests and treatments should be avoided.

✔ Good medicine is not about doing more — it is about doing what is appropriate.

✔ Science, trust, patience, and positivity must work together.

Subarna and Sanchita succeeded not just because of technology —but because they trusted the process, stayed patient, and moved step by step.Medicine is not about the ability to perform IVF. 

It is about knowing when IVF is needed — and when it is not.

  • Science matters.
  • Trust matters.
  • Time matters.
  • And above all — hope matters.