Infertility Evaluation in Nagpur

The standard definition of infertility is failure to conceive after twelve months of regular unprotected intercourse, and that is the usual point at which evaluation begins. The threshold drops to six months if the woman is 35 or older, and there is no reason to wait at all where something already points to a cause — periods that are absent or very irregular, known endometriosis, previous pelvic surgery or infection, a previous testicular problem, or two or more miscarriages. Waiting the full year in those situations wastes the one thing that cannot be recovered, which is time.

It is common. The World Health Organization's 2023 report estimated that about 17.5% of adults — roughly one in six people worldwide — experience infertility at some point, with very little difference between high-income and low- and middle-income countries. Roughly speaking, causes divide between female factors, male factors, both together, and a group in whom no cause is found despite complete testing. The last group is genuinely frustrating and it is not a failure of investigation.

Both of you. Dr. Kunda counsels the male partner and reviews the semen analysis herself. This matters practically: a male factor accounts for a substantial share of couples, and a semen analysis is quicker, cheaper and less invasive than most of what would otherwise be done to the woman first. It is arranged early rather than after months of investigating one partner alone. Bring your husband to the first appointment if you can, and bring any previous reports he has had.

It is a short series of ultrasound scans across one cycle that watches a follicle grow, confirms that it releases an egg, and measures the endometrium at the same time. Scanning usually begins a few days after your period ends and is repeated every two or three days as the follicle approaches maturity. It answers questions a single blood test cannot: whether ovulation is happening at all, when in your cycle it happens, whether the follicle is growing properly, and whether the lining is thickening as it should. Dr. Kunda performs these scans herself, which is why the timing of the next one is decided on the spot rather than by guesswork.

In most couples the first round is completed within one menstrual cycle: history and examination of both partners, a pelvic ultrasound, blood tests including thyroid function and prolactin, ovarian reserve assessment where it is relevant, an ovulation study across the cycle, and a semen analysis. Tubal and uterine assessment follows if the first round does not explain things. Nothing is ordered because it exists — each test is ordered because its result would change what happens next.

Two ways, and which one is used depends on what else is being asked. Saline sonohysterography is performed at the clinic by Dr. Kunda: sterile saline is instilled into the uterine cavity during an ultrasound, which outlines the cavity and can show a polyp, a fibroid pressing into it, or a septum that a plain scan would miss. For a formal hysterosalpingogram, which is an X-ray study of tubal patency, you are sent to a centre that performs it and the films come back here for interpretation and the decision that follows.

No. Intrauterine insemination is not performed at this clinic. Where IUI is the appropriate next step, you are told so plainly and referred. This is stated here so that nobody travels to Dhantoli expecting a service that is not offered.

No. IVF, ICSI, embryo freezing, donor programmes and surrogacy are assisted reproductive technology services, which in India may only be provided by clinics registered under the Assisted Reproductive Technology (Regulation) Act, 2021. This is not an ART clinic and does not claim to be one. What happens here is the evaluation, the first-line treatment, the surgery where surgery is what is needed, and an honest statement of when the next step belongs with a reproductive medicine specialist.

Ovulation induction with letrozole or clomiphene, with the response monitored by scan; correction of the things that suppress fertility on their own — thyroid disease, high prolactin, weight, uncontrolled diabetes; treatment of infection; and surgery where it is indicated. Dr. Kunda performs hysteroscopy, so a polyp or a septum in the cavity can be dealt with directly, and she performs laparoscopy, which is what is used to assess and treat endometriosis and adhesions. She writes the prescription and does the monitoring scans herself, rather than sending you elsewhere between the two.

With ovulation. In PCOS the commonest reason for not conceiving is that ovulation is infrequent or absent, and the international PCOS guideline published in 2023 names letrozole as the preferred first-line drug for ovulation induction, ahead of clomiphene. Monitoring by ultrasound during the first treated cycle is part of doing it properly, not an optional extra. Weight, insulin resistance and thyroid function are addressed alongside, because they change how well the treatment works. PCOS itself is covered on its own page.

When continuing here would only delay you. In practice that means: both tubes blocked; a severely abnormal semen analysis; markedly reduced ovarian reserve; ovulation induction that has not produced a pregnancy after a reasonable number of properly monitored cycles; or age that makes the arithmetic unforgiving. Dr. Kunda says this at the point it becomes true rather than several cycles later. A timely referral is part of the care, not the end of it.

There can be, for two specific things. The first is a second opinion on the uterine side — cavity, endometrium, fibroids, polyps, adenomyosis and hydrosalpinx are all assessable here, and they are the part of the picture that sometimes goes unexamined between cycles. The second is recurrent implantation failure alongside pregnancy loss, which overlaps with the recurrent pregnancy loss pathway. Once a pregnancy is achieved, monitoring an IVF pregnancy is a separate service and one Dr. Kunda provides.

For a transabdominal scan a moderately full bladder helps; for a transvaginal scan an empty bladder is better, and a transvaginal scan is what most fertility questions need. No fasting is required for the scan itself, though some blood tests are timed to particular days of the cycle and a few need to be fasting. You will be told which applies when you book, so bring the dates of your last period.

The consultation, each scan, the laboratory tests and any procedure are charged separately, and an ovulation study spans several scans across one cycle rather than a single visit. Because what you actually need is decided as the picture emerges, we quote current charges on WhatsApp rather than publish a package price that will not match your situation. Message +91 8087471244 with how long you have been trying and any reports you already have.

No, and yes. Infertility in India carries a weight of blame that is placed almost entirely on women and is not supported by the biology. The consultation is confidential, both partners are assessed on the same footing, and nothing is disclosed to a family member without your agreement. If it helps to come alone the first time, that is fine too.