If you’ve had two or more miscarriages, you’ve likely been told — by well-meaning people and sometimes even doctors — that it’s “just bad luck” and to “keep trying.” And while it’s true that chromosomal errors in individual embryos are common and largely random, recurrent pregnancy loss is a different situation that deserves real investigation.

In about half of couples with recurrent miscarriage, we find a specific, treatable cause. In the other half, the cause remains unclear — but even these couples have a good chance of success with appropriate support and monitoring.

You deserve a proper answer, not a brush-off.

How Common Is This?

Recurrent miscarriage (defined as 2 or more losses) affects approximately 1–2% of couples. After 3 losses, a cause is found in around 50% of cases. The important thing to know: finding and treating these causes significantly improves the next pregnancy’s outcome.

The Main Causes — and What We Do About Them

Chromosomal Errors in Embryos

The most common cause overall — especially in women over 35. As eggs age, the risk of chromosomal errors increases. These embryos typically stop developing very early.

Solution: IVF with preimplantation genetic testing (PGT-A) allows us to check embryos for chromosomal normality before transfer — so only chromosomally normal embryos are transferred.

Uterine Abnormalities

A uterine septum, submucous fibroids, polyps, or adhesions inside the uterine cavity can prevent normal implantation or lead to early pregnancy loss. Diagnosed with hysteroscopy and often corrected in the same procedure.

Antiphospholipid Syndrome (APS)

An autoimmune condition where specific antibodies cause blood clots in the placental blood vessels, cutting off blood supply to the pregnancy. Diagnosed with blood tests. Treated with low-dose aspirin and heparin during pregnancy — with excellent outcomes. This is one of the most rewarding treatments in recurrent miscarriage management because it works so well.

Thyroid Disease

Even mildly elevated TSH significantly increases miscarriage risk. Often overlooked. Easy to treat. I test every recurrent miscarriage patient.

Sperm DNA Fragmentation

Normal semen analysis doesn’t rule this out. High levels of DNA damage in sperm can cause early embryo arrest and recurrent miscarriage. Requires a specific test — DNA Fragmentation Index (DFI). Treatable with antioxidant therapy, lifestyle changes, or IVF with ICSI using testicular sperm.

The Investigations I Recommend

• Karyotyping of both partners (chromosomal analysis)
• Hysteroscopy (uterine cavity assessment)
• Antiphospholipid antibodies panel
• Full thyroid panel including antibodies
• Sperm DNA fragmentation test
• Blood sugar and other hormonal tests

The Outcome Is Better Than You Think

With appropriate investigation and treatment, over 70% of couples with recurrent miscarriage go on to have a successful pregnancy. That’s a meaningful statistic — and it starts with refusing to accept “just try again” as an answer.

At Punit Fertility, Kandivali Mumbai, we take recurrent pregnancy loss seriously and provide a thorough, compassionate workup.

Book a recurrent miscarriage consultation at Punit Fertility

The post Recurrent Miscarriage: Why It Happens and What Can Actually Be Done appeared first on Punit Fertility & Women's Center.

There’s a reason for that. Thyroid disorders — particularly hypothyroidism — are extraordinarily common in Indian women, and they are one of the most frequently missed causes of infertility and recurrent miscarriage.

The frustrating part is that many women with subclinical hypothyroidism feel completely fine. No fatigue, no weight gain, no obvious symptoms. But their TSH is silently elevated, quietly disrupting their reproductive hormones, and they have no idea.

The good news: it’s one of the easiest fertility problems to fix.

How the Thyroid Affects Fertility

Thyroid hormones regulate virtually every metabolic process in the body — including reproductive hormone production. When thyroid function is off, the ripple effects on fertility are significant:

• Irregular or absent ovulation: Low thyroid hormone disrupts the hormonal cascade needed for ovulation
• Elevated prolactin: Hypothyroidism raises prolactin, which further suppresses ovulation
• Poor egg quality: Thyroid hormones directly affect follicle development
• Implantation failure: The uterine lining needs thyroid hormones to prepare properly
• Miscarriage: Even mildly elevated TSH significantly increases miscarriage risk

The Number That Matters: TSH

The standard “normal” range for TSH in most labs is 0.5–5.0 mIU/L. But for women trying to conceive or undergoing fertility treatment, most reproductive endocrinologists — myself included — aim for TSH below 2.5 mIU/L.

That means a woman with a TSH of 3.8 might be told by her GP that her thyroid is “normal” — but from a fertility perspective, she’s suboptimal, and treatment will improve her chances.

Thyroid Antibodies: The Hidden Factor

Even when TSH is within the optimal range, the presence of anti-TPO antibodies (thyroid peroxidase antibodies) is associated with increased miscarriage risk and IVF failure. This is an autoimmune condition where the immune system attacks the thyroid.

I test for thyroid antibodies in all my recurrent miscarriage patients and in IVF patients who’ve had unexplained failure — because the antibodies matter even when the TSH looks fine.

Treatment Is Simple

Hypothyroidism is treated with levothyroxine — a synthetic thyroid hormone tablet taken once daily. When TSH comes into the optimal range, ovulation often normalises within 1–2 months. It’s one of the most satisfying treatments in fertility medicine: identify, treat, conceive.

Women who are already on levothyroxine often need their dose increased once pregnant — so early thyroid monitoring in pregnancy is essential.

Get Tested Before You Spend Months Wondering

At Punit Fertility, Kandivali Mumbai, thyroid screening is part of every fertility workup. It’s a simple blood test that takes 5 minutes and could explain months of difficulty.

Book your fertility evaluation at Punit Fertility today

The post Thyroid and Infertility: The Connection Most People Miss appeared first on Punit Fertility & Women's Center.

Most pregnancy advice starts the moment you get a positive test. But the truth is, the weeks and months before you conceive may be just as important for your baby’s health as anything you do after.

The first 8 weeks of pregnancy — when most major organs are forming — often pass before a woman even knows she’s pregnant. By the time you’re taking that test, your baby’s neural tube has already closed. That’s why what you do before conception genuinely matters.

Here’s what I tell every patient who comes in asking how to prepare.

Start Folic Acid Now — Not After a Positive Test

This is the most important single piece of advice I give. Folic acid (400–800 mcg daily) dramatically reduces the risk of neural tube defects like spina bifida. But it needs to be on board for at least 1–3 months before conception to be effective.

If you’re thinking about pregnancy in the next 6 months, start now. It’s available at any chemist, it’s inexpensive, and the evidence for it is overwhelming.

Get a Preconception Blood Panel Done

Before trying, it’s worth checking:

• Thyroid (TSH): Hypothyroidism is extremely common in Indian women and increases miscarriage risk significantly if untreated. Easy to fix once found.
• Blood sugar: Uncontrolled diabetes — even undiagnosed — increases the risk of birth defects and miscarriage in early pregnancy.
• Haemoglobin: Anaemia is very common in Indian women and affects both fertility and early pregnancy.
• Rubella immunity: If you’re not immune, vaccination now (not during pregnancy) protects your baby.
• Vitamin D: Severe Vitamin D deficiency is linked to PCOS and ovulation problems. Supplementation is easy.

Address Existing Conditions Before Trying

If you have PCOS, thyroid disease, diabetes, asthma, epilepsy, or depression — don’t just start trying and hope for the best. Some medications are unsafe in pregnancy and need to be swapped in advance. Some conditions need to be better controlled before conception for the best outcome.

Come in for a preconceptional counselling appointment and we’ll go through this together.

For Your Partner: Sperm Health Takes 3 Months to Improve

Sperm take about 72 days to mature. That means lifestyle changes your husband makes today will affect sperm quality in about 3 months. Worth knowing if you’re planning ahead:

• Stop smoking — it damages sperm DNA
• Reduce alcohol
• Avoid prolonged heat exposure (hot baths, tight underwear, laptop on lap)
• Get to a healthy weight if overweight

Lifestyle Basics (I’ll Keep This Brief)

Stop smoking. Reduce alcohol to minimal or zero. Move your body regularly — you don’t need a gym, brisk walking works. Get to a healthy weight if possible, because both underweight and overweight affect ovulation and pregnancy outcomes.

Start Your Pregnancy Journey the Right Way

At Punit Fertility, Kandivali Mumbai, we offer dedicated preconceptional care consultations to help you prepare thoroughly before you start trying.

Book a preconception consultation at Punit Fertility

The post Planning a Pregnancy? Do These Things First. appeared first on Punit Fertility & Women's Center.

Female fertility declines with age. This isn’t a scare tactic. It’s biology — and it’s something I wish more women had honest information about earlier, so they could make more informed choices about when to try, when to seek help, and when to consider options like egg freezing.

I’m not saying this to create anxiety. I’m saying it because I’ve sat with too many women in their early 40s who wish someone had told them this clearly in their mid-30s.

What Actually Happens to Fertility With Age

Women are born with all the eggs they’ll ever have — roughly 1–2 million at birth. By puberty, that’s down to about 300,000. Every month, many follicles are recruited but only one (usually) ovulates, and the rest are lost. By the mid-30s, both the quantity and — critically — the quality of eggs starts declining more noticeably.

Egg quality matters enormously. A poor-quality egg is more likely to be chromosomally abnormal — which means a higher rate of failed implantation, miscarriage, and conditions like Down syndrome. This is why IVF success rates drop with age: it’s not the uterus, it’s the eggs.

The Numbers, Honestly

• Under 30: Peak fertility. Most healthy couples conceive within 6–12 months naturally.
• 30–34: Fertility is still good. Slight decline beginning, but success rates with treatment are strong.
• 35–37: A noticeable step-down in egg quality. IVF success per cycle drops from ~50% to ~35–40%. Doctors recommend seeking help after 6 months, not 12.
• 38–40: Decline accelerates. IVF success ~25–30% per cycle. Time genuinely matters now.
• Over 40: Natural conception is possible but significantly less likely. IVF with own eggs: 10–15% per cycle. IVF with donor eggs: 50–60% per cycle regardless of age.

What is AMH and Why Does It Matter?

AMH — Anti-Müllerian Hormone — is a blood test that reflects your current ovarian reserve. It can be done on any day of your cycle and gives a snapshot of how many eggs are remaining. It doesn’t tell you about egg quality (age is the best proxy for that), but it tells us how you’re likely to respond to IVF stimulation.

I recommend AMH testing for any woman in her 30s who is thinking about having children — even if she’s not ready yet. It informs the timeline.

What About Egg Freezing?

If you’re in your late 20s or early 30s and not ready for pregnancy, egg freezing is worth considering. The younger your eggs when frozen, the better the quality preserved. Eggs frozen at 30 are more viable than eggs frozen at 38. It’s an insurance policy — not a guarantee, but a meaningful option.

You Have More Options Than You Think

Whatever your age, come in and find out where you actually stand. At Punit Fertility, Kandivali Mumbai, we give you honest information and a realistic picture — along with a plan for whatever stage you’re at.

Book a fertility assessment at Punit Fertility today

The post Age and Female Fertility: The Truth Nobody Tells You Clearly Enough appeared first on Punit Fertility & Women's Center.

The uterus is where an embryo has to implant and grow. And yet, for a long time in fertility medicine, we were essentially guessing about what was going on in there — relying on ultrasound images that sometimes miss things entirely.

Hysteroscopy changed that. It lets us look directly inside the uterine cavity with a tiny camera, in real time, with far more detail than any scan.

I use it regularly at Punit Fertility — and it changes the management plan for a significant number of patients.

What the Procedure Involves

A thin, flexible telescope (hysteroscope) is passed gently through the cervix into the uterine cavity. No cuts. No stitches. The uterus is distended slightly with saline to get a clear view, and we can see the entire inner surface of the uterus — the lining, the corners where the tubes enter, any abnormalities.

Diagnostic hysteroscopy (just looking) can be done without general anaesthesia in most cases — it takes about 10–15 minutes. Operative hysteroscopy (treating what we find) is done under light sedation or anaesthesia.

What We Find and Fix

Uterine Polyps

Small, finger-like outgrowths of the uterine lining. They’re extremely common and often symptomless — yet they significantly impair implantation. Removal via hysteroscopy is simple, quick, and has been shown to improve IVF success rates.

Submucous Fibroids

Fibroids that protrude into the cavity distort the uterine shape and make implantation difficult. Hysteroscopic removal restores the normal cavity.

Uterine Adhesions (Asherman’s Syndrome)

Scar tissue inside the uterus — usually following a D&C or infection — that can partially or completely obliterate the cavity. Hysteroscopic adhesiolysis (cutting the adhesions) can restore a functional cavity. This is delicate surgery requiring experience.

Uterine Septum

A partition dividing the uterine cavity — a developmental abnormality. Associated with recurrent miscarriage. Easily removed hysteroscopically with excellent outcomes.

When I Recommend Hysteroscopy

• Before IVF — especially if previous cycles have failed
• Recurrent miscarriage (2 or more losses)
• Abnormal uterine finding on ultrasound
• Heavy or irregular bleeding suggesting a structural cause
• Unexplained implantation failure

Recovery and What to Expect After

Diagnostic hysteroscopy: most women return to normal activity the same day or next. Some mild cramping and spotting for 1–2 days.

Operative hysteroscopy: typically 1–3 days rest, minimal discomfort. Fertility treatment can usually resume the following cycle.

Let’s Make Sure Your Uterus Is Ready

At Punit Fertility, Kandivali Mumbai, we believe in checking the uterine cavity before any fertility treatment — because even the best embryo won’t implant in a hostile environment.

Book a hysteroscopy consultation at Punit Fertility

The post Hysteroscopy: What It Is, Why It Matters, and What to Expect appeared first on Punit Fertility & Women's Center.

I’ve seen it hundreds of times — a couple walks into the clinic, sitting slightly stiffly, not quite sure what they’ve walked into. Sometimes they’ve waited a long time before coming. Sometimes they’re convinced something is seriously wrong. Sometimes they just want answers.

Whatever brings you in, the first consultation at Punit Fertility is a conversation — not an interrogation, not a sales pitch, not a commitment to treatment. Here’s exactly what happens so you can come in feeling prepared.

Before You Come: What to Bring

• Any previous test results you have — blood tests, ultrasounds, semen analysis
• A rough idea of your cycle length and regularity
• How long you’ve been trying
• Any past pregnancies (including losses)
• Current medications
• Your partner, if possible — especially for the first visit

Don’t stress if you don’t have everything. We can work with whatever you bring.

The History: The Most Important Part

The consultation starts with a detailed history. I’ll ask about your menstrual cycle — how regular it is, whether periods are painful or heavy, when you last had a normal cycle. I’ll ask how long you’ve been trying, whether you’ve had any pregnancies before, and about your general health and medical history.

For your partner: questions about his health history, any known issues with sperm, whether a semen analysis has been done.

These questions help me narrow down where to look. A 28-year-old with regular cycles and a husband with normal sperm needs different investigations than a 38-year-old with irregular cycles and a history of pelvic infection.

Initial Tests I’ll Likely Order

Depending on your history, I’ll recommend some combination of:

For You:

• Day 2/3 hormone panel: FSH, LH, AMH (ovarian reserve), oestradiol
• Thyroid function (TSH) — thyroid disease is very common and very treatable
• Transvaginal ultrasound: uterus shape, ovarian appearance, antral follicle count
• HSG (tubal patency test) — to check if the tubes are open

For Your Husband:

• Semen analysis — this is non-negotiable. We test both partners.

What You’ll Leave With

After the first consultation, you’ll have a clear list of investigations to complete and a follow-up appointment booked to review results. You won’t be pressured into starting any treatment. You’ll leave knowing what the next steps are and why.

One Thing I Always Tell New Patients

Coming to see a fertility specialist does not mean you need fertility treatment. Many couples come in, we do the evaluation, and I tell them everything looks normal and to keep trying for a few more months. That information has value too — it rules out the treatable causes and removes the anxiety of not knowing.

Book your first consultation at Punit Fertility, Kandivali Mumbai

The post Your First Visit to a Fertility Clinic: What Actually Happens appeared first on Punit Fertility & Women's Center.

The diagnosis of endometriosis hits hard for many women. Especially when you’re trying to get pregnant and someone tells you that this condition — the one causing those agonising periods you’ve been managing for years — is also affecting your fertility.

I want to be honest with you about what endometriosis means for conception. Not to give false hope, but also not to catastrophise unnecessarily. Because the reality is more nuanced than “endometriosis = infertility.”

What Endometriosis Actually Does

Endometriosis is where tissue similar to the uterine lining grows outside the uterus — on the ovaries, tubes, bowel, bladder, peritoneum. Every month, this tissue responds to your hormonal cycle — it swells, bleeds, but has nowhere to drain. This causes inflammation, pain, and over time, scar tissue.

How it affects fertility depends significantly on the stage:

• Mild (Stage 1–2): May not significantly impair fertility. Many women with mild endometriosis conceive naturally.
• Moderate to Severe (Stage 3–4): Adhesions can block tubes, displace ovaries, or distort the pelvic anatomy. Ovarian endometriomas (chocolate cysts) can reduce egg reserve.

The inflammation and the hostile pelvic environment also affect sperm function, egg quality, and embryo implantation — even without visible structural damage.

Your Treatment Options

Trying Naturally With Monitoring

For young women with mild endometriosis and no other fertility issues, attempting natural conception with cycle monitoring is a reasonable first step. Time is still a factor though — I wouldn’t wait more than 6 months before moving to treatment.

Laparoscopic Surgery

This is the gold standard for moderate-severe endometriosis. Laparoscopic excision of endometriotic deposits improves natural conception rates in Stage 1–3 endometriosis. It’s also the only way to definitively diagnose and stage the disease.

IUI Post-Surgery

For younger women after surgical treatment of mild-moderate endometriosis, IUI with ovulation induction can be an effective next step.

IVF

For moderate-severe endometriosis, older patients, or those who haven’t conceived after surgery and IUI — IVF is the most effective option. It completely bypasses the pelvic environment where endometriosis does its damage.

The Ovarian Reserve Question — This Is Important

If you have endometriomas on your ovaries, I strongly recommend getting your AMH level checked before any decision about surgery. Operating on endometriomas can reduce ovarian reserve, so sometimes we need to weigh the benefit of surgery against the risk to egg supply. This is a decision I never rush.

You Don’t Have to Figure This Out Alone

At Punit Fertility in Kandivali, Mumbai, I see endometriosis patients regularly and build a personalised plan based on stage, age, ovarian reserve, and your priorities. Many of my endometriosis patients have gone on to have successful pregnancies.

Book an endometriosis and fertility consultation at Punit Fertility

The post Endometriosis and Pregnancy: Yes, It’s Still Possible appeared first on Punit Fertility & Women's Center.

One of the most common conversations I have goes like this: a couple has done every blood test, every ultrasound, even an HSG — and everything looks normal. Yet pregnancy isn’t happening. Or they’ve had multiple failed IVF cycles with good embryos. And then we do a laparoscopy — and find endometriosis that wasn’t visible on any scan.

Laparoscopy is the closest thing to a window inside the pelvis. And sometimes it changes everything.

What Laparoscopy Actually Is

It’s a minimally invasive surgical procedure done under general anaesthesia. Three very small incisions — about 5–10mm each — are made in the abdomen. A tiny camera (laparoscope) goes in through one, and instruments through the others if needed.

The surgeon can see the uterus, ovaries, fallopian tubes, and surrounding structures in real time — far better detail than any ultrasound can provide. And if something is found, it can often be treated right then and there, in the same procedure.

You’re usually home the same day. Most women take 3–5 days off, then return to normal activity.

What Laparoscopy Can Find and Fix

Endometriosis

The most important one. Endometriosis — where uterine-like tissue grows outside the uterus — can only be definitively diagnosed via laparoscopy. Ultrasound misses early-stage endometriosis entirely. During the same procedure, the tissue can be excised or ablated, which has been shown to improve natural pregnancy rates.

Blocked or Damaged Tubes

While an HSG gives an idea of tube patency, laparoscopy gives a far more detailed picture and can sometimes treat minor blockages or adhesions.

Ovarian Cysts (Endometriomas)

Chocolate cysts can be drained or removed, improving access to eggs and potentially improving egg quality — though this decision needs careful consideration regarding ovarian reserve.

Pelvic Adhesions

Scar tissue from past infections, appendicitis, or previous surgeries can distort the reproductive anatomy. Laparoscopy allows us to cut and remove these adhesions.

Laparoscopic Ovarian Drilling (for PCOS)

For PCOS patients who don’t respond to ovulation-inducing medications, small punctures are made in the ovary surface — this can restore regular ovulation for months or years.

When I Recommend Laparoscopy

I recommend it when:

• There are symptoms suggesting endometriosis (severe period pain, pain during sex)
• HSG shows abnormal tube findings
• There have been multiple unexplained IVF failures despite good embryos
• An ovarian cyst needs proper assessment or removal
• Unexplained infertility has been present for more than 2 years

I don’t recommend it routinely for everyone — only when there’s genuine clinical reason.

Expert Laparoscopic Surgery at Punit Fertility, Kandivali

I perform both diagnostic and operative laparoscopy with a focus on preserving fertility at every step. At Punit Fertility, we discuss clearly before any procedure whether it’s likely to improve your chances — and what we’ll do with the findings.

Book a consultation to discuss whether laparoscopy is right for you

The post Laparoscopy for Fertility: What It Is, When You Need It, What to Expect appeared first on Punit Fertility & Women's Center.

In almost every couple who comes to see me, the woman has already had a pile of tests done. Blood work, ultrasounds, maybe an HSG. And when I ask about the semen analysis, I often get a pause — sometimes an awkward look — and “we haven’t done that yet.”

Male infertility accounts for about 40% of all cases where a couple can’t conceive. Another 20% involve factors from both partners. This means in the majority of infertility cases, there is a male component. And yet the semen analysis is often the last test done, not the first.

I don’t say this to be harsh. I understand the cultural and emotional weight around male fertility. But addressing it early isn’t an accusation — it’s practical medicine that saves time and avoids unnecessary procedures for the woman.

What a Semen Analysis Actually Measures

A standard semen analysis looks at:

• Count: How many sperm per millilitre (normal ≥15 million/ml)
• Motility: What percentage are moving, and how well (normal ≥40% progressive motility)
• Morphology: What percentage have a normal shape (normal ≥4% by Kruger)
• Volume: Total semen volume (normal 1.5–5ml)

A normal-looking semen analysis doesn’t always rule out male factor though — sperm DNA fragmentation (damage to the genetic material inside sperm) can cause recurrent miscarriage and IVF failure even when the basic analysis looks fine.

Common Causes Worth Knowing

• Varicocele: Enlarged veins in the scrotum that raise temperature and damage sperm. The most common treatable cause — surgical repair can significantly improve parameters.
• Hormonal issues: Low testosterone, high prolactin, thyroid problems
• Past infections: Mumps orchitis, STIs, epididymitis — all can affect the testes
• Lifestyle factors: Smoking, heavy alcohol, steroids, heat exposure (tight underwear, laptop on lap, frequent saunas)
• Azoospermia: No sperm in the ejaculate — may be obstructive (blockage) or non-obstructive (production issue)

What Can Be Done

For mild-moderate male factor, IUI with sperm washing concentrates the best sperm and significantly improves the odds.

For severe cases, IVF with ICSI — where a single sperm is injected directly into an egg — can achieve fertilisation even with very few motile sperm.

For azoospermia, sperm can often be surgically retrieved directly from the testes (TESA/PESA) and used for ICSI.

A Word for the Men Reading This

Getting a semen analysis does not reflect on your masculinity, your virility, or your worth as a man or partner. It’s a diagnostic test — like a blood test. Getting it done is one of the most caring things you can do for your partner.

We Evaluate Both of You From the Start

At Punit Fertility in Kandivali, we assess both partners from the very first consultation. It saves time, avoids unnecessary testing, and gives us the complete picture faster.

Book a couples fertility evaluation at Punit Fertility

The post Male Infertility: The Thing Couples Don’t Talk About Enough appeared first on Punit Fertility & Women's Center.

There’s a difference. Your period is the 4–6 days of bleeding. Your cycle is the entire 28 (or 24, or 35) day process of hormonal events that either leads to pregnancy or resets for the next round.

If you’re trying to conceive, understanding your full cycle — not just when your period comes — is one of the most practical things you can do. And if something in your cycle isn’t right, it’s often the first clue that something needs attention.

A Quick Tour of the Four Phases

Phase 1: Menstruation (Days 1–5)

Day 1 of your period is Day 1 of your cycle. The uterine lining sheds. Meanwhile, the pituitary gland is already sending FSH to start recruiting follicles for this month’s potential egg.

Phase 2: Follicular Phase (Days 1–13)

Several follicles begin to grow. One becomes dominant and produces increasing amounts of oestrogen, which thickens the uterine lining and prepares the body for potential pregnancy. By Day 12–13, oestrogen peaks.

Phase 3: Ovulation (Around Day 14)

The oestrogen peak triggers a LH surge — and about 36 hours later, the dominant follicle releases its egg. This is your fertile window. The egg lives for only 12–24 hours. Sperm, however, can survive up to 5 days inside the reproductive tract — which is why the 3–4 days before ovulation are just as important as the day itself.

Phase 4: Luteal Phase (Days 15–28)

The empty follicle becomes the corpus luteum and produces progesterone. This prepares the uterine lining for implantation. If no pregnancy occurs, progesterone drops and your period starts.

How to Actually Track Ovulation

I get asked this constantly in clinic. Here’s what actually works:

• LH ovulation predictor kits (OPKs): Available at any chemist. Test from Day 10 onwards. A positive means ovulation is 24–36 hours away. This is the most reliable at-home method.
• Cervical mucus: Around ovulation, discharge becomes clear, stretchy, and slippery — like raw egg white. This is your body’s natural signal.
• Basal body temperature (BBT): Your temperature rises very slightly (about 0.2°C) after ovulation. Track it daily first thing in the morning. It confirms ovulation happened but doesn’t predict it in advance.
• Ultrasound monitoring: The most accurate method — we do this in clinic when we’re doing ovulation induction. We can see the follicle grow and confirm rupture.

What Irregular Cycles Actually Mean

If your cycle varies wildly — sometimes 25 days, sometimes 40 — that usually means irregular or absent ovulation. You can’t reliably time intercourse, and some months there may simply be no egg to fertilise.

In my experience, PCOS is the most common cause in younger women. Thyroid disease is the second most common. Both are completely treatable.

Come In and Let’s Look Together

A transvaginal ultrasound on Day 2–3 of your cycle and a progesterone test on Day 21 can tell us a huge amount about your ovulatory health in just two tests.

At Punit Fertility, Kandivali Mumbai, we make this simple.

Book a cycle assessment at Punit Fertility today

The post Your Menstrual Cycle Is Trying to Tell You Something — Are You Listening? appeared first on Punit Fertility & Women's Center.