IVF Outcomes in Northern India: Examining Treatment Choices and Positive Pregnancy Tests

Research from northern India offers a closer look at how different treatment choices were linked to positive pregnancy tests and what the findings mean for patients.

For people going through IVF, the wait for a pregnancy test carries hopes that a clinic's statistics cannot fully describe. Research from northern India offers a closer look at how different treatment choices were linked to positive pregnancy tests and what the findings mean for patients.

The study, "Treatment decisions, not patient demographics, predict a positive pregnancy test after autologous IVF: a retrospective cohort study from northern India," by Rajesh Kamath and colleagues, was published in Frontiers in Public Health. Its central finding was that fertilisation method and embryo transfer type were associated with positive pregnancy tests among women using their own eggs at one private fertility centre. The findings describe an early stage of pregnancy, with no information about how many pregnancies continued to birth.

What the researchers measured

The researchers reviewed records from 288 women who underwent IVF at a private centre in Faridabad, Haryana, between April 2023 and October 2024. Each woman contributed her most recent treatment cycle, so the results represent the outcome of her latest recorded attempt rather than the success rate of every cycle performed.

Of these women, 211 used their own eggs, known as autologous IVF, and 77 received donated eggs. The groups were analysed separately because donor egg outcomes depend partly on the donor's age and egg quality, making the recipient's characteristics harder to interpret.

A positive blood test for beta-human chorionic gonadotropin, or beta-hCG, was recorded in 70.6% of women using their own eggs and 54.5% of donor egg recipients. This hormone provides an early pregnancy signal; the records contained no follow-up confirming pregnancy by ultrasound, tracking miscarriage, or documenting live birth.

Women using their own eggs had an average age of about 31 and had experienced infertility for roughly seven years. Around 72% belonged to upper or upper-middle socioeconomic groups, reflecting the largely self-paying population served by the clinic. Almost nine in ten received two embryos, and the centre did not routinely offer elective single-embryo transfer during the study period.

Two treatment choices stood out

Intracytoplasmic sperm injection, known as ICSI, involves injecting a single sperm directly into an egg. Conventional IVF places eggs and sperm together so fertilisation can occur without direct injection. Positive pregnancy tests were recorded in 76.0% of women treated with ICSI, compared with 46.2% receiving conventional IVF.

Frozen embryo transfer had a positive test rate of 74.9%, compared with 51.3% for fresh transfer. Both associations remained after the researchers accounted for age, the number of eggs retrieved, and the duration of infertility. Their statistical model estimated differences of 32.5 percentage points associated with ICSI and 18.5 percentage points associated with frozen transfer. These are adjusted estimates of association, not promised improvements for an individual patient.

Collecting more eggs showed a small, borderline association with a positive result, with each additional egg corresponding to an estimated 1.8-percentage-point difference in the main model. The researchers repeated their analysis after removing 48 cases involving male-factor infertility, where ICSI was required according to the paper. The associations with ICSI and frozen transfer remained. Accounting for whether treatment was a first or later attempt made little difference.

Why the findings need careful interpretation

A study based on existing records can identify patterns, but it cannot establish that a treatment choice caused a better outcome. The clinic's laboratory expertise, clinicians' preferences, or differences between patients could have influenced both treatment selection and pregnancy results.

Important details were unavailable, including sperm measurements, embryo grades, and the thickness of the uterine lining. ICSI and frozen transfer were each used in about 81% of autologous cases, leaving much smaller comparison groups.

The paper's discussion notes that randomised research has not consistently found ICSI superior to conventional IVF for couples without male-factor infertility. Its findings support further investigation in Indian settings rather than routine use of a more expensive and invasive procedure.

Frozen transfer may offer a more favourable uterine environment after the hormonal effects of ovarian stimulation have settled. The wider evidence discussed in the paper varies across patient groups, with no consistent improvement in cumulative live birth. Research cited by the authors links frozen transfer to higher risks of some pregnancy complications, including hypertensive disorders, pre-eclampsia, and larger babies. Freezing and storage add costs.

Age, body mass index, education, occupation, socioeconomic status, infertility type, previous pregnancies, stimulation protocol, and the number of embryos transferred showed no clear associations in this cohort. The duration of infertility and treatment cycle number did not independently predict the outcome.

The absence of an age association deserves particular care: women using their own eggs were aged 22–42, only 35 were 36 or older, and every participant over 42 received donor eggs. The study was too small and restricted to overturn established evidence that age affects IVF outcomes.

Donor recipients were older, averaging 39 years, and more often received three embryos. Missing donor information prevented predictive modelling, so their lower positive test rate cannot establish that donated eggs were less effective.

The bigger question is who can reach treatment

The study included women who could afford IVF at a private clinic and completed treatment. It left out people who could not afford care, never started, or stopped before completing a cycle. Income was not linked to pregnancy-test results in this group, but it can still affect who gets treatment.

The authors describe IVF in India as mostly private and paid for by families, creating financial pressure. Infertility and treatment can bring emotional stress, social pressure, and limited support, which may lead people to stop treatment. This study did not measure how these issues affected pregnancy results. The paper discusses rules intended to protect patients and egg donors, but it could not assess donor recruitment, how well regulations worked, or surrogacy arrangements.

These results are not national IVF success rates or live-birth rates. Using each woman's latest attempt may make the figures look higher because people often stop treatment after success. Follow-up ended at the pregnancy blood test, so the study highlights treatment choices without showing how many pregnancies led to a baby.