Natural conception: Here the male and female partners are deemed normal after testing. The male should be able to deposit semen deep inside the birth passage of his wife. Semen should stay in the vagina for at least 4-6 hours before it can ascend through the uterus and reach the tube to meet the egg. Egg is released around 9 days of completion of periods (for 5 days bleed usually). The concept of fertile period is important and it can vary from person to person and sometimes between cycles. A safe estimate is to have alternate day sex roughly around the same time from day 7 or 2-3 days after bleeding has stopped and continue for at least 12-14 days or till onset of bleeding. If you are unable to conceive for 1 year of proper trying (will be defined by your doctor) then you may need assisted reproductive techniques despite everything being normal due to unknown factors.
Assisted reproductive techniques:
While performing ART, male sperm treatment should be optimized to match the plan of the wife. Wife should be evaluated for egg production and patency of tubes. Egg monitoring is done by serial scans to see if egg is produced and released and the number of days for ovulation. For successful ART wife should be <30 years old or at least <35 years old. Chance of successful ART and pregnancy is reduced with advancing age of mother. In case of repeated abortions, there is a need for further testing and you should discuss this with your doctor.
IUI
IUI is the simplest form of ART with a reasonable success especially when the wife is young. Here the semen of husband is injected into the uterus. Ovulation induction may be done in woman and the timing of IUI is fixed based on egg monitoring. This is the cheapest form of ART.
IVF & ICSI
Here eggs are retrieved from the ovary and are fused in vitro (outside the human body) with sperms and the embryo is placed back inside the uterus. Once successful then it continues like a normal pregnancy. In ICSI the sperm is injected into the egg directly. Success is obviously best with ICSI and next best is IVF, and so is the cost.