1,000 injections, 2 miscarriages: Actor Tejaswini Kolhapure’s IVF journey tells us what to expect in repeat attempts

Why repeat IVF cycles may be needed

An unsuccessful cycle does not necessarily mean that pregnancy is unlikely in the future. Instead, every cycle provides valuable clinical information that helps fertility specialists understand how a patient’s body responds and what changes might improve the chances of success in subsequent attempts.

A repeat IVF cycle may be recommended for several reasons. Sometimes the ovaries produce fewer mature eggs than anticipated despite stimulation. In other cases, fertilisation rates may be lower than expected, embryos may not develop optimally in the laboratory, or implantation may fail after embryo transfer. There are also situations where an early pregnancy is achieved but unfortunately ends in miscarriage despite an initially positive pregnancy test.

Each of these outcomes offers important insights. Fertility specialists carefully evaluate ovarian response, embryo quality, laboratory performance and medication protocols before deciding on the next course of treatment. Based on these findings, they may adjust hormone doses, modify stimulation protocols, change the timing of embryo transfer or recommend additional investigations before beginning another cycle. Rather than simply repeating the same treatment, every IVF attempt is usually tailored using lessons learned from the previous one.

Why IVF often involves so many injections

One aspect of Kolhapure’s revelation that surprised many was her statement that she received a series of injections during her fertility journey. While the number may seem staggering, repeated hormone injections form a routine part of IVF treatment, particularly when multiple cycles are required over several years.

Every IVF cycle begins with hormone therapy designed to stimulate the ovaries to produce multiple eggs instead of the single egg released during a natural menstrual cycle. These medications are administered through carefully timed injections over several days or weeks. Alongside hormone therapy, patients undergo regular blood tests and ultrasound scans to monitor follicle development before egg retrieval is performed. Once the eggs are collected and fertilised, the resulting embryos are monitored before embryo transfer takes place. If additional cycles become necessary, the entire sequence is repeated.

Although hormone injections are generally well tolerated, they can cause temporary side effects such as bruising or discomfort at the injection site, bloating, abdominal discomfort, breast tenderness, headaches, fatigue and mood changes. In some women, the ovaries may respond excessively to stimulation, leading to ovarian hyperstimulation syndrome (OHSS), a condition that requires prompt medical attention. Depending on an individual’s response, doctors may occasionally recommend delaying the next cycle to allow the body sufficient time to recover.

The emotional journey can be as challenging as the medical one

While the physical procedures are often visible, the emotional burden of IVF is less frequently discussed. Every stage of treatment carries its own uncertainty. Patients spend days waiting for scans to assess follicle growth, anxiously await updates on fertilisation and embryo development, and then face another emotionally difficult wait before pregnancy test results become available. When treatment does not result in pregnancy or when an early pregnancy ends in miscarriage, feelings of disappointment, grief, anxiety and emotional exhaustion are common.

For many couples, IVF also affects everyday life in practical ways. Frequent hospital visits must often be balanced with work commitments, family responsibilities and travel. Treatment schedules are largely dictated by the body’s biological response rather than personal convenience, making planning difficult.

At the same time, financial considerations become increasingly important. Multiple IVF cycles, embryo freezing, genetic testing and additional laboratory procedures can substantially increase the overall cost of treatment. Having open discussions with the treating team about the anticipated treatment plan and possible expenses allows patients to prepare both emotionally and financially before embarking on another cycle.

Preparing for another IVF attempt

A repeat IVF cycle should never be viewed as merely repeating what has already been done. Instead, each previous attempt helps doctors refine the treatment strategy based on the patient’s unique response.

Medication doses may be adjusted, stimulation protocols modified, embryo transfer strategies altered or additional diagnostic investigations recommended to optimise the chances of success. This personalised approach is one of the reasons why outcomes may improve in later cycles.

Patients are also encouraged to optimise their overall health before beginning another round of treatment. Maintaining a healthy weight, eating a balanced diet, staying physically active, managing chronic medical conditions and avoiding smoking and excessive alcohol all contribute to better reproductive health, although no lifestyle intervention can guarantee pregnancy.

Equally important is pre-treatment counselling, which helps patients understand the treatment process, possible outcomes and the realistic possibility that more than one IVF cycle may be required before achieving a successful pregnancy.

Setting realistic expectations from the outset enables patients to make informed decisions and approach each stage of the journey with greater confidence and preparedness.