India is witnessing a rise in infertility. India has a population of as many as 27.5 million infertile people, including men and women, according to the Indian Society of Assisted Reproduction.
A recent Lancet study revealed that India’s total fertility rate (TFR) — the average number of children born per woman — is dipping irreversibly to 1.29, far lower than the replacement rate of 2.1.
Interestingly, the rising demand for In Vitro Fertilization (IVF) treatments underscores the growing prevalence of infertility issues, with the IVF market projected to reach $3.7 billion by 2030, up from $793 million in 2020. Moreover, India IVF Services Market was valued at USD 1,092.3 Million in 2024 and is expected to reach USD 5,051.3 Million by 2033, at a CAGR of 16.23% during the forecast period 2024 – 2033. The rising infertility rates among couples is one of the key driving factors of the growth of this market.
In an e-mail interaction with Financial Express.com, Abhishek Aggrawal, Chief Business Officer, Birla Fertility and IVF, C.K Birla Group talked about the current status of the fertility care, challenges, socio-economic challenges and more. Excerpts:
What is the current status of fertility care in India? What more needs to be done in this segment?
There exists a notable lack of awareness among couples regarding fertility treatments. To address this gap, it is essential to strengthen awareness, empowering couples to make informed decisions. This can be done by engaging with young individuals in schools and colleges through targeted programs and workshops focused on reproductive sexual health and fertility education. Strategic efforts to raise awareness, improve accessibility, and enhance affordability will ensure that IVF treatments are more widely accepted in the Indian market. Ensuring accessibility to IVF treatment is essential in addressing the declining Total Fertility Rate (TFR). Public-private partnerships and government initiatives can play a crucial role in subsidizing treatments for individuals with limited financial means, thereby expanding access to IVF across various segments of society. Additionally, it is vital for the government to include IVF treatments in insurance coverage to improve accessibility and affordability. This inclusive approach will contribute to mitigating the impact of declining fertility rates and fostering reproductive health across the nation.
How has the landscape of infertility treatment evolved in India? What are some of the existing challenges? Also, what is the impact of a poor fertility rate on a country’s demographics? How can the status be improved?
The landscape of infertility treatment has evolved drastically. To reverse the downward trend in fertility rates across the country, a multifaceted approach encompassing various economic policies and interventions is imperative. Firstly, policies offering greater support for parents can play a crucial role in mitigating the extent of low fertility.
This includes initiatives such as affordable childcare, investments in healthcare, and large-scale male engagement programs, along with free or subsidized schooling. Additionally, implementing child-related cash transfers, tax incentives, childcare subsidies, extended parental leave, and re-employment rights can provide tangible support for parents to care for and financially support their children. Furthermore, economic policies that stimulate growth and job creation, coupled with social security and pension reforms, are essential in and mitigating the impacts of declining fertility rates. Encouraging higher male engagement in household activities is also paramount, as it allows women to balance careers with motherhood more effectively. Regular and open education programs for both women and men would empower them with the knowledge required to protect their fertility and make informed decisions about family planning. Recognising the same, Birla Fertility and IVF is contributing to the same by educating couples in its capacity – helping them better understand and acknowledge their infertility. By implementing these comprehensive economic policies and interventions, we can address the underlying factors contributing to declining fertility rates and create a more supportive environment for family formation and childbearing.
A recent report by The Lancet has revealed that the fertility rate has declined drastically. According to you, what are the possible reasons?
In India, the total fertility rate (TFR) has seen a significant decline, dropping from 6.18 children per woman in 1950 to 2.03 children per woman in 2021. Projections suggest that by 2026, the TFR will further decrease to 1.75 children per woman. In rural areas of India, several factors have contributed to this decline such as societal stigma surrounding infertility – deterring couples from seeking timely diagnosis and treatment, high infant mortality rates, nutritional deficiencies (both in the mother and child), inadequate access to quality medical facilities and limited access to IVF treatment. In urban India, the declining TFR is linked to delays in marriage, the widespread adoption of modern contraception and increasing female literacy rates and female workforce participation, resulting in later pregnancies. Lifestyle factors such as obesity, smoking, alcohol consumption, and pollution along with high-stress occupations are also dissuading individuals from considering parenthood altogether.
How have IVF treatments evolved in India over the years? What has been the role of Birla Fertility & IVF in this segment?
The evolution of IVF in India over the past four decades has been marked by significant milestones, advancements, and an increasing acceptance of assisted reproductive technologies (ART). It began in the 1980s with the birth of India’s first IVF baby in 1986. The 1990s saw gradual acceptance of IVF with technological advancements, improved success rates, and initial regulatory steps. The 2000s marked a period of technological and institutional growth, with a proliferation of IVF clinics, increasing affordability, and the introduction of advanced techniques such as Intracytoplasmic Sperm Injection (ICSI) and Preimplantation Genetic Diagnosis (PGD). The 2010s brought the establishment of the Assisted Reproductive Technology (Regulation) Bill, rising public awareness, and innovations like time-lapse embryo imaging.
In the 2020s, advanced genetic screening, artificial intelligence, and stringent government regulations have further enhanced the field. Rising infertility rates have increased demand, while a focus on quality and accreditation ensures high standards of practice and patient safety. From its pioneering efforts to modern technological advancements, IVF in India has become a critical component of reproductive healthcare, offering hope to countless couples facing infertility. It is in this context, that in the last 3 years, BFI has emerged in India as one of India’s most trusted and fastest-growing fertility care brands. Renowned for its clinical excellence, industry-leading IVF success rates, and exceptional service experience, the brand aims to address gaps in fertility care through effective treatments, outstanding clinical outcomes, affordable and transparent pricing, research, and innovation.
Their motto, “All Heart. All Science,” reflects the brands commitment to integrating compassionate care with the science of conception. They employ a multidisciplinary approach, bringing together fertility specialists, andrologists, and counsellors to promote good fertility health and provide comprehensive treatments. This includes fertility preservation options like ovarian tissue freezing for cancer patients. Supported by a team of experienced doctors and embryologists, along with world-class infrastructure, Birla Fertility & IVF aims to be a one-stop destination for IVF and other fertility treatments, serving patients both locally and from other regions.
What is the impact of a poor fertility rate on a country’s demographics? How can the status be improved?
A low fertility rate can significantly impact a country’s demographics by leading to an aging population and a shrinking workforce. This demographic shift can strain social welfare systems, reduce economic productivity, and create a higher dependency ratio where fewer workers support more retirees. To improve the fertility rate, policies such as providing financial incentives for families, improving childcare support, ensuring work-life balance, and creating a supportive environment for parents can be implemented. Additionally, promoting gender equality and facilitating access to reproductive healthcare can also help address this issue.
What are the potential socio-economic consequences of failing to address the decline in India’s Total Fertility Rate (TFR)?
Persistently low fertility rates over time can lead to demographic shifts characterized by inverted population pyramids, with an expanding proportion of older individuals and a dwindling working-age population. This demographic trend may precipitate labour force shortages, posing significant challenges for industries and overall economic productivity. As the working-age cohort diminishes, there could be a heightened reliance on immigration to sustain economic growth, necessitating the
development of ethical and effective immigration policies through global cooperation. Furthermore, the aging population resulting from low fertility rates will exert increased pressure on national health insurance, social security programs, and healthcare infrastructure. Managing the growing elderly population effectively requires the creation of employment opportunities that capitalize on the skills and experience of older individuals. Additionally, primary caregivers may experience heightened stress as they balance responsibilities for both children and aging parents. This underscores the critical need for implementing supportive policies and programs that alleviate caregiver burdens and promote work-life balance. Such initiatives are essential for maintaining societal well-being amidst shifting demographic dynamics.
What are your upcoming business growth plans? What are your plans for FY25?
We are one of India’s leading IVF networks and part of the $3.0 billion C K Birla Group. We have recently acquired ARMC IVF Fertility Centre, marking our entry into South India. Currently, we operate 30 centres, and with this acquisition, we will expand our presence across Kerala, Karnataka, and Tamil Nadu, now operating a total of 37 centres across the country. The C K Birla Group runs hospitals in Kolkata, Jaipur, Gurugram, and Delhi, all supported by state-of-the-art medical
infrastructure and technology. Our goal is to raise awareness and provide reliable fertility treatments, and with this acquisition, we will expand and strengthen our presence in the South, enabling us to address a larger audience and reaffirm our commitment to becoming a leading fertility and IVF provider in India. We have a holistic approach to promote good fertility health and treatment and partner with people on a variety of topics, like fertility preservation, including ovarian tissue freezing for cancer patients.
What are some recent advancements in the IVF treatment landscape? What are some common misconceptions regarding IVF treatments?
Recent Advancements in the IVF Treatment Landscape:
- Time-Lapse Imaging: This technology allows continuous monitoring of embryo development, leading to better selection of viable embryos for transfer. This advancement can improve success rates and reduce the time to pregnancy
- Genetic Screening and Testing: Techniques such as Preimplantation Genetic Testing (PGT) have become more refined. PGT helps identify genetic defects in embryos before implantation, increasing the chances of a healthy pregnancy
- Personalized Medicine: Tailoring IVF protocols to the individual needs of patients based on their genetic, hormonal, and metabolic profiles is becoming more common. This personalized approach can enhance the effectiveness of treatments
- Artificial Intelligence (AI) and Machine Learning: AI is being used to analyze large sets of data to predict the best embryos for transfer and optimize treatment protocols, potentially increasing IVF success rates
- Oocyte Cryopreservation: Improvements in egg freezing techniques have made it a viable option for women who wish to delay childbearing. The success rates of using frozen eggs have improved significantly
- Improved Culture Media: Advances in the composition of culture media used to grow embryos in the lab have contributed to better embryo development and higher success rates in IVF treatments
Common Misconceptions Regarding IVF Treatments
- IVF Guarantees a Baby: One of the most common misconceptions is that IVF guarantees a successful pregnancy. While IVF increases the chances of pregnancy, success rates vary based on multiple factors, including age and individual health conditions
- Only for Infertile Couples: Many believe IVF is only for those who cannot conceive naturally. However, IVF is also used by single women, same-sex couples, and those who wish to avoid genetic issues
- Multiple Births are Inevitable: While IVF can increase the chance of multiples, modern techniques and careful monitoring often aim to transfer a single embryo to reduce the risk of multiple pregnancies
- Only Young Women Should Freeze Eggs: Egg freezing is often thought to be beneficial only for young women. However, women in their early 30s can also benefit from this technology to preserve fertility
