Dr. Hitesha Ramnani Rohira DNB Ob/Gyn

Clinical Associate at Corion Fertility Clinic, Mumbai


India, the world’s second most populous nation at 1.3 billion people after China (1.4 billion) has always intrigued demographers. And now, with the United Nations projecting that India’s population will outstrip China’s as early as 2022, it looks like the country may well be ready to explode at its seams.

However, few know about an entirely unexpected problem that is currently bedevilling Asia’s third largest economy — a dramatic decline in its fertility rate. While this may be welcome news for the overpopulated nation, it also points to the disconcerting trend of young couples unable to procreate.

The World Population Prospects: The 2017 Revision report estimates that the fertility rate of Indians (measured as the number of children born to a woman), has plummeted by more than 50 percent, from 4.97 during the 1975-80 period to 2.3 for the current period of 2015-20. By 2025-30, the report projects, the rate will nosedive further to 2.1, touching 1.86 from 2045-50 and 1.78 from 2095-2100. A fertility rate of about 2.2 is generally considered the replacement level, the rate at which the population would hold steady. When the fertility rate dips below this number, the population is expected to decline.

What is infertility :The Cochrane Systematic review define infertility as defined as failure to achieve a clinical pregnancy after regular intercourse for 12 months or more. Increasingly, couples are turning to assisted reproductive technology (ART) for help with conceiving and ultimately giving birth to a healthy live baby of their own.

Urban Indian fertility is now at levels seen in developed countries and in some places among the lowest in the world. According to the Indian Society of Assisted Reproduction,( ISAR) infertility currently affects about 10 to 14 percent of the Indian population, with higher rates in urban areas where one out of six couples is impacted. Nearly 27.5 million couples actively trying to conceive suffer from infertility in India.




Advanced age

Late marriages and delayed child bearing

Lifestyle changes – lack of exercise ,changing food habits

Smoking and other addiction


Rampant use of gadgets like mobile phone and laptops

Exposure to environmental toxins , more use of fertilizers and pesticides.

Injudicious use of emergency contraception and surgical abortions leads to infections and causes irreversible infertility.

Hormonal disorders like PCOS , Hypothyroidism , diabetes and other.

Although the government’s Ninth Five-Year Plan (1997–2002) document included infertility in its comprehensive reproductive and child health package, the country’s primary healthcare system is still not equipped to handle such cases. A survey by the Indian Council of Medical Research (ICMR) found that most state-funded government health centers are “ill-equipped” to deal with cases of infertility. It discovered that a majority of the community health centers and primary health centers had “inadequate physical and diagnostic facilities” and that advanced laboratory services were available in less than 42 percent of district hospitals and 8 percent of community health centers.

According to the study “Infertility Concerns among Young Couples in Rural India,” as in many developing countries, in India infertility treatment is also missing from available reproductive health services. Also, India’s public health program falls short of addressing infertility even though the International Conference on Population and Development’s program, to which the government is a signatory, states that reproductive health services should include prevention and appropriate treatment of infertility.


Another question  “ Infertility treatment is still a taboo “

Infertility is a multi-layered and complex phenomenon, and a number of issues are involved for the people living with it, as it spans the biological, emotional, physical, social, financial and psychological aspects of lives and relationships.

It is a widely held expectation that if and when we choose to, we will be able to have a family. We don’t challenge this assumption until difficulties in conceiving arise. Some couples will conceive naturally, in time, but for those who do not, the pain and loss can be immense, and have a sudden and significant negative impact on relationships.

It’s an emotional rollercoaster for couples who live in month-to-month cycles of hope and disappointment as they navigate a tight schedule of appointments, tests and treatments which place their lives on hold. Prolonged fertility problems invade every area of life, eroding self-confidence and straining friendships. Infertility is, quite simply, devastating.

It’s frustrating that our society is not more open about infertility. Couples going through the treatment journey can feel stigmatised because of their infertility, that it is still a taboo subject, which makes them feel somehow they have failed.

The World Health Organizationrecognises infertility as a physical illness that requires treatment, yet society doesn’t. There’s still a long way to go and we need to move with the times, and raise much more awareness of the pain of infertility because it’s not going away. The more people put their names and faces to this disease, the more our society will understand the scale and impact of the problem. It’s time for infertility to come out of the closet. No one has the right to have a child. But surely everyone should be able to have the choice.

With rising trends in infertility cases Indian government should start fertility awareness programs and also It is vitally important to make both men and women aware of this impending doom so that they can make informed decisions about their lives. Also young couples who want to delay their parenthood for whatsoever reasons should be made aware about fertility preservation..

Fertility treatments are complex and costly, and each assisted reproduction cycle consists of several steps. The cost of IVF procedure in India varies anywhere from Rs. 1 lac to Rs. 2.5 lacs and it depends on the hospital you’re receiving the treatment from, the IVF specialists who are in charge, and your health condition overall.

Most of the general health insurance policies in India do not cover IVF treatments unlike other countries. With the rising cases of infertility  the government should take adequate steps towards providing necessary aids to patients.






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