We recently spoke with Vinesh Gadhia, the CEO at ART Fertility Clinics India, and learned a ton about fertility in India. If you’re struggling with infertility, you might feel alone, but you should know that there are many people out there who are going through the same thing. Read ahead to learn more the state of infertility in India.
How many couples in India are struggling with infertility?
The high number might surprise you. According to a report by Ernst & Young, India faces a heavy burden of infertility, with an estimated 22 to 33 million couples of reproductive age dealing with the problem.
Multiple factors, including clinical issues, healthcare problems and lifestyle choices, are having a detrimental effect on both male and female fertility. Unfortunately, only around 1% of infertile couples in India couples seek medical intervention as a treatment option. The reasons for this include a lack of acceptance, a lack of awareness, and in many cases, a lack of access.
Is infertility on the rise in India? Why is this?
Infertility has emerged as one of the most common health issues faced by young couples trying to conceive. It is estimated that about 30 million couples suffer from sub-fertility or lifetime infertility. In addition, factors like obesity, a sedentary lifestyle, increased use of contraceptives, and sexually transmitted diseases are adding to infertility in both genders.
From a genetic point of view, Indians differ from theirCaucasian peers. For example, a study (by Mahmud, G., López Bernal, a, Yudkin, P., Ledger, W. & Barlow) stated that Indian women had an earlier onset of decline in antral follicular counts (AFC), nearly 6.3 years earlier than their Western counterparts.
Also, despite younger patient age and similar embryo quality, Indian women have a significantly lower live birth rate following IVF than white women (24% vs 41%, respectively) suggesting a poorer quality ovarian reserve. This could have been a significant factor as to why our forefathers had early marriages. However, delayed marriages and later parenthood are other major factors contributing to rising infertility in India.
Is male infertility as common as female infertility?
In a country like India, infertility is still considered a condition affecting women – male infertility is always ignored. As per an EY report, women account for 40%-50% of infertility among infertile couples, while male infertility accounts for 30%-40%,proving that infertility is no longer a condition associated only with women. Increased levels of tobacco and alcohol use are risk factors closely associated with male infertility.
Clinically speaking, tobacco use affects spermatogenesis and has been linked with low sperm count, and alcohol consumption has been shown to increase leukocyte counts in seminal fluid, reduce seminal quality, and lower testosterone levels. Increasing levels of obesity and a high prevalence of sexually transmitted infections are also linked with increased infertility.
What are the most common causes of infertility?
The prevalence of infertility is on the rise in India due to clinical factors, such as increased use of contraceptives, a high prevalence of polycystic ovarian syndrome and endometriosis, and increased sexually transmitted diseases. In addition, lifestyle factors, like a later marriage age, high prevalence of obesity, and increased tobacco and alcohol consumption add up and contribute to infertility.
While these are common causes, one cannot rule out the genetic reasons that seem to push infertility problem to the forefront in India. A recent study states that Indian women have lower Anti-Mullerian Hormone levels (AMH), higher Follicular Stimulating Hormone (FSH) levels, and a shorter duration of fertility, despite being significantly younger when compared to their Caucasian peers. These racial differences seem to have a significant role in infertility, and even impact outcomes after assisted reproductive technology (ART) treatment
What percentage of couples seek medical assistance if they find it hard to conceive?
Some people get pregnant quickly, but for others, it can take longer. Women aged 30 and over and anyone who’s already aware they may have fertility problems should first consult their gynaecologist. They’ll check for common causes of fertility problems and to seek possible treatments that may improve their fertility. Unfortunately, out of the 7.5% of couples in India suffering from infertility, only 3.5% come forward for evaluation.
To put this percentile in perspective, out of 22 million infertile couples, only 1% seek medical help. There is a need to nudge the others, be it through raising awareness of the options available or increasing the ease of access, to even creating easy financing options for couples facing financial challenges.
Why do you think so many couples shy away from seeking medical assistance?
Infertility is recognized as a disease by the World Health Organization, and it should be treated like diabetes, cancer, and other diseases are treated. The stigma associated with infertility comes from our deep-rooted thoughts – we despise failure. In most cases, women suffer a lot of psychological and emotional pain.
Another common notion is that “infertility will not happen to me”, which is incorrect, because infertility is just like any other disease. It can happen to anyone, and no one should delay treatment. Despite the importance of parenthood, couples in India are often unfamiliar with the various assisted reproductive treatments available, especially in Tier 2 & 3 cities. Our recent campaign #UnComplicate aimed to address the hesitation and doubts that Indians have surrounding the treatment, and busting myths related to IVF.
What should couples do first if they are struggling to conceive?
Around 1 in 7 couples may have difficulty conceiving. Most couples can conceive within six months to one year, so for couples who are unable to conceive naturally after a whole year of trying, it is best to consult your gynaecologist. They will refer you to a fertility specialist after reviewing your medical history.
How many couples have had IVF in India?
Even with the current 2,50,000 cycles per annum through 1,750 IVF centers (the world’s second-highest, after China) across all players, India is still an extremely under-penetrated market with immense potential to become a leader in clinical fertility research. At ART Fertility Clinics, we want to be the essential bridge for couples battling subfertility and/or infertility in their journey towards parenthood by providing them with the best possible treatment and compassionate care.
Is IVF expensive?
India has advanced technology and state-of-the-art equipment and infrastructure comparable to any global fertility center. The cost of IVF treatment in India is usually between US $2,000 and US $3,000, while in developed countries such as the United States and Europe, the cost of a basic IVF cycle is about US$10,000 to US $15,000. Since most fertility specialists, consultants and caregivers in India can communicate in English, patients and their families understand their treatment better and feel safer.
What is the success rate of IVF?
At ART Fertility Clinics, we follow the doctrine of evidence-based medicine and provide personalized treatment plans for all our patients. Our treatment plans are personalized based on proprietary research that takes into account ethnicity, social and cultural mores, and previous medical history. This holistic approach, which combines scientific, natural and geographic factors, has enabled ART Fertility Clinics to achieve a world-leading 69% successful pregnancy rate.