How Innovations and Regulations Impact the Future of IVF Treatment
By Arunima Rajan
As IVF demand rises, cutting-edge technology and stringent regulations are driving growth and transforming fertility care across the nation.
Kalpana never thought she'd need help to start a family. And yet, when years passed without success, the HR executive knew she had to explore other options. Turning to in vitro fertilization (IVF), she found hope and ultimately, success. Her journey mirrors a broader trend across India, where modern couples, marrying later, often face infertility and seek advanced medical solutions. Lifestyle changes, rising awareness, and technological advancements are transforming the IVF landscape. Influential celebrities have helped reduce the stigma around infertility, further boosting the market.
Sharda Agarwal, co-founder of Sepalika, an online health advisory service, points out that modern couples are marrying later and having children in their mid to late 30s. However, fertility rates drop significantly with age. Women's fertility is highest in their mid to late 20s, but by their 30s, their ovarian reserve decreases to one-tenth of its earlier level. Currently, one in six couples globally and in India struggle with conception. Lifestyle choices, such as poor sleep, chronic stress, consumption of refined and inflammatory foods, and exposure to xenoestrogens like phthalates and BPA from plastics and chemicals, contribute to infertility. “A 2017 meta-analysis in the Journal Human Reproduction Update reported a 50% decline in sperm counts over 40 years, with lifestyle being a major factor,” says Agarwal.
IVF, with a success rate of about 30-35%, continues to be the most advanced and rapid solution for infertility, particularly in today's fast-paced society. Agarwal points out that the significant stigma surrounding infertility, especially for women, prompts couples to opt for IVF sooner, with doctors also recommending it more quickly than before.
Shivani Sachdev Gour, Director of SCI Healthcare, notes that celebrities like Shah Rukh Khan have helped reduce the stigma around IVF. India's young population has driven up demand, with over 1 in 10 couples facing conception issues. “While surrogacy for international patients is banned, many still come from SAARC and African countries for IVF. The industry has become more organized, with new centres and corporate IVF chains,” says Gour.
“India currently conducts an average of 200,000 to 250,000 IVF cycles per year, with projections indicating this could rise to 500,000 to 600,000 cycles annually. The 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, growing at a CAGR of 16.23% during the forecast period. By 2030, the market value is expected to surpass $3.721 billion, compared to $793 million in 2020,” says Ganesh Lakshmanan, former regional director of Bourn Hall Clinic.
He also predicts that the market will likely see the entry of new players as well as numerous mergers and acquisitions. Smaller local players may be acquired by larger companies, a trend similar to that seen in the hospital sector, which will lead to greater transparency and higher quality treatments for patients. He notes that major brands are aiming to expand their reach to tier 2 and tier 3 cities.
The Impact of Legislation
Niki J Panchal, Senior Consultant Embryologist at Kinder Hospitals, Bangalore, states that the Assisted Reproductive Technology Regulation Bill, passed on December 20, 2021, is a significant legislative effort by the Union Cabinet to safeguard women's reproductive rights. This bill aims to ensure the safe and ethical practice of assisted reproductive technology (ART) services across India. It mandates the registration of all IVF clinics to ensure they possess the necessary equipment and expertise to provide proper IVF treatments. This regulation addresses the issue of inadequately equipped IVF clinics proliferating unchecked nationwide. It also ends the practice of traveling IVF specialists and embryologists. Historically, India lacked comprehensive regulations governing ART practices, eligibility criteria, and surrogacy arrangements. The passing of two laws by the Indian Parliament in December 2021 marks a transformative change in the nation's fertility landscape.
Panchal highlights a significant initiative from government-run medical colleges and hospitals in Maharashtra, which plan to offer expensive IVF treatments, typically costing over Rs. 2 lakh, at no cost. This initiative is aimed at addressing fertility issues in rural areas. According to Panchal, these efforts demonstrate steps being taken to make IVF treatment more accessible and affordable for couples in India, showcasing a commitment to supporting individuals struggling with infertility.
Panchal explains that the fertility market's growth is driven by the increasing number of fertility clinics and the improving success rates of fertility treatments. As demand for these services rises, more clinics are emerging to meet the needs of individuals and couples seeking fertility treatments. Advancements in assisted reproductive technologies and ongoing research and development are also contributing to higher success rates. This includes improved methods for embryo selection, better culture media, and enhanced cryopreservation techniques, which lead to higher chances of successful pregnancies.
Panchal adds that these factors—more fertility clinics, higher success rates, and technological advancements—create a positive perception of fertility treatments among potential patients. As more people become aware of the increased chances of achieving pregnancy through these treatments, the demand for fertility services, particularly IVF, continues to grow, driving overall market expansion.
In India, most health insurance plans traditionally do not cover infertility treatments, including in vitro fertilization (IVF), as it is often viewed as an elective procedure rather than a necessary medical treatment. Consequently, insurance companies typically do not cover its costs. Government hospitals lack the facilities and trained personnel to perform IVF treatments, and only a few charitable hospitals offer these services. Additionally, very few government medical colleges include specialized curricula with hands-on training for IVF procedures.
Barriers to Accessing IVF treatment in India
Vaishali Chaudhary, Director of IVF & Fertility at Sahyadri Super Speciality Hospital in Pune, outlines several barriers to accessing IVF treatments in India:
Financial Cost: The high cost of ART (Assisted Reproductive Technology) is the most significant barrier.
Availability of IVF Centres: IVF requires advanced medical equipment and skilled professionals, which are often unavailable in smaller towns. Patients must travel to larger cities, incurring additional costs and losing daily wages.
ART Law of 2022: Strict regulations regarding the establishment of IVF centres and mandatory documentation reduce the number of compliant centres.
Success Rates and Emotional Toll: IVF does not guarantee success, and the emotional strain of failed cycles can be overwhelming. Additionally, there may be a lack of trained counsellors to support couples.
Myths and Misunderstandings: Couples fear mix-ups of semen or oocyte samples and have misconceptions about the health of babies conceived through IVF and the necessity of caesarean sections.
Psychological Barriers: Infertile couples often feel isolated, facing increased shame and stigma associated with infertility and IVF treatment.
Cultural Barriers: Cultural and religious beliefs can lead to the rejection of IVF. Some view IVF as unnatural and consider the discarding of unhealthy embryos sinful.
Chaudhary explains that the cost of an IVF cycle in India ranges from Rs 1.3 lakhs to Rs 2.5 lakhs. This variation depends on factors such as the type of injections (gonadotrophins) used, the choice of culture media, whether the procedure is part of a batch IVF or if a trained embryologist is available daily in the lab, and whether fresh transfers or frozen embryos are used. Additional procedures, like laser-assisted hatching and preimplantation genetic testing, can further increase the overall cost.
Economic Comparisons
Ajit Guruswamy, CEO of SIA IVF, observes a significant change in the perception of IVF in India over the past decade. Previously seen as taboo, IVF is now more accepted as a legitimate and necessary treatment for infertility, largely due to increased awareness and education. He points out that countries like Denmark and Israel have high IVF success rates, partly because of strong state support. India can learn from these countries by enhancing government funding for fertility treatments, providing subsidies, and implementing comprehensive insurance coverage to make IVF more accessible and affordable. Guruswamy explains that the cost of IVF in India is much lower than in countries like the USA and Israel, with an average cost of $1,500 per cycle in India, compared to $18,000-$25,000 per cycle in the USA and $4,000-$9,000 per cycle in Israel.
Impact of Technology
Satish Kumar Adiga, the head of the Centre of Excellence in Clinical Embryology and Coordinator of the Centre for Fertility Preservation at the Department of Reproductive Science, Kasturba Medical College, MAHE, highlights the significant impact of technology on the IVF industry in India. He notes that AI in sperm and embryo selection, Preimplantation Genetic Testing (PGT), Non-invasive prenatal testing (NIPT), advanced sperm selection platforms, and automation are key advancements. These technologies are crucial for transforming the IVF market by improving success rates, increasing accessibility to treatments, and enhancing the patient experience. Adiga also points out that the presence of innovative startups and the adoption of these advanced technologies are driving major growth and development in the sector.
The professor notes that recent policy changes and proposed regulations in India could significantly impact the IVF market.
For many couples facing infertility, IVF has become a vital option, much like Kalpana's successful journey highlights. As the IVF industry in India continues to grow, the focus on ethical practices, affordability, and accessibility remains crucial. Industry experts emphasize the importance of collaboration between medical professionals, policymakers, and corporate entities to ensure that IVF treatments are effective and widely available. With the market expanding rapidly, these collective efforts are essential to meet the rising demand and help countless families achieve their dream of parenthood.
