Last week in the US, a Bill to improve access to in-vitro fertilisation (IVF) treatments was blocked again by the Republicans, as the country readies for polls in November. In fact, IVF finds itself at the heart of many animated, political discussions in that country.
But the lens is very different in India, where IVF clinics are plotting healthy growth plans to support people seeking assisted reproductive technologies (ART) to have a baby.
Either way, IVF appears to be here to stay, as countries record stabilising or falling fertility rates — something that could impact their demographic profile, industry insiders explain.
The World Health Organization says one in six people of reproductive age face infertility issues — so there is a problem, and it’s growing, says Dr Kshitiz Murdia, Co-founder and Chief Executive Officer of Indira IVF, pointing to people’s rapidly changing lifestyles and priorities.
IVF clinics are mushrooming across the country and there’s private equity interest fuelling mergers and acquisition in this segment — all this despite insufficient awareness of fertility treatments and lack of affordability in India, compared to developed countries, he points out. An estimated 34 million people are dealing with fertility issues in India, but few opt for treatment, he says, and fewer still — about 3.5 lakh — go through the IVF cycle.
Vinesh Gadhia, Executive Director and CEO, Ferty9 (a unit of Star Fertility Private Ltd), clarifies that while it may seem like boom-time, there’s more ground to be covered. “We have just taken off… cruising altitude of this industry is 10-20 years away,” he says.
The boom, he says, is fuelled by a young population, the urge for parenthood, and changing lifestyles negatively impacting fertility. Besides, people are becoming aware that infertility is a medical disease and not a personal shortcoming, he says. Gadhia estimates that about 50 million people have fertility issues and “we are still scratching the surface”.
Addressing the persisting social overhang over IVF, Murdia adds that rising awareness has people talking more freely about IVF. And with data suggesting that infertility afflicts men and women equally — there is an understanding that both partners should be checked to devise an effective IVF treatment plan, he says.
Ageing population
The discourse around IVF gains prominence even as countries deal with an ageing population and are encouraging more people to have children. The total fertility rate has slipped below the replacement level, says Murdia. Countries like China and Japan are offering more incentives to couples birthing or raising a child, he says, foreseeing a similar situation in India in the future.
In a populous country like India, where an estimated 25 million babies are born every year, necessitating building more educational, healthcare and living infrastructure, can a dip in fertility rates really be a major source of concern?
Murdia clarifies that annually an estimated 1.5 lakh births are through IVF. “So it’s really not about pushing the population,” he says, but encouraging people to have a child. “If you don’t have people reproducing and your total fertility rate is below replacement levels, you are ultimately heading towards an ageing population, which is what Japan is suffering from today.”
For a country’s economy to grow, it needs young people working to support it, he says, adding that while India may not be facing a problem today it could in the next few decades “with the kind of decline we’re seeing in the total fertility rate”.
Gadhia echoes this sentiment, pointing to China, Japan, South Korea and Denmark. India’s baby boom is a strength, he says, and infrastructure growth must keep pace to avert a tough economic situation in the future.
Insurance lags
IVF is expensive and medical insurance still falls short in covering it, says Murdia. Most developed countries have insurance schemes, or the State sponsors a few IVF cycles, or there are co-pay arrangements. “Affordability is still a big issue in the country,” he says, as one IVF cycle could cost ₹1.5-2 lakh, and there’s no guarantee of success.
Gadhia adds that India’s ART Regulation Act helps build consumer confidence in the industry. Calling on health insurance companies to step up to the challenge, he says infertility is classified as a medical disease, not a cosmetic problem.
And the need for solutions like IVF are clearly being voiced in urban and rural India, apart from across the borders, say industry watchers.