IVF Pushes 9 in 10 Couples into Catastrophic Debt; Study Recommends PM-JAY Cover of ₹81,332 Per Cycle

A recent multi-center study has revealed the staggering financial burden that infertility treatment, particularly In Vitro Fertilization (IVF), places on Indian families. The study found that nearly 90% of couples undergoing IVF face "catastrophic expenditure," with costs often exceeding 10% of their annual household income. This financial strain occurs even when treatment is sought at public hospitals.

The analysis, conducted across five major institutions, highlights the urgent need for financial assistance for couples struggling with infertility, which affects an estimated 3.9% to 16.8% of Indian couples. The World Health Organization (WHO) reports that approximately 8% of these couples require advanced and expensive treatments like IVF.

High Out-of-Pocket Expenses

The study revealed that the average out-of-pocket expenditure (OOPE) for a single IVF cycle is approximately ₹1.1 lakh in public hospitals and ₹2.3 lakh in private hospitals. These high costs force more than half of the couples to borrow money to cover the expenses. Alarmingly, only 5% of the participants had any insurance coverage for IVF, and even those with coverage received limited support.

To address this crisis, researchers recommend that the Pradhan Mantri Jan Arogya Yojana (PM-JAY) consider including IVF in its coverage. Based on their analysis, the study suggests a reimbursement package rate of ₹81,332 per IVF cycle. This figure represents the estimated health-system cost of one IVF cycle, irrespective of hospital efficiency. The study further recommends that subsequent IVF cycles could be covered at ₹35,087.

Broader Infertility Treatment Costs

The financial burden extends beyond IVF. Among couples undergoing infertility treatment for conditions like Polycystic Ovary Syndrome (PCOS), endometriosis, tubal disease, or male-factor infertility, 25% still experienced catastrophic expenditure. The median OOPE for non-IVF infertility treatment was ₹11,317. While direct medical costs for medicines and investigations were higher in private facilities, public facilities imposed higher indirect and non-medical expenses. These include costs related to travel, accommodation, and loss of wages.

Impact on Quality of Life

The study also assessed the quality of life among couples seeking infertility treatment and found it markedly poorer, especially among those undergoing IVF. Women reported significant pain, anxiety, and depression, while men showed increased anxiety scores.

The Need for PM-JAY Coverage

Currently, PM-JAY does not cover OPD expenses, which constitute a significant portion of infertility treatment costs, including IVF. The study emphasizes the need to consider this aspect when including IVF in the PM-JAY package. High out-of-pocket expenses remain a major barrier to accessing IVF treatment.

Several factors contribute to the high cost of IVF in India, including medication costs, diagnostic tests, and additional procedures like Intra Cytoplasmic Sperm Injection (ICSI) or Preimplantation Genetic Testing (PGT). These costs can vary widely depending on the clinic, city, and specific treatments required.

Moving Forward

The inclusion of IVF under PM-JAY would provide significant relief to economically vulnerable couples, increasing access to treatment and reducing the emotional and financial burden of infertility. While some states have started including IVF under PM-JAY, a nationwide policy change is needed to ensure equitable access to these essential services. By addressing the financial barriers to infertility treatment, India can take a crucial step towards improving the well-being of couples and promoting reproductive health.