India is facing a demographic shift, with its fertility rate dipping below the replacement level. This "baby bust" is prompting a surge in demand for In Vitro Fertilization (IVF) and other assisted reproductive technologies (ART). While the IVF market is growing, the government needs to catch up to ensure equitable access and address the broader implications of this demographic transition.
According to a recent UNFPA report, India's fertility rate has declined to 1.9, falling below the replacement level of 2.1. This means that, on average, Indian women are having fewer children than needed to maintain the population size from one generation to the next, without migration. Several factors contribute to this decline: increased female literacy and workforce participation, changing societal attitudes towards marriage and reproduction, rising infertility rates, urbanization, and economic pressures. As more women pursue education and careers, they are delaying marriage and childbearing. Urban lifestyles and rising costs of living are also making it more challenging for couples to raise larger families.
The decline in fertility rates has significant socio-economic implications. An aging population can strain social welfare and healthcare systems, leading to higher dependency ratios. A shrinking young workforce can negatively impact productivity and economic growth. Some states, particularly in South India, are already experiencing these challenges, with the elderly population surpassing the younger demographic and a shrinking workforce due to youth migration.
In this context, IVF is emerging as a crucial solution for couples struggling with infertility. The Indian IVF market is experiencing significant growth, driven by rising infertility rates, changing lifestyles, increased disposable incomes, and growing awareness of ART. The market is projected to grow at a CAGR of 16.23% from 2025 to 2034. India is also becoming a preferred destination for IVF medical tourism due to its cost-effectiveness compared to developed countries. The average cost of IVF in India ranges from ₹85,970 to ₹2,57,910, significantly lower than in countries like the UK.
However, despite the growing demand for IVF, access remains a challenge for many. The high cost of treatment is a major barrier, and most standard health insurance policies in India do not cover fertility treatments. While some government schemes and insurers are beginning to explore partial coverage options, more needs to be done to make IVF affordable and accessible to all.
The government has taken some steps to support fertility treatments. Certain government hospitals provide IVF at subsidized rates, and some states have launched programs to support fertility treatments for economically disadvantaged individuals. The Pradhan Mantri Jan Arogya Yojana (PM-JAY) – Ayushman Bharat provides coverage of INR 5 lakh per year per family for secondary and tertiary care. Also, state governments like Tamil Nadu and Rajasthan offer free or subsidized IVF treatments through specific schemes.
To effectively address the challenges posed by declining fertility rates and ensure equitable access to IVF, the government needs to take a multi-pronged approach: Increase financial support for IVF treatments through government schemes and insurance coverage, expand IVF services beyond major cities to reach rural and underserved populations, promote awareness programs about fertility health and reproductive rights to encourage early intervention, invest in research and development to improve the success rates and affordability of IVF technologies. By addressing these issues, the government can help bridge the gap in infertility treatment and secure India's demographic future. It's time for the government to catch up and create a supportive ecosystem for couples seeking to start a family through IVF.
