Infertility Issues in India & Challenges | A Meeting with Health Secretary

Infertility issues in India are rising gradually and the point of concern is the challenges concomitant with it. The challenges are even harder to resolve than the issue due to many reasons such as lack of information or high cost or social awareness and so on. In the meeting with Health Secretary, I got introduced to few major issues which need a quick resolution. In a house full of doctors we had some very in-depth perspectives shared on infertility care and management.

And, now on this table, I will bring the patient perspective. I have been a patient myself for a very long time and now that I deal with patients myself counseling them on the emotional, financial and medical management of treatment through InfertilityDost creating an interactive platform for patients to facilitate informed decision making. I can authoritatively say that a lot needs to be done to create a safe and reliable ecosystem around infertility issues in India.

Let me reflect upon the biggest issues faced by mostly all infertility patients.

1. Which one is a good clinic or doctor?

Every patient has this one big question to ask. And this is quite complicated for a normal patient to determine. There are these mushrooming clinics that play with the hopes of a desperate couple which eventually leads people to lose faith in good doctors. So, we need an open and accessible portal with a listing of authenticated and consolidated information about clinics and doctors like accreditations, number of successful cases etc.

Every clinic or doctor I have visited has never quoted their success rate below 60% and it slowly comes down after the treatment fails. Then a lot of these IVF cases are a donor or frozen cycles but patients are misled to believe that these are all first IVF success. Then, though conception happens through IVF but it does not result in live birth and there is no accountability for it.

Again, counseling is important and mandatory by rules to provide in a clinic but leaving a few top-notch clinics no one provides or it is there just for namesake.

Thus, we need a nodal agency with strong control monitoring periodically and ensuring transparent reporting over treatment cycles. Simultaneously, patients must be educated to leverage this information to ensure best practices and good choices. Going forward this accessibility of data will lead to finding ethical doctors and clinics.

2. Cost Issues

I will simply ask a straight question – Why is the treatment cost so high?

For a middle-class family, approximately 2 lakh rupees per IVF cycle and a minimum of 1.5 cycles for average success are stretching it too far.

Firstly, we need to bring down the cost. For example, most clinics insist on medicines to be brought in-house and not through wholesaler where the cost is drastically less. Surely, a vigilant eye over margins can make the cost affordable.

Secondly, why don’t we have enough insurance companies cover infertility treatment? Very recently, one private company has started giving insurance but has difficult abiding policies. With 33 million people affected I think it is time to push for its inclusion. And, once insurance companies jump into it they will also ensure that protocols are followed and good treatment given sieving out the mushrooming clinics and also guiding the patients for it is now their money at stake and we know how brutal insurance companies can be. The government needs to set some example with pushing government insurance bodies in infertility treatment.

Thirdly, while pregnancy delivery is part of insurance provided by employers, infertility treatment has absolutely no acknowledgment. With infertility affecting corporate couples and in metros usually leading to women workforce to drop out of job, we should work towards making infertility treatment a part of employee insurance, at least partially. This will also do away with all the stigma attached to it and encourage open conversations.

3. Alternative Treatments for Infertility Issues in India

We have spoken at length about Allopathy treatment. Though I don’t deny the fact that medical interventions like ART have outstanding results but parallelly I would say that alternative treatment methodologies can’t be totally ignored.

Ayurveda has good results in managing initial stages of infertility and control hormone fluctuations or managing lifestyle disorder issues. Acupuncture has proven impact on increasing IVF success. Alternative treatments ensure holistic wellbeing.

All I want is that government helps in bringing it to the forefront to fight infertility issues in India. Give an impetus. At least people should know. They should be aware of available options.

4. Creating Social awareness about Infertility Issues in India

I urge the government to help spread awareness thereby breaking the social taboos. Needless to say, infertility is less of a medical problem and more of a social problem. There is no dearth of instances where women undergoing infertility have been ostracized, pushed into depression and forced out of marriage all because of infertility. As per a research if we compare a woman undergoing cancer and a woman undergoing infertility treatment then the former get social empathy while the latter, the women with infertility gets social flak and apathy. Why?

The government can’t shy away by saying that increasing population is already a big problem.

We need educational programs and awareness campaigns, and especially for Tier 2 and Tier 3 cities where social complexities are far more binding and knowledge about correct treatment option hardly any.

We need to change this and when the government begins to take a strong stand on this we may be able to penetrate the patriarchal mindset that invariably blames the woman for all fertility related issues. We must help the woman who bears the brunt of it all.

5. Infertility treatment should be patient-centric

We know that infertility patients go through depression but do we have any numbers on it? Do we have any stats on emotional health and wellbeing of women undergoing treatment? We don’t have enough patient data. Make that data collection and analysis – mandatory and a regular protocol. This way we will be able to help the patients better and fight infertility issues in India.

In fact, we need to bring more digitization to the complete process of infertility care. We have to create an ecosystem. Currently, we are just focused on the medical part of it.

Digitization will increase accessibility of treatment information which at present sadly stands at 1% as per EY report and that too only in the metros. It will also reduce patient harassment and misleading. We need a modal portal backed by government authenticity to address all information related issues. And to reassure the patients that they are listened to. We need to bring regulation and accountability.

6. Preventive Care

As infertility issues in India are increasing with the estimated addition of 10 million cases every year and most of this is induced by lifestyle issues. It is time to focus on preventive care not only to ensure that our future generations continue to procreate and we don’t end up like Germany or Japan but also to help with managing the quality of health and life.

The focus should be on informing and helping young generation understand the issue and its future impact. This will work as a double benefit sword as it will also build the right attitude and social environment for future.

A time will come when infertility issues in India will be seen as no more than a normal treatable medical condition and not marred by social complexities of demeaning a woman.

“Towards that day we need to prepare from today itself”

I am working towards social awareness and patient-centric ecosystem through my venture FertilityDost but I plead government to help me in this endeavor so that together we can create real value and positively impact many more people.

It is the high time when Infertility issues in India need immediate initiative not only from the government but also from the society. We, the society must urge for a change in every aspect concerned with this issue. whether a social stigma or an administrative negligence, the society need to raise voice against it and must demand a healthy conclusion.