In India, the conversation about infertility as a condition, in both men and women, has found acceptance only in the recent past. Infertility is defined as the inability of a couple to conceive after one year of unprotected sex, or due to some other proven medical condition preventing the same. According to All India Institute of Medical Sciences (AIIMS), 10-15 percent of the nation’s population exhibit complications related to fertility. For a country with a 1.3 billion population, that would account for almost one in seven people.
Despite advancements in fertility treatments, India is still far behind in meeting rising demand. Infertility has become a personal and public health issue in India, with a double-digit increase. Aside from the social stigma, infertility causes a lot of financial and emotional stress for couples. As a dangerous public health issue, all stakeholders—patients, professionals, legislators, and health insurers—must pay close attention.
Infertility in India
According to the Indian Society of Assisted Reproduction (ISAR), roughly 10-14 percent of Indian couples are now experiencing infertility. Infertility is more prevalent in urban regions than in rural places. One out of every six couples in urban areas is affected. In India, approximately 27.5 million couples actively attempting to conceive suffer from infertility, according to a study by Med Tech Company.
In terms of knowledge and adoption of methods such as IVF, India has achieved significant development in the field of reproductive treatment. Infertile couples now have the option of IVF treatment, which involves combining eggs and sperm and fertilizing them in vitro or outside the body; however, only 1% of infertile couples seek fertility treatment.
Reasons for infertility
Infertility in India is commonly acknowledged to be caused by a modern lifestyle, fast urbanization, hormonal changes (particularly in prolactin levels), job pressures, stress, vehicular pollution, and deferring parenting. Infertility is caused by lifestyle illnesses like as obesity and diabetes. Sexually transmitted infections, polycystic ovarian syndrome, fibroids, and genital tuberculosis are also new concerns for women.
Sexually transmitted infections (STIs) have become more common as a result of more unprotected intercourse, as well as extensive use of emergency contraception and surgical abortions, both of which can result in serious infections that can lead to infertility. According to the NCBI, in India, the average age of menopause is 47 years, compared to 52 years in Western countries. Environmental pollutants are also to blame for the dramatic drop in fertility.
A non gender-specific issue
It is a fallacy to believe that the problem of infertility is gender-based. In truth, both male and female couples may share equal blame for the failure to conceive. Only 30% of Indian males have normal sperm qualities, causing women to have difficulty conceiving. Couples have a tendency to avoid tests, and we feel that seeing an infertility specialist in person can help manage a huge majority of cases with easy, conventional therapies.
Only true situations requiring advanced fertility therapies such as IVF, egg donation, or surrogacy should be referred. To make both genders aware of the issue, awareness and sensitization are essential. Fertility preservation, or the preservation of sperm and eggs for future use, has been made possible because of medical discoveries in reproductive health. Stem cell therapy is also on the verge of discovering new ways to rejuvenate the eggs and sperms, a process known as "fertility rejuvenation."
Health insurance and Fertility treatments
Fertility treatments are becoming a financial and physical risk for many people, and insurers can aid individuals who can't afford it on their own in a large way. Both commercial and governmental health insurance companies currently exclude fertility procedures and treatments from their coverage policies. Health insurance plans that cover all surgeries, treatments, and care would be a godsend for infertile couples who have been denied access to modern medical facilities owing to financial constraints.
In India, the cost of a fertility treatment is generally high. For many couples considering a particular fertility treatment, the cost can be a deterrent. It is necessary to move fertility treatment from the "out of pocket" to the "insured" category. Physical and medical risks can be managed by experts; however, insurers can significantly reduce financial risks. With affordable fertility treatment plans, accessibility will not be an issue and couples will be able to enjoy the joy of parenthood.
Because insurance companies primarily cover illness and disorders that necessitate hospitalization, providing mediclaim for fertility treatments is difficult. Fertility treatments are for issues relating to pregnancy or pregnancy-related issues, which are not illnesses. Only birthing is covered by health insurance; fertility treatment is not. Insurance companies only cover specific diagnostic and therapeutic procedures, not the total cost of the operation. The majority of the aftermath is usually covered by insurance, but not the planning.
In many parts of the country, infertility has long been considered a taboo and a social stigma. People are apprehensive about openly sharing and discussing their problems. Lack of understanding about infertility and limited sources of awareness poses a challenging situation, especially in villages and smaller cities in India. However, since last one decade, there has been a markedly increasing trend of infertile couples and fertility services providers throughout India.
Fertility treatments require extensive care and insurance coverage. Insurers should include intrauterine insemination (IUI), in vitro fertilization (IVF), or frozen embryo transfer (FET) in their products, according to experts. For all stakeholders in the fertility industry, comprehensive care and coverage for fertility therapy would open up a new vision.
(The writer is CEO, Milann Fertility & Birthing Hospitals & Healthcare Services Director – Healthcare Global Enterprises Ltd.)