On July 25, 1978, the world witnessed the birth of Louise Brown, the first test tube baby. Since then, IVF clinics have proliferated, even reaching India's tier-II cities. This surge in assisted reproductive technology (ART) use comes amid a notable decline in fertility rates.
India conducts around 2-2.5 lakh IVF cycles annually. This increase in IVF usage correlates with a significant drop in the country's fertility rate. Awareness about reproductive health and fertility issues has grown, leading more childless couples to seek assistance from private clinics.
Recent studies confirm this trend. For instance, a study in The Lancet shows India's fertility rate plummeted from 6.18 in 1950 to 1.91 in 2021, with projections of further decreases to 1.3 by 2050 and 1.04 by 2100. The total fertility rate (TFR), which measures the average number of children born to a woman in her lifetime, needs to be 2.1 to maintain a stable population. When the TFR falls below this replacement level, population decline begins.
Globally, fertility rates have halved over the past 70 years, as reported by the World Economic Forum (WEF) in 2022. Several economic, social, and biological factors contribute to this decline. The cost of raising children, women's empowerment, and access to contraception and reproductive health services are key economic reasons. Socially, increased female literacy and workforce participation play significant roles.
In India, lifestyle choices and biological factors also contribute to the declining fertility rates. Dr. Sonia Malik, Chief Clinical Mentor at Nova IVF Fertility, notes that 1 in 6 couples worldwide face infertility due to various factors, including lifestyle choices. Indian women, for example, experience a quicker decline in ovarian function compared to their Caucasian counterparts.
Environmental and genetic factors are crucial in understanding infertility. Dr. Rajendra Shitole, an IVF Consultant and Endoscopic Surgeon, highlights that male infertility can be due to low sperm count, poor motility, or abnormal sperm shape. Female infertility can stem from hormonal imbalances, ovulation disorders, and age-related egg quality decline.
Dietary factors also contribute to infertility. Dr. Monica Jani, a Gynaecologist & Obstetrician, explains that problems like irregular ovulation, amenorrhoea, and ovarian cysts or fibroids can arise from poor diet and lifestyle choices. Men can face fertility issues from hypothalamus or pituitary diseases, compounded by lifestyle choices like smoking, excessive alcohol consumption, and obesity.
Delayed parenthood is another significant factor. Couples often prioritize financial stability and career advancement, postponing childbearing. Dr. Malik emphasizes the need for couples to regularly assess their fertility health and prioritize fertility tests.
All these factors contribute to declining fertility rates. With increasing awareness and changing mindsets, more Indians are turning to fertility clinics for help.
