Dr. Mannan Gupta
For millions of young Indians today, life follows a familiar trajectory—higher education, career growth, financial stability, and then starting a family. While this shift reflects changing aspirations and greater opportunities, our biology has not evolved at the same pace. Fertility remains governed by age, and delaying parenthood without understanding its biological implications is becoming one of the biggest reproductive health challenges of our time.
The conversation around fertility must move beyond celebrating medical breakthroughs to encouraging awareness, early intervention, and informed choices. IVF has undoubtedly transformed reproductive medicine, but the larger message is that couples should not wait until IVF becomes their only option.
According to global estimates, nearly one in six couples experience infertility during their reproductive years. India is witnessing a steady rise in fertility-related concerns, driven by delayed marriages, sedentary lifestyles, obesity, diabetes, stress, environmental factors, polycystic ovary syndrome (PCOS), endometriosis, and declining reproductive health. Despite this growing burden, infertility continues to be viewed through the lens of stigma rather than science.
One of the most common misconceptions is that infertility is primarily a woman’s problem. Medical evidence tells a different story. Male factors contribute to nearly half of all infertility cases, either independently or in combination with female factors. Yet, in many households, women continue to shoulder the emotional burden, often undergoing repeated investigations while the male partner delays even a basic fertility assessment. Fertility is a shared responsibility, and evaluation should always involve both partners from the outset.
Another widespread myth is that IVF is recommended to every couple struggling to conceive. In reality, IVF is only one of several evidence-based fertility treatments. Many couples conceive successfully with lifestyle changes, medications, ovulation induction, treatment of hormonal disorders, minimally invasive surgeries, or intrauterine insemination (IUI). IVF is advised only after a comprehensive clinical evaluation, taking into account the woman’s age, ovarian reserve, sperm quality, duration of infertility, and previous treatment history.
The most important factor that couples often underestimate is time. Female fertility begins to decline gradually after the age of 30 and more rapidly after 35, primarily because both the number and quality of eggs reduce with age. While advances in reproductive medicine have significantly improved success rates, medical science cannot completely reverse the natural ageing process of the ovaries. This is why women over the age of 35 should seek fertility evaluation after six months of unsuccessful attempts to conceive, while younger couples should consult a specialist after one year.
The good news is that fertility care today is more advanced than ever before. Modern IVF is no longer the physically demanding and uncertain treatment it was decades ago. Innovations such as advanced embryo culture systems, time-lapse embryo monitoring, highly efficient embryo freezing techniques, improved laboratory conditions, minimally invasive egg retrieval procedures, and genetic testing in selected medical situations have made treatment safer and more effective. Importantly, fertility treatment is increasingly personalised, ensuring that each couple receives a protocol tailored to their unique medical profile rather than a one-size-fits-all approach.
Equally significant is the growing role of fertility preservation. Many women today choose to delay pregnancy due to education, career aspirations, or personal circumstances. Others may require cancer treatment or have medical conditions that threaten future fertility. Egg and embryo freezing now offer scientifically validated options that provide greater reproductive flexibility, although these decisions should always be made after detailed medical counselling.
However, successful fertility treatment is not just about technology. Emotional wellbeing is an equally important pillar of care. Couples undergoing fertility treatment often experience anxiety, self-doubt, financial stress, and emotional exhaustion. Compassionate counselling, psychological support, and open communication between clinicians and patients are essential to improving not only treatment outcomes but also the overall patient experience.
As clinicians, we also have a responsibility to promote fertility awareness before infertility develops. Simple lifestyle measures—including maintaining a healthy weight, exercising regularly, managing chronic illnesses, avoiding tobacco and excessive alcohol consumption, reducing stress, and seeking timely medical advice for menstrual irregularities or reproductive health concerns—can positively influence fertility and improve pregnancy outcomes.
The infertility is a medical condition—not a personal failure, a social taboo, or a reason for shame. Couples deserve empathy instead of judgment, scientific guidance instead of myths, and timely medical care instead of delayed reassurance.
The dream of parenthood has become achievable for millions because of advances in reproductive medicine. But the greatest success of fertility care will not be measured only by the number of IVF pregnancies. It will be measured by how effectively we educate people to understand their fertility, seek help without hesitation, and make informed reproductive choices before time becomes the biggest obstacle.
(The author is Chairman Obstetrics, Gynaecology & IVF Expert, Elantis Healthcare, New Delhi. He can be reached at [email protected])
