India has witnessed its fertility levels drop below the replacement rate, thereby sparking a debate about the country's future demographics. Although much attention is being paid to population trends and their impact on the economy, fertility experts argue that another issue deserves equal attention: infertility and subfertility.
Fertility experts state that reproductive health has increasingly become a public health concern rather than remaining solely a personal issue. Several factors, including delayed parenthood, lifestyle-related health conditions and a lack of fertility awareness, have influenced how Indians approach family planning.
More couples are seeking fertility treatment
According to Dr Rohit Gutgutia, Medical Director, Nova IVF Fertility, fertility clinics have witnessed a noticeable rise in the number of couples seeking help to conceive over the past decade.
Several health conditions are becoming increasingly common among people of reproductive age, including:
- Polycystic Ovary Syndrome (PCOS)
- Endometriosis
- Thyroid disorders
- Obesity
- Diabetes
- Reduced semen quality
- Environmental exposures
- Chronic stress
Many of these conditions can affect fertility years before couples begin planning for a child.
The fertility awareness gap
Experts say one of the biggest challenges is the lack of awareness around reproductive health.
While most people pay attention to heart health, diabetes and fitness, fertility often receives attention only when conception difficulties arise. By that point, valuable reproductive years may already have passed.
According to Dr Gutgutia, fertility depends not only on age but also on overall well-being, lifestyle habits, environmental influences and timely medical care.
Delayed parenthood is becoming more common
Another important factor behind changing fertility trends is the increasing age at which people choose to marry and have children.
According to Dr Sandhya Ghode, Consultant – Infertility Specialist, Motherhood Fertility & IVF, many people today prioritise education and career goals before starting a family. As a result, the average age of parenthood continues to rise.
The biological implication of this trend is that female fertility begins to decline after the age of 30 and drops more sharply after the age of 35.
Urban lifestyles may be playing a role
Differences in fertility rates across regions also provide important insights.
Experts have highlighted the significant gap between urban areas and regions with relatively higher fertility levels. According to Dr Ghode, several aspects of urban life may indirectly influence reproductive health and family planning decisions, including:
- High stress levels
- Sedentary lifestyles
- Environmental pollution
- The rising cost of raising children
Why reproductive health needs to become a public health priority
Experts emphasise that infertility is not always the sole reason behind declining fertility rates. However, many people who wish to become parents may face biological challenges that could potentially be addressed through earlier awareness and intervention.
This is why experts are calling for greater emphasis on:
- Fertility education
- Reproductive health screening
- Improved access to fertility specialists
- Preconception health check-ups
- Public awareness campaigns
- Family-friendly workplace policies
Experts believe that helping individuals make informed decisions about their reproductive health can benefit both personal well-being and long-term population health.
According to fertility specialists, the conversation must move beyond birth statistics alone and focus more broadly on reproductive health and well-being.
As India continues to evolve socially and economically, awareness, preventive healthcare and timely medical guidance are likely to play an increasingly important role in supporting reproductive choices and family-building goals.
