On World IVF Day, fertility experts across the country are warning of a quiet fertility crisis that’s affecting younger women than ever before. Diminished Ovarian Reserve (DOR)—a condition typically associated with women approaching their 40s—is increasingly being diagnosed in women as young as 25.
DOR involves a decline in the number and quality of eggs, a key factor in a woman’s ability to conceive. And the signs of this decline often emerge long before a woman plans a pregnancy.
“We now regularly see women under 30 with severely low AMH levels,” said Dr Beena Muktesh, Clinical Director–IVF at Motherhood Fertility & IVF, Gurugram. “Alongside genetic factors, today’s urban stress, PCOS, poor sleep, dietary deficiencies, and toxin exposure from plastics and pesticides are all playing a role in accelerating ovarian ageing.”
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Dr Aakriti Batra, fertility specialist at Nova IVF Fertility in Delhi-NCR, noted a marked increase in younger patients. “Crash diets, high stress, hormonal imbalances, and smoking are disrupting reproductive health earlier than ever. Fertility is not just about age anymore—it’s how we live, work, eat, and manage stress.”
The concern is echoed across regions. Dr Sheikh Hilal, a gynaecologist based in Kashmir, added that conditions like Polycystic Ovarian Disease (PCOD), endometriosis, genital tuberculosis, and fibroids are major contributors to infertility among Indian women. “Symptoms like recurring pelvic pain, abnormal discharge, or painful periods shouldn’t be dismissed,” he said. “They may indicate deeper infections like genital TB, which is a leading but underdiagnosed cause of infertility—especially in both men and women in the northern belt.”
According to Dr Hilal’s clinic records, female infertility accounts for around 40% of cases, male infertility 25–30%, and combined or unexplained causes cover the rest. He also debunked the myth that IVF is always needed. “Over 70% of couples can conceive with medical management alone. IVF is usually considered when there are fallopian tube issues or long-standing infertility.”
Greater access, better outcomes
India is also witnessing rapid evolution in IVF technology and access. “IVF is no longer confined to metro cities or elite hospitals,” said Dr Mandavi Rai, senior fertility & IVF specialist, Motherhood Fertility & IVF, Noida. “We now see increasing uptake even in Tier-2 towns, thanks to EMI options, government subsidies, and generic medication.”
Dr Archana Dhawan Bajaj, IVF expert at Nurture Clinic, explained that recent innovations have helped increase IVF success rates, especially for older women or those with prior failed cycles. “Preimplantation Genetic Testing (PGT) helps identify healthy embryos. Time-lapse embryo imaging improves embryo selection. Even AI is now being used to predict embryo viability. Vitrification—advanced freezing—has made frozen embryo transfers more reliable,” she said.
She said factors like age, egg and sperm quality, uterine health, PCOS, endometriosis, and lifestyle habits all affect outcomes, adding, “Couples must maintain a healthy BMI, eat well, avoid smoking, and reduce stress. Supplements like folic acid and antioxidants can help. So can yoga, therapy, or mindfulness. IVF requires emotional and physical stamina—support matters.”
Breaking the silence
Doctors agree that social acceptance of IVF has grown in India, especially in urban centres. “Ten years ago, IVF was whispered about. Today, celebrities talk openly, and couples are more proactive in seeking treatment,” said Dr Bajaj. “Clinics are holding awareness camps, webinars, and outreach in Tier-2 cities. The silence around infertility is finally breaking.”
Yet affordability remains a barrier for many. “A typical IVF cycle costs between Rs 1.2 to Rs 2.5 lakh,” said Dr Bajaj. “While simplified protocols, government hospitals, and Ayushman Bharat are helping, we still need stronger insurance coverage and wider policy support,” she added.
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The ART Law’s role
India’s Assisted Reproductive Technology (ART) law, enforced in recent years, has improved patient rights and safety. Clinics must now follow strict protocols, ensure counselling, obtain consent, and maintain full records. “The law protects patients and sets accountability in motion,” said Dr Rai, adding, “It gives couples confidence when pursuing IVF.”
Dr Himani Gupta, consultant gynecologist at Medicover Hospitals, Mumbai, underlined that the pace and pressure of modern life are deeply connected to reproductive health. “Erratic work hours, stress, poor diet, lack of rest—all these disturb hormonal cycles. We now see women in their twenties reporting low ovarian reserve and irregular cycles,” she said.
“You only get one body—respect it. Fertility isn’t just a medical condition anymore. It’s a reflection of our entire lifestyle,” she added.
With infertility affecting one in six Indian couples and the age of onset shifting downward, experts urge early screening, better lifestyle habits, and emotional preparedness. “Modern science has opened new doors,” said Dr Bajaj. “But awareness and timely action are still the most powerful tools couples have,” she further adds.
