Report urges public IVF funding as India fertility rate falls

A National white paper has urged India to publicly finance fertility care and reform infertility insurance. It says falling fertility and unequal IVF access now demand a public health response.India should move towards publicly financed fertility care and overhaul insurance coverage for infertility treatment as the country's total fertility rate has fallen below the replacement level of 2.1, according to a national white paper released on World IVF Day.The paper, by the IHW council in partnership with the Indian Institute of Health Management Research (IIHMR), argues that infertility should no longer be treated as an elective or lifestyle issue but should be recognised as a core reproductive health condition requiring public investment.It comes at a time when the country's fertility rate has slipped below two children per woman, with the National Family Health Survey (NFHS)-6 recorded a total fertility rate of 2.0, marking the first time India fallen below replacement level.It is estimated that nearly 2.8 crore couples in India are affected by infertility, but access to treatment remains largely determined by the ability to pay. While assisted reproductive technology (ART) and in-vitro fertilisation (IVF) have become increasingly common in the private sector, public provision remains limited, fragmented and confined to a handful of tertiary care institutions.It notes that female factors account for 46 per cent of infertility cases, while male factors contribute 20 per cent, underscoring the need to shift away from the widespread perception that infertility is primarily a women's issue.PUBLIC FUNDING MODELS The White Paper points to several government-backed programmes that have demonstrated the feasibility of publicly financed fertility care and calls for their replication across states.Goa has emerged as the country's first state to provide completely free, end-to-end IVF services through the ART/IUI/IVF Centre at Goa Medical College and Hospital, launched in September 2023.Supported through corporate social responsibility funding, the centre offers diagnostics, ovarian stimulation, embryology and embryo transfer free of cost.Sikkim's Vatsalya Scheme provides financial assistance of up to Rs 3 lakh per eligible couple for IVF treatment at approved public or empanelled private centres. The initiative, launched in 2022, forms part of the state's broader efforts to address declining fertility.West Bengal has also established a free IVF facility at the Centre of Excellence in Reproductive Medicine at Kolkata's IPGME&R-SSKM Hospital, the first such public clinic in eastern India.The paper also highlights existing support under the Employees' State Insurance Corporation (ESIC), which fully funds IVF treatment for insured workers and their dependants at its Delhi facility, while the Central Government Health Scheme (CGHS) reimburses eligible government employees for up to three fresh IVF cycles under specified conditions.Several states, including Tamil Nadu, Rajasthan and Maharashtra, have introduced subsidised IVF services at select government medical colleges, reducing treatment costs to around Rs 20,000–50,000 per cycle.The Centre's Jiyo Parsi Scheme, meanwhile, provides free or highly subsidised fertility treatment for married Parsi couples to help address demographic decline within the community.The report argues these initiatives demonstrate that fertility care can be made affordable through targeted public financing and partnerships with the private sector.INSURANCE OVERHAUL URGEDBeyond expanding public provision, the paper calls for sweeping reforms in private health insurance, where infertility treatment is often excluded or subject to long waiting periods and restrictive conditions.It recommends that the Insurance Regulatory and Development Authority of India (IRDAI) standardise fertility coverage by reducing waiting periods for ART procedures from the current 24–48 months to a maximum of 12 months.Insurers should also be required to cover at least 50–70 per cent of the cost of a modern IVF cycle through standardised sub-limits, while gradually expanding coverage for donor gametes, cryopreservation and preimplantation genetic testing under higher-tier plans.The report also proposes revising reimbursement ceilings under CGHS, ESIC and other government health schemes to reflect the current costs of recombinant medicines and advanced embryology.It recommends extending eligibility to couples experiencing secondary infertility and removing restrictive clauses related to existing children in cases involving blended families or child loss.A major recommendation is the creation of a hub-and-spoke public fertility care network, with advanced ART centres located at state medical colleges and linked to district hospitals offering basic infertility diagnostics, semen analysis and referral services.Such a model, the paper says, would reduce travel costs, improve early diagnosis and decentralise access beyond major cities.The White Paper also advocates a national fertility awareness programme to reduce stigma and encourage early evaluation of both partners.It recommends integrating fertility education into existing reproductive and maternal health programmes, expanding male fertility services in public hospitals, and using frontline health workers to promote timely diagnosis and counselling.It further urges employers to include fertility benefits as part of workplace health coverage, including IVF, fertility preservation, diagnostics and counselling, with insurance caps ranging from Rs 1 lakh to Rs 5 lakh, and its inclusion in Ayushman Bharat-Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY).The paper also recommends extending such benefits to single parents, LGBTQ+ employees and those choosing delayed parenthood, in line with prevailing legal provisions.- EndsPublished On: Jul 30, 2026 16:17 IST