A new study has revealed that while India has a regulatory framework for advanced infertility treatments such as In Vitro Fertilisation (IVF), the cost of these procedures remains unregulated. As a result, couples continue to face significant financial pressure. The study aimed to estimate the cost of infertility diagnosis and management—including IVF—as well as the impact on quality of life among infertile couples.
Out-of-Pocket Expenses Place Heavy Financial Strain
According to the Indian Council of Medical Research–National Institute for Research in Reproductive and Child Health (ICMR-NIRRCH), many patients reported high out-of-pocket expenditure. On average, one IVF cycle cost over ₹1 lakh in both public and private hospitals. Out-of-pocket payments refer to expenses individuals pay from their own resources, without support from insurance or third-party coverage.
Study Methodology and Patient Profile
For the study, researchers selected three public and two private tertiary facilities. They collected primary data from 30 patients undergoing IVF and 100 patients receiving infertility treatment for specific conditions such as PCOS, endometriosis, male infertility, uterine factors, and tubal issues. In India, female factors accounted for 46% of infertility cases, male factors for 20%, and 10% of couples had both. Couples with idiopathic or multiple contributing factors were excluded from the study.
Common Causes of Infertility Among IVF Users
Among couples undergoing IVF, oligospermia and tubal factor infertility emerged as the leading causes. Only about 8% of infertile couples required advanced treatments like IVF, which remain expensive and technically complex. The study also noted that PCOS was the most common infertility factor among women seeking treatment.
IVF Success Rates Vary Widely
Experts emphasized that no fixed number of IVF cycles guarantees success. However, they noted that most women have a good chance of conceiving after three stimulated cycles, and cumulative success rates improve with each attempt.
Breakdown of Treatment Costs
IVF involves multiple stages, including ovarian stimulation, egg retrieval, fertilization, embryo transfer, and pregnancy monitoring. The study reported a median out-of-pocket expenditure of ₹11,317 for infertility treatment.
Direct medical costs—mainly medicines and diagnostic tests—were higher in private facilities. Meanwhile, non-medical and indirect costs, such as transportation and lost wages, were more burdensome for patients visiting public hospitals.
Impact on Quality of Life
Patients with uterine factor infertility and endometriosis reported the lowest health-related quality of life. Pain, discomfort, anxiety, and depression significantly affected their well-being. The health-system cost for one year of infertility management ranged from ₹6,822 to ₹11,075 in public facilities, although costs were generally higher in private centres.
Infertility Trends and Need for Insurance Coverage
With one in six couples in India facing infertility, experts stressed the need to integrate fertility care into national health insurance frameworks. Shobhit Agarwal, CEO of Nova IVF Fertility, said that declining fertility rates make accessible and transparently priced infertility care essential. He added that including IVF in the Pradhan Mantri Jan Arogya Yojana (PM-JAY) could reduce emotional and financial stress for couples while supporting population health goals.
Limited ART Services in Public Sector
Currently, only a few public facilities provide Assisted Reproductive Technology (ART) services. As reported by The Hindu, the expanding private sector meets most of the demand, but ART prices remain unregulated despite the ART (Regulation) Act, 2021 and accompanying rules. A systematic review found that the medical cost of one ART cycle in India is 166% higher than the average annual income, highlighting the scale of financial burden.
Government Policies and Reimbursement Limits
At present, the Central Government Health Scheme (CGHS) reimburses up to ₹65,000—or actual cost, whichever is lower—for three fresh IVF cycles if specific criteria are met. Although PM-JAY covers many secondary and tertiary care procedures, it excludes fertility treatments.
Call for Inclusion of IVF in PM-JAY
In response to rising demand and financial strain, the Health Ministry requested Health Technology Assessment in India (HTAIn) to estimate IVF treatment costs for potential inclusion in PM-JAY. ICMR-NIRRCH conducted the study to address this request.
The report recommended covering IVF under PM-JAY at ₹81,332 per cycle. However, the study pointed out that most infertility-related expenses occur in outpatient departments, which PM-JAY does not currently cover. This gap must be addressed before IVF can be effectively integrated into the insurance package.