A new government-commissioned study has revealed the staggering financial burden Indian couples face while pursuing fertility treatment, warning that nearly 90 percent of those opting for in-vitro fertilisation (IVF) are driven into catastrophic medical debt. The analysis, carried out by the ICMR–National Institute for Research in Reproductive and Child Health (NIRRCH), found that a single IVF cycle costs about Rs 2.3 lakh in private hospitals and around Rs 1.1 lakh in public facilities amounts far beyond the reach of most Indian households. Since many couples require at least three cycles to achieve pregnancy, the financial shock becomes even more severe.
India’s first empirical assessment of infertility-related expenditure shows that 89 percent of IVF patients spend more than 10 percent of their annual household income on treatment. Even before reaching IVF, one in four couples seeking infertility care had already experienced catastrophic costs. With an estimated 2.8 crore couples affected by infertility and WHO data suggesting that primary infertility impacts 4–17 percent of Indian couples, the need for accessible and affordable treatment is urgent. The report also highlights that 8 percent of these couples require advanced reproductive technologies like IVF.
The study was conducted across five institutions three government facilities in Chandigarh, Delhi and Thiruvananthapuram, and two private centres in Wardha and Chennai. Polycystic ovarian syndrome (PCOS) emerged as the most common cause of infertility. Interestingly, while private-sector patients bore high direct costs for medicines and investigations, public-sector patients ended up spending significantly on travel, accommodation and wage loss, indicating that non-medical expenses heavily weigh down families seeking treatment.
Submitted as a Health Technology Assessment for the National Health Authority, the report strongly recommends that IVF be covered under the Ayushman Bharat–Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY), which currently provides hospitalisation coverage of up to Rs 5 lakh but excludes outpatient services. Since most infertility treatments, including IVF consultations, diagnostics and monitoring, fall under OPD care, experts argue that the scheme needs to expand its coverage design. The report suggests using the calculated health-system cost of Rs 81,332 per IVF cycle as the reimbursable rate if the treatment is brought under PM-JAY.
Doctors and industry leaders say the inclusion of IVF under government insurance is long overdue. Mumbai-based IVF specialist Dr Nandita Palshetkar pointed to Madhya Pradesh where IVF is already covered under PM-JAY as an example of how transformative such policies can be. Abhishek Aggarwal, CEO of Birla Fertility & IVF, noted that infertility treatment should be recognised as essential medical care, especially when the average rural household spends roughly Rs 17,000 per month, making IVF costs devastating for lower- and middle-income families.
Even within public hospitals, the annual health-system cost for infertility care ranges from Rs 6,822 to Rs 11,075, lower than private-sector expenses but still unaffordable for many without insurance. The report makes clear that despite the high prevalence of infertility, it remains largely invisible in India’s public health agenda, leaving couples with little financial protection. The findings make a compelling case for national action, urging the government to integrate infertility diagnostics and IVF under existing insurance schemes to prevent families from falling into deep debt in their pursuit of parenthood.