Fertility Challenges In India: Examining Current Trends Of Infertility

Trends Of Infertility

Infertility is the inability of a body to reproduce by natural means. In a heterosexual relationship, infertility may be caused due to either male or female. It is defined to be a failure to achieve pregnancy after 12 months of regular unprotected intercourse.

Infertility and childlessness is a global problem affecting about 10-12 percent of married couples across the world. In India, the infertility rate is estimated between 4 and 16 by the World Health Organization. The cause of infertility and childlessness has a grievous impact on statistical analytics of the population.

The prevalence of infertility has caused psychological issues like mental suffering, anger, depression, and stress, and some social issues like isolation, partner violence, divorce, and societal rejection. However, infertility affects both men and women effectively.

Infertility In India

In the context of Indian culture, a woman’s ability to get pregnant and give birth is deemed to be crucial for her identity. In a childless family, the woman is more likely to get criticized for lacking children. They face discrimination and societal separation in their communities if their family is childless after a particular period. On the other hand, a man/woman can choose to have children after a certain period with the consent of their respective partner, but not for too long.

The rationale for Infertility differs from people, places, environment, and climatic conditions across the sub-continent. Some studies and surveys suggest that the infertility rate is high among women in urban areas. This is primarily because teenagers focus on high levels of educational aspirations which results in delayed marriages. While the lifestyle in urban areas promotes later marriages and age is futile for them, a survey by NFHS (National Family Health Survey) suggests that age is one of the most significant causes of infertility in the female reproductive system.

Primary Infertility

Primary Infertility

The inability to give live birth to any child even after several years of marriage is classified under primary infertility. When a married couple has not been able to conceive a child despite having unprotected intercourse for 12 months or more without any pregnancies, they often seek the guidance of fertility specialists and assisted reproductive technologies like IVF (In Vitro Fertilisation), IUI (Intrauterine Insemination) and/or fertility medications. Some of the causes of primary infertility are age, physical condition, health condition, style of living, environmental factors, and in some cases unidentified.

Secondary Infertility

The inability to give birth to an additional child after a year or more since having one or more children in the past is classified under secondary infertility. This refers to a despair situation when the couple is unable to conceive another pregnancy for a longer period than planned. It is time-consuming to understand the situation and the analysis of secondary infertility commences after a particular wait period is over.

The identification and treatment of secondary infertility involves a thorough observation of the causation of male and female reproductive medical history and health conditions. Secondary infertility can be attributed to different factors such as age, divergence in reproductive organs, previous birth-related complications, changes in the partner’s fertility, lifestyle, and health factors.

Childlessness In India

As per reports, 10-12 percent of couples in India are childless. ‘Childless’ is used to describe a couple or a parent who does not have children by birth, or hasn’t adopted any children, or if the child dies after birth. Childlessness can be a temporary state which may result from factors beyond infertility and living circumstances. Childlessness can be a choice. The term ‘childless’ means the absence of children. It can vary with individual preferences and aspects. 

In India, it is acceptable to be a childless couple. Just like any other couple, childless couples are free to design their lives however they want to see it. Focus on a career may lead some couples to go childless, while some opt to travel without the responsibilities of a parent and some couples may consider the fact of financial freedom keeping in mind the investment to raise children.

Some couples choose to be childless in fear of genetic diseases that they carry from their ancestors and few others may consider preventing their sexually transmitted diseases to their spouse. Reportedly, there are also many cases of womb abnormality which causes the risk of miscarriage and preterm birth depending on the shape of the womb.

A woman’s immune system is also involved in recurrent pregnancy loss and hormone abnormalities. Diseases like thyroid, diabetes, and obesity may also have impactful effects on the pregnancy period.

Data and Analytics

Data was collected on surveys based on the study of the overall population consisting of men and women aged between 15 and 50.

  • According to NFHS, the fertility rate in India is 2.0 children per woman.
  • According to WHO, the infertility rate in India varies from 3.9 to 16.8 percent depending on the age of marriage.
  • According to NFHS, the childlessness rate is 12 percent in India.
  • According to the Indian Society of Assisted Reproduction (ISAR), 10-14 percent of couples in India are affected with infertility as of 2022.
  • According to the National Health Family Survey (NFHS), 10-12 percent of couples are childless in India as of 2021.


The trends of infertility and childlessness have psychological and societal significance among married couples in India. Infertility and childlessness are related, yet distinct aspects of individuals and reproductive health conditions. It is important to recognize the factors and circumstances that are entangled, which can be personal or life circumstances. Conclusively, when an individual is infertile or childless, the value and fulfillment of their life must be respected and not criticized under any circumstances, whether they choose to be childless or infertile from medical conditions. 

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