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The Collection Wed, 06 Aug 25 |
Multiple stories, multiple perspectives, one theme worth your time—every week. |
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I’ll never forget the day I found out that miscarriages are far more common than I thought they were—it was when I learnt that my mother had gone through three of them in five years in her mid-30s.
She isn’t alone. On average, at least 7% of all known pregnancies result in miscarriages in India, with the risks increasing steadily with age. General fertility also decreases swiftly past the mid-30s, reducing the chances of conception. For women, both the quality of eggs and their overall count declines; for men, the same holds true for sperm count and motility.
But increasingly now, despite the higher risks and lower chances of conception, many Indians are choosing to get pregnant at a later age than previous generations. Changing career paths, family dynamics, financial realities… all play a part.
And a $1.4 billion industry has taken shape catering to the hopes of this market.
In vitro fertilisation (IVF) is now a booming business in India.
But is it the miracle solution so many fertility hospitals tout it to be? And is it the best choice for everyone who is choosing to opt for it? In this edition of The Collection, we look at a series of stories that dive into these questions, and more.
Last month, my colleague Sudeshna Ray wrote about how IVF in India has reached a stage where it’s being pushed as the default choice by many fertility clinics, sometimes positioned as better than more natural methods of conception.
But IVF is, at its core, a numbers game. And the odds are often stacked against it.
It’s all about math. One in every 12 retrieved eggs may result in an implantation-ready embryo. Even then, things like age, sperm quality, and uterine health throw errant factors into the mix.
But IVF chains in India aren’t deterred by paltry things like probabilities. They’ve made IVF the new C-section—essentially, a revenue-generating procedure pushed before natural alternatives are even considered.
[…]
The Ken visited 10 IVF clinics in Bengaluru. Many coaxed women—even those who hadn’t given natural conception a shot—with words like “there’s no harm in trying it”, “at your age, it’s safer to go for it if you can afford it”, and “I have helped women who have come in with one egg to get pregnant”. If the odds of conception through IVF are slim, counsellors and doctors simply don’t mention it. And if they do, they encourage women to hope for a miracle.
You should certainly read her story to understand how this approach is impacting patients and making insurers uneasy, but at the same time, also making these chains more attractive to investors.
IVF clinics sell miracles—not probabilities—to patients and VCs alike
Rising private-equity investments—like IVI RMA’s recent acquisition of ART Fertility Clinics—are fuelling the growth of IVF in India; but it’s coming at a cost
For instance, Indira IVF, one of the largest fertility chains in India, refiled its IPO papers confidentially this July for a Rs 3,500 crore issue. In this 2023 story, we had written about how Indira established a cookie-clutter approach to what was once a “super specialty”.
How an Indian IVF chain became a global giant
Infertility, now a public-health emergency, affects one in every six people. Private equity has found its asset-market fit in India and placed a US$1.1B valuation on Indira IVF, making it the world’s second-largest such bet
In fact, IVF isn’t just being boosted by private-sector investment.
Gone are the days when governments in India frantically sought to control population growth. Now, with India’s total fertility rate dropping below the replacement level, states have started to remove disincentives for people having more than two children and begun incentivising fertility options.
We explored how and why government hospitals are now offering IVF procedures in this August 2024 story.
IVF treatment can break the bank. So how are states offering it for “free”?
India’s fertility rate has dropped below the replacement level. To bandage the issue, states are promising “free” IVF, but experts warn the devil’s in the details
The rising popularity and viability of IVF, and other alternative conception methods, is also leading many women to freeze their eggs and keep their options open well into middle-age. But contrary to popular belief, not all of them are delaying conception just to achieve more in their careers.
We sat down with Dr. Marcia Inhorn, a professor at Yale and author of Motherhood on Ice, to discuss this topic for a Daybreak episode in 2024.
Daybreak • 345 |
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All that said, though, funding such procedures if you don’t have enough money banked away can be difficult, because Indian insurers really do not seem to like pregnancies, with many regular insurance policies excluding its coverage.
We explored why the aims of insurers and policyholders often sit at odds with each other in this 2024 story, and what you can do about it.
What do health insurers have against pregnancies?
Here’s how you can make sure you don’t pay the price for that
That’s all for this edition. Do write to me at [email protected] if you have any thoughts, suggestions, or feedback.
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Rahul leads the promotion and distribution efforts for the journalism produced by The Ken. He works at the intersection of the publication's editorial and business operations.
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