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Billboards advertising in-vitro fertilisation (IVF) clinics are increasingly dotting the landscape of Haldwani, Jamnagar, Meerut, Amritsar, Prayagraj and scores of other such Tier-II and Tier-III cities as major IVF chains are expanding in smaller cities which are seeing a rise in fertility issues mainly due to lifestyle changes.
“One in six couples are now experiencing infertility in India. There is a need for fertility chains to expand to cater to the couples battling infertility,” Shobhit Agarwal, chief executive officer (CEO) of Nova IVF Fertility, said.
A recent United Nations Population Fund (UNFPA) report flagged that India’s total fertility rate (TFR) fell to 1.9 births per woman, which is below the replacement level of 2.1 births per woman. The UN report is in line with the National Family Health Survey (NFHS) 5, which had calculated India’s TFR to be at 2.0 births per woman for 2019-21.
The NFHS-5 data had also highlighted that decline was more prominent in rural areas, where the fertility rate stood at 2.1 from 3.7 births in NFHS-1 held in 1992-93, compared to urban areas where it came down to 1.6 from 2.7 births in 1992-93.
While infertility is not the only reason for the lowering TFR, experts say that such cases are expected to rise and go beyond Tier I cities due to stress-induced lifestyle diseases and climate change.
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Birla Fertility and IVF, which currently operates around 30 centres in Tier II and III cities, is expecting to open at least 15 to 16 more centres in the financial year 2025-26 (FY26), with two-thirds of them being in the smaller cities.
Similarly, Nova IVF, which sees 40 per cent of its revenue from Tier II and III cities, is exploring options in 15 more locations such as Haldwani, Jamnagar and Meerut.
Indira IVF, the biggest infertility player in the country has also announced plans to enter over 25 Tier III cities by FY27. ALSO READ: IVF after 40: Can you still get pregnant? What fertility experts say
Industry experts add that IVF players are already witnessing an increased demand for infertility treatment from Tier II and III cities.
Abhishek Aggrawal, CEO at Birla Fertility and IVF, told Business Standard that more than 50 per cent of its annual IVF cycles are conducted in cities such as Siliguri, Varanasi and Prayagraj. “While there is a rising segment in metros with IVF chains receiving queries from women for procedures like egg freezing to push their parenthood, Tier 2 cities are providing players an opportunity to tap the less penetrated, high-potential markets,” he added.
Agarwal said that another reason is that many couples from the Tier II regions find it difficult to travel to the big cities for their fertility treatments, with the travel cost, coupled with accommodations and loss of wages, proving to be an expensive affair.
“With expansion, we are bringing in standardised fertility treatment in the comfort of their home towns with the best clinical acumen and embryologists,” he added. This model, he said, is affordable and saves them the hassle.
India currently sees around 200,000 to 250,000 IVF cycles annually, and the market is expected to grow to 400,000 cycles by 2030, with smaller cities forming a good chunk of the clientele.
Aggrawal added that to tap the growing demand, the chains are also looking to go beyond clinical care and work towards spreading awareness to ensure that fertility care is both understood and accessible to all who need it.
