Why availability of infertility data is crucial?

By Jisha Krishnan

Published on June 13, 2017

Do you know the number of infertility clinics in India? There seems to be one on every street in big and small cities these days, but there’s no way to get the exact count. Because the Assisted Reproductive Techniques (Regulation) Bill, 2014 – or ART Bill – is yet to be tabled in parliament.

However, if a recent market report is to be believed, the Indian IVF (in vitro fertilisation) services market is estimated to reach $775.9 million by 2022. Clearly, the number of infertility clinics, sperm and egg banks are on the rise. But what is their success rate? Which age group constitutes the highest percentile of infertile couples seeking treatment?

We don’t have credible data since the sector is unregulated in India. While the merits and demerits of the ART Bill have been deliberated upon, we need to think about vital statistics that have been missing from the public arena. Data that could help infertile couples make informed decisions and the government frame better health policies.

Number crunching

If you look at the total fertility rate – the average number of children per woman – across the National Family Health Surveys, you’ll see a steady drop. It was 3.4 in NFHS-1 (1992-93), 2.9 in NFHS-2 (1998-99) and 2.7 in NFHS-3 (2005-06). In NFHS-4 (2015-16), the total fertility rate stood at 2.2. For urban India, the figure was 1.8, while it was 2.4 for the rural parts. There’s no mention of infertility indicators, though.

In 2013, a study, endorsed by the Indian Society for Assisted Reproduction and conducted by a pharmaceutical company across nine Indian cities, found that of the 2,562 people who participated in the survey, nearly 46 per cent were infertile. Aparallel survey conducted among 100 infertility specialists showed that about 63 per cent of the infertile couples belonged to the age group of 31 to 40 years; younger couples (21-30 years) constituted nearly 34 per cent of the patients seeking treatment.

According to the World Health Organisation, infertility is “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse”. The causes could range from poor sperm count in men to polycystic ovarian disease (PCOD) in women, to name a few.

Lack of regulation

Recently, a 40-year-old businessman from Mumbai was caught undergoing a secret surrogacy procedure without his wife’s knowledge. The couple has two daughters. In the absence of law regulating surrogacy in India, the police could only charge the man, his mother and sister under relevant sections of the Indian Penal Code.

Last month, when a Pune-based doctor performed the first uterus transplant in India – an experimental procedure for infertility - experts were quick to express the need for framing guidelines to regulate such procedures. Like the Union Cabinet did with the Surrogacy (Regulation) Bill, 2016, banning commercial surrogacy in India.

Once the proposed ART Bill - drafted by the Indian Council of Medical Research and having survived debates and discussions for almost a decade – is passed, there will be a national framework for the regulation and supervision of assisted reproductive technology in the country. The plan is to establish Surrogacy Boards at the central as well as state levels, while the National Registry of the Assisted Reproductive Technology Clinics and Banks in India will initiate the registration and accreditation of ART clinics.

Until then, finding infertility-related data in India will remain a challenge.