The Congress party has included In Vitro Fertilisation (IVF) as an area of focus in its manifesto for the Rajasthan Assembly election. Integrating infertility with political agenda is not a new development — Goa recently became the first Indian State to offer free IVF, Assisted Reproductive Technology (ART), and Intrauterine Insemination (IUI) services; Maharashtra is also looking into providing financial support to people from rural areas for IVF treatments under the Mahatma Phule Jan Arogya Yojana.
Infertility, which is recognised as a public health issue by the World Health Organization (WHO), has often been shrouded in silence. Finding its way into the Congress’ election manifesto has thus sparked a crucial conversation over the financial, societal, and emotional implications of infertility, and the role of politics in addressing it.
A study titled ‘Pattern of health promises for Indian democracy: A qualitative review of political manifestos’ finds that health has been a feature in political agendas but healthcare issues are yet to dominate political campaigns in India as they do in the U.K. and the U.S. “Public health problems, health financing, improving infrastructure are the most common promises that share space in all manifestos of major national parties,” the study noted.
According to the WHO, and the Indian Society for Assisted Reproduction (ISAR), one in six couples in India find it difficult to conceive a child, may require medical help, and treatment cost is expensive. The average cost of an IVF cycle ranges from ₹2.5 lakh to ₹4 lakh.
The Census of India finds that infertility increased among couples in the reproductive age group from 13% in 1981 to 16% in 2001. The need for assisted reproduction is so high that the Federation of Obstetric and Gynaecological Societies of India (FOGSI) has appealed to the government to bring IVF treatments under Ayushman Bharat.
Also Read | Male fertility crisis: what environmental contaminants have got to do with it
Infertility, in clinical terms, is the failure to conceive even after being sexually active for one year or more of regular cohabitation without any contraceptive use.
“WHO categorises infertility as a disease, so, like any other disease, subfertility treatment or IVF treatment is a right of everyone,” Rachita Munjal, senior consultant, Birla Fertility and IVF, Gurugram, said.
She explained that fertility issues are silent and invisible whereas pregnancy, childbirth, and medical disorders are visible. “So, if all medical treatments can be included in a manifesto, infertility should be included too,” Dr. Munjal said.
Doctors in India explain that despite the high incidence of the problem, solutions for the diagnosis and treatment of subfertility, including IVF, remain inaccessible for many due to the high cost of treatment, and social stigma. They add that infertility can impact quality of life.
Also Read | Lifestyle, pollution causing rise in infertility: expert
“Through my experience in talking to women who come for fertility treatment, lack of emotional support, and holding back from promotion and career opportunities, in addition to stressful subfertility issues can be overwhelming. So, normalising the conversation around fertility treatments can be an important step in moving out of the silence over the issue,” Dr. Munjal said.
Doctors note that government policies on IVF treatment can mitigate the financial burden and emotional impact of infertility on family life. Benefits planned around pre-conception, fewer working hours for women under fertility treatment to manage regular visits to doctors, and the emotional and financial aspects of treatment, would help considerably.
