'We Are Seeing A Lot More Male Fertility Cases'

Doctors attribute the rise in male infertility to obesity, diabetes, smoking, chronic stress, inadequate sleep and sedentary lifestyles.

Male infertility is emerging as a key growth driver for India's assisted reproduction industry, prompting fertility chains to expand diagnostic and treatment offerings as more men come forward for evaluation amid changing lifestyles and delayed parenthood.

The shift comes as India's in-vitro fertilisation (IVF) market, estimated at $1.4 billion and comprising more than 2,000 clinics, prepares for its next phase of expansion.

The country currently performs about 200,000 to 250,000 IVF cycles annually, a number expected to rise to around 400,000 by 2030, with smaller cities contributing significantly to the growth.

IVF Market Expansion

Executives at leading IVF chains and fertility specialists told Business Standard that male factors now account for around 40 to 50 per cent of infertility cases, either independently or alongside female infertility.

They said this reflects both changing lifestyle and a greater willingness among men to undergo fertility assessment.

Male Infertility Trends

Dr Rohit Gutgutia, medical director at Nova IVF Fertility Kolkata, said male infertility cases in his clinic had risen by roughly 25 per cent over the past five years, with men aged 30 to 35 accounting for a growing share of consultations.

"In the past, one in four infertility visits had confirmed male factors.

"Today, the figure is nearer one in three due to improved awareness and a genuine rise in conditions such as poor sperm count, reduced motility and abnormal sperm morphology," said Dr Manika Khanna, chairperson and managing director at Gaudium IVF.

The increase in men seeking diagnosis and treatment is reshaping consultation patterns and fuelling demand for advanced procedures such as intracytoplasmic sperm injection (ICSI).

"For years, infertility investigations largely focused on women first.

"That is changing as more couples undergo evaluation together and men are increasingly willing to be tested," said Dr Manisha Singh, additional director for reproductive medicine and surgery at Fortis Hospital, Bengaluru.

Advanced Fertility Treatments

Industry watchers said male infertility-related consultations, investigations and treatments contribute nearly 40 per cent to overall fertility revenue at several smaller IVF chains.

An executive with a Delhi-based IVF firm said ICSI could cost between Rs 1.2 lakh and Rs 2.5 lakh per cycle, while consultations and initial tests could cost upwards of Rs 20,000, depending on age and clinic location.

Khanna, however, said infertility treatment is planned for a couple rather than an individual partner, making it difficult to strictly separate revenue attributable to male and female infertility.

"Most treatment pathways, including intrauterine insemination and IVF, have been designed based on the combined fertility profile of the couple," she said.

Clinics are also witnessing higher demand for advanced semen analysis, sperm DNA fragmentation testing, fertility preservation and surgical sperm-retrieval procedures.

Lifestyle Risks Increase

Doctors attribute the rise in male infertility to obesity, diabetes, smoking, chronic stress, inadequate sleep and sedentary lifestyles.

Occupational pressures, particularly among technology professionals and others with irregular work schedules, are also emerging as a contributing factor.

"Prolonged scrotal heat exposure from laptop use, tight clothing and extended sitting contributes to impairment of testicular function," said Dr Gautam Daftary, founder and managing director of Mumbai-based Aksigen IVF.

Doctors also flagged exposure to endocrine-disrupting chemicals found in plastics, pesticides, food packaging and industrial pollutants, which can interfere with the hormonal regulation of sperm production.

"The misuse of anabolic steroids for muscle building has also emerged as an important concern because it can significantly affect sperm production," said Dr Rini Sharma, director at Noida-based Kailash IVF.

Delayed family planning is another factor, with many individuals choosing to have children later because of career and financial priorities.

The mean age at first fatherhood has risen to the early thirties across urban India over the past two decades.

"Published infertile cohorts have reported DNA fragmentation rates in the range of 24 per cent in men over 40, compared with around 17 per cent in men under 30," Dr Daftary said.

"Delayed parenthood, which is often a sensible individual response to economic and career pressures, has a biological cost at the level of male reproductive health," Dr Daftary added.

Tier-II Cities Drive Growth

While Bengaluru, Hyderabad, Chennai and Delhi-NCR remain large markets, fertility providers said consultations are rising rapidly across Tier-II and Tier-III cities as awareness improves and advanced services become more accessible.

"We are seeing a lot more male fertility cases in Tier-II regions, with a contribution of about 45 per cent.

Apart from metros, our observation is that the prevalence is higher in North and Central Indian cities such as Varanasi, Gorakhpur and Bhopal," Dr Gutgutia said.

Several chains said male-only consultations are also increasing, although joint consultations remain dominant.

Clinics are increasingly encouraging simultaneous evaluation of both partners, allowing earlier diagnosis and treatment.

"While acceptance in smaller cities is getting better, we believe we have just touched the tip of the iceberg, and there is still greater awareness needed that infertility impacts both genders," said Shobhit Agarwal, chief executive officer at Nova IVF.

Kshitiz Murdia, chief executive officer of Indira IVF, said greater awareness of male reproductive health was encouraging more men to undergo evaluation, enabling earlier and more comprehensive assessment of both partners.

Feature Presentation: Ashish Narsale/Rediff