What if we approached our reproductive health with the same vigilance as our heart health? Imagine routinely checking fertility markers, interpreting data early, and taking proactive steps years before planning a family, rather than waiting for infertility to become a crisis. This is the urgent message a growing chorus of reproductive health experts is broadcasting across India, where a silent epidemic of late-stage infertility is emerging alongside falling fertility rates in several states.
The Rising Tide of Late Diagnoses and a Preventable Crisis
A troubling pattern is unfolding in fertility clinics nationwide. Couples are increasingly arriving for consultations only after years of unsuccessful attempts to conceive. By this time, women often present with diminished ovarian reserve and men with poor sperm quality—conditions that could have been identified and potentially managed much earlier with basic screening. Experts point to a confluence of factors fueling this trend: delayed marriages, demanding careers, lifestyle stressors, and environmental toxins. They argue that a shift towards prevention-focused reproductive health, including routine fertility testing and workplace support systems, is now an essential public health measure, not a luxury.
What Science Reveals About Fertility Decline
The biological decline of fertility with age is both real and predictable. A 2020 study published in Fertility and Sterility confirms that ovarian reserve and egg quality diminish over time, leading to reduced fertility and longer times to pregnancy. This reproductive aging is a major determinant of fertility potential. Unlike the gradual decline of some health markers, female fertility, in particular, follows a steeper curve, with significant reductions often seen after the age of 35.
Proactive testing can empower better planning. Research from Human Reproduction in 2021 found that women who underwent routine assessments of ovarian reserve and reproductive hormones were better informed about their reproductive timelines and made family planning decisions earlier. Knowledge of Anti-Müllerian Hormone (AMH) levels, antral follicle counts, or sperm parameters during peak reproductive years allows couples to make intentional choices about timing, preservation, or lifestyle changes.
It's crucial to note that male fertility is not immune to time. A 2017 study in the Asian Journal of Andrology highlighted that advancing age in men is linked to reduced semen volume, sperm motility, and morphology, alongside increased DNA fragmentation. Early semen analysis can uncover modifiable issues related to oxidative stress, smoking, or toxin exposure long before a couple faces a fertility challenge.
Bridging the Biological Clock Gap: A Call for Normalization
In an interview, Shobhit Agarwal, CEO, and Dr. Rohit Gutgutia, Medical Director of Nova IVF Fertility, emphasized the need to treat fertility like any other aspect of preventive health. They draw a parallel to heart health, which decades ago lacked widespread preventive awareness. Today, monitoring blood pressure and cholesterol is standard; fertility health should follow suit.
"Routine fertility screening is not about instilling fear; it's about creating preparedness," they asserted. Basic tests like AMH for women, semen analysis for men, and thyroid profiles for both can identify risk factors—such as PCOS, thyroid disorders, or low ovarian reserve—years before family planning begins. The emotional and financial cost of identifying these factors early is far lower than confronting them during a crisis, when options may be limited to advanced treatments like IVF or the use of donor eggs or sperm.
The experts also highlight a significant gap in workplace health benefits. While corporate India heavily invests in check-ups for heart health, cancer, and stress, fertility health remains conspicuously absent for a workforce predominantly in its reproductive years. A positive shift is underway, with some progressive companies beginning to include fertility tests and even egg-freezing in their benefits packages.
They advocate for broader systemic support, suggesting that government health programs should integrate preconception and premarital health tests. Citing the example of Saudi Arabia, which mandates Thalassemia testing before marriage, they note that in India, where over 1.5 lakh children are born with thalassemia major annually, such preventive screening could have a profound impact. Subsidizing these tests could shift the national focus from crisis management to prevention and healthier births.
The Path Forward: From Crisis to Preparedness
The consensus is clear: India must cultivate a preventive mindset towards fertility. The high cost and emotional burden of treating advanced infertility underscore that early screening is a wise investment. By normalizing fertility check-ups, encouraging workplace support, enhancing government-led access, and educating the public about preconception counselling, India can transition from a state of crisis to one of preparedness.
Fertility health deserves a seat at the table of routine preventive care, right alongside monitoring cholesterol and blood sugar. The time to start the conversation and take action is now.
