Table of Contents

"We used to take the whole day to get AMH results. Today, I get it in one and a half hours. But it's not just about speed—it's about validated machines, improved efficacy, and giving patients choices to take valid decisions."

"So many advancements have happened... we are trying to make our whole process of fertility care way better."

"We have barely 8 tier-one cities in the country where fertility services are well developed. The rest of India is still underserved Tier 3 and 4 cities are not very well defined and mostly lack proper ART services."

"We go to international conferences and feel ashamed that such a big country has no unified data to share. Everyone is doing excellent work, but documentation is lacking."

"It’s time to come together—IFS, ISAR, FOXY—to build a data registry so India can be recognized as a global leader in IVF."

"There is a difference between low Total Fertility Rate (TFR) and biological infertility. TFR can decline for sociocultural reasons, not necessarily due to clinical infertility."

"We don’t have national-level ICMR data on infertility, but we do have NFHS estimates based on five-year inability to conceive."

"We have to look at PCOS differently—not just as an infertility condition. Many women need hormonal correction, not IVF."

"We must treat women before conception, because epigenetics tells us that fetal outcomes are affected by the mother’s hormonal status."

"The problem with the law is that it’s made for urban, elite people—85% of our population is rural. We should have had more representation before framing this."

"Altruistic surrogacy has become a joke. The surrogate is not getting anything, but the agent gets paid, and costs have doubled."

"The judiciary has played a huge role—granting maternity benefits to surrogate mothers, for instance. Law and society must move forward together."

"When we do look at it, the biggest barrier is the high cost—and it's out of pocket. IVF can cost anywhere between ₹1 lakh to ₹3 lakhs per cycle, excluding drugs, stay, and travel. The lack of public funding and insurance makes it worse."

"Rather than just reducing the cost of IVF, if we reduce the cost of failure, then we will definitely help these patients—both in saving money and achieving their goal of having a baby."

"The fertility divide exists because insurance still treats infertility as elective. But in 20 U.S. states, IVF is mandated under insurance—and those states see 3x the number of IVF cycles and clinics. That tells us everything."

"The best model for affordable IVF is the hub-and-spoke system—especially for Tier 2 and Tier 3 cities. With digital tools and SOPs, we can bring quality care closer to patients while cutting down travel and wage loss."

"Financing fertility isn’t just about cost—it is about access, agency, and justice."

"The law gives me the right to become a parent. But is the child ready to be accepted by society? That’s the ethical dilemma."

"Whatever technology we have today, put it to use fully—and of course, the research will one day be available to us in practical use."

"Why would a woman need stem cells in the future if today she has frozen her eggs?."

"We have to fulfill patient expectations—but within the limits of the ART law and medical ethics."

"We cannot stop science. But we must ground our practice in reality, legality, and the best interest of the future child."

"We need a standard questionnaire for semen analysis and must educate couples on proper collection techniques. Semen analysis is the most important test—train people to do it right."

"Oxidative stress is a known risk factor for abnormal sperm. Selective use of antioxidants like NAC, CoQ10, Vitamin C, E, zinc and omega-3 can improve IVF outcomes."

"You're not just looking at sperm—you're analyzing a transport vehicle carrying critical information. Semen analysis is one of the most underlooked tests in India."

"Men feel left out after semen submission. They think, ‘I’ve given her the doctor, the money—what more do you expect?’ This leads to emotional withdrawal and breakdown in communication."

"Forty to fifty percent of infertility issues come from men—but for too long we’ve discussed male infertility without the male. It’s time we change that."

"Fix your outcomes first. Then scale. And don’t expect to get everything right on Day 1—it’s a journey."

"As a clinician, I’m not chasing unicorns. I’m building strong, long-running horses that can deliver every day."

"You need the four Ds: Demand, Digital, Delivery, and Dollar. Don’t touch the last until the first three are rock solid."

"Everyone’s chasing the patient at the bottom of the funnel. We need to start educating them at the top—before they even realize they need IVF."

"India is great for IVF treatment but poor for research. Global collaboration is how we bridge that gap."

"You’re delivering babies, yes. But you're also delivering returns, reliability, and retail discipline."

"I was never taught IVF. I never went abroad. Whatever I did, I did with my own hands—from preparing the media, washing glassware, to distilling water."

"The first successful pregnancy happened in the 18th patient. That’s why, even today, 18 is my lucky number."

"I don’t believe in fooling the patient. If there is a 10% chance, I say there is a 10% chance. I don't give false hope."

"I have always believed in telling the patient not to waste their money if there’s no hope. The patient’s well-being comes first."

"We talk of IVF only for infertility, but it can help in cancer treatment, genetic disease prevention, and regenerative medicine. It’s a goldmine for research."

"You are the reason for many of us to pursue IVF. Your resilience and innovation created the foundation we now walk on."

"It is important for the next generation to hear your journey—not just the successes, but the struggles and the science behind them."