“Hum Do, Hamare Do” To IVF. A Social Price For Progress?

India, once grappling with the challenge of a burgeoning population, embarked on a nationwide public campaign in the 1970s and 1980s to promote the concept of limiting family size to two children per family. The slogan "hum do, hamara do" (we two, ours two) became ingrained in the collective consciousness of the nation. It was an era that my generation of youngsters grew up in and an era where visual depiction in mainstream media of intimacy or romance meant the famous “twinning of flowers”.

In the past four decades of its economic growth, and societal thinking shifts, India has come a long way. There have been myriad of influences to have changed our mindset and acceptance of many aspects in life. For a nation that had population-control in mind, the present India, atleast the urban india, seems to have problem of infertility. Fast forward to the present day, and India is witnessing a contrasting trend - a rise in infertility clinics, extensive advertising for infertility treatments.

In a reflection, atleast the society is now open to speaking of this topic. The number of infertility clinics is on the rise. So is their open advertising and PE investments into such chain of clinics. Large corporates are offering benefits of paying for infertility treatment for those who need them in their teams. Suddenly those infertility brands seem to be one of leading advertisers in the Indian media.

What happened in one generation ?

Over the past few decades, India has undergone significant socio-economic changes. Urbanisation, modernisation, and increased access to education and travel have led to a transformation in lifestyle choices and societal dynamics. Yet in pockets, the modern Indian society seems to have the fundamental challenge of commitment and trust in human-relationships. Individuals, have the liberty now. They have choices. All in searching for relationships. But many struggle to make those relationships work or be meaningful.

Frequent breakups or the inability to establish stable partnerships can affect the timing of family planning and may contribute to delayed pregnancies. Unstable relationships can hinder the process of finding a suitable partner for a long term or lifelong relationship, as well as the preparedness for shared parenthood.

As individuals pursue careers, delay marriage, and prioritise personal aspirations, the age at which couples plan to start a family has gradually increased. Some may prioritise personal freedom, career aspirations, or fear the constraints associated with marriage and family life. As a result, they may postpone the decision to start a family, potentially reducing the window of optimal fertility. This delay, coupled with physiological factors, can contribute to fertility issues and the need for specialised treatment.

Another factor that may have contributed to the rise in infertility cases is the changing dietary patterns and nutrition. Rapid urbanisation has resulted in a shift from traditional diets to processed foods, which may lack essential nutrients vital for reproductive health. Factors like obesity and poor nutrition can adversely impact fertility and reproductive functions. Additionally, exposure to environmental toxins, pollution, and increased stress levels in urban areas may also play a role.

Changing societal dynamics have resulted in a delay in the average age of marriage and subsequent attempts to conceive. Youngsters today are prioritising their education, careers, and personal aspirations before starting a family. While this shift offers individuals more choices and opportunities, it also means that they may attempt to have children later in their mid to late 30s. However, fertility declines with age, and this biological reality can cause anxiety and stress for couples trying to conceive at a later stage of life.

The growing number of infertility clinics and their prominence in Indian media can be attributed to remarkable advancements in medical science. Assisted reproductive technologies (ART) such as in vitro fertilization (IVF) and intrauterine insemination (IUI) have become more accessible, effective, and widely accepted. These treatments offer hope to couples facing infertility challenges, providing them with an opportunity to realise their dreams of parenthood. As a result, the demand for infertility clinics has surged, leading to increased advertising and investments in this sector.

The evolution of Indian media has also contributed to the prominence of infertility treatments in public discourse. From the days of All India Radio (AIR) and Doordarshan (DD) promoting family planning and contraceptive methods, we have now witnessed a shift in messaging. The open discussion about infertility treatments in various media channels reflects a growing societal acceptance and willingness to address reproductive health issues openly.

Emotional & social

While infertility treatment offers hope and possibilities for couples struggling to conceive, it also brings forth a set of social issues and emotional challenges. In Indian society, where family and procreation hold significant importance, the experience of infertility and seeking medical assistance can be emotionally demanding.

Infertility is often surrounded by social stigma, with society often placing the burden of reproduction solely on women. Couples experiencing infertility may face judgment, societal pressure, and even ostracisation.

Women, in particular, bear the brunt of this, as their ability to conceive is frequently tied to their worth as individuals and their roles within the family. In Indian society, there is a prevailing expectation that couples should conceive and start a family shortly after marriage, typically within one to three years. This societal pressure to have children quickly can add immense strain on couples, especially if they face difficulties in conceiving naturally. The constant inquiries from family, friends, and relatives about their reproductive plans can be emotionally challenging, leading to feelings of inadequacy and guilt. Such social expectations can create a stressful and isolating environment for those seeking infertility treatments.

Undergoing infertility treatment can be an emotional rollercoaster for young couples. The process often involves numerous medical procedures, hormonal treatments, and the uncertainty of success. Each unsuccessful attempt can bring feelings of disappointment, grief, and frustration. The emotional strain can also strain relationships, as couples navigate the challenges together, dealing with financial burdens, and making difficult decisions about treatment options.

Medical science has undoubtedly expanded the possibilities of parenthood, enabling individuals and couples to overcome infertility challenges and conceive children. However, it is important to recognise that the journey of parenting requires more than just medical intervention. It demands active involvement, commitment, and emotional investment in the well-being and growth of a child. By acknowledging the responsibilities and embracing the commitment to parenthood, individuals and couples can embark on a fulfilling journey of raising children, shaping their lives, and creating a future generation that is loved, nurtured, and guided to reach their full potential.

Of course, while these are broad observations, it does not delve into various other variables in this topic. We have to be respectful that despite this public topic, the tribulations that the impacted individuals undergo is to be acknowledged, and their privacy and decisions respected.

Influence on Indian economy

The topic of infertility, delayed pregnancies, and the use of assisted reproductive technologies (ART) such as IVF is important for the future of the Indian economy and demographics due to several reasons.

Economic Implications: India's demographic dividend, which refers to the potential economic growth that can result from a youthful and productive workforce, is a significant driver of the country's economic development. However, delayed pregnancies and fertility issues can affect the size and composition of the workforce. If a significant portion of the population delays parenthood or faces challenges in conceiving, it can impact the demographic dividend and potentially lead to a decline in the working-age population. This could have implications for economic productivity, labor supply, and future economic growth.

Healthcare Expenditure: The rise in infertility clinics, increased use of ART, and associated medical expenses can contribute to healthcare expenditure in the country. As more individuals and couples seek fertility treatments, it may place a financial burden on individual families and the overall Indian healthcare system. The availability, affordability, and accessibility of infertility treatments become important considerations for policymakers and healthcare providers to ensure equitable access and sustainable healthcare spending.

Social Security Systems: The ageing population and declining fertility rates pose challenges to social security systems such as pensions, healthcare, and elder care. A reduced birth rate and delayed pregnancies can strain these systems as the proportion of elderly individuals increases and the working-age population declines. Adequate planning and policy measures are needed to address the potential strain on social security systems and ensure the well-being of the ageing population.

Shift in Family Structures: The use of ART, including IVF, allows individuals and couples to pursue parenthood through non-traditional family structures. This includes single parents, same-sex couples, and individuals who may choose to have children without a partner (regulations permitting). These evolving family structures have implications for social norms, legal frameworks, and support systems. Adapting to these changes and creating an inclusive environment is crucial for societal cohesion and the well-being of diverse family units.

Societal Attitudes and Gender Equality: Infertility issues and the use of ART can also shed light on societal attitudes towards gender equality and women's reproductive health. Addressing infertility requires considering both male and female factors, and recognising and addressing any gender disparities or biases in the diagnosis, treatment, and support provided to individuals and couples. Promoting gender equality in reproductive healthcare is essential for ensuring equitable access to fertility treatments and supporting couples in their journey toward parenthood.