Vinesh Gadhia, Executive Director and CEO, Ferty9 Fertility Center stresses that the rapid transformation of the IVF industry in tier 2 and tier 3 cities highlights India’s progress toward equitable healthcare access. However, it is a work in progress, requiring continued community education, infrastructure expansion, and innovative ideas to make fertility treatments even more accessible and affordable
The IVF industry in India has come a long way from being an urban-centric solution to a nationwide movement. What was once considered a specialized and niche service available only in metropolitan hubs has now found its way into smaller cities and towns across the country. Fertility treatments, particularly in vitro fertilization (IVF), are transforming lives in tier 2 and tier 3 cities, where accessibility and awareness were once significant barriers. This expansion is not just a medical breakthrough but also a societal shift, as conversations around infertility become more normalised, and families embrace science-backed solutions to achieve parenthood.
A changing landscape of fertility care
There has been a significant change in the demand for IVF services in the past couple of years. Previously, reproductive health services were offered only in large cities, where advanced medical facilities and specialised care were available. However, in recent years, there has been constant growth in the number of people seeking fertility treatments across tier 2 and tier 3 cities in India.
This growth is primarily driven by lifestyle choices as late marriage and alcohol consumption. Previously, couples in villages travelled long distance to saints and temples on the name of faith or to metro cities for fertility treatments, often facing both the stress of the journey and the financial burden of the treatment.
There has been a significant increase in the demand for IVF services over the past few years. Previously, reproductive health services were primarily available in large cities with advanced medical facilities and specialised care. However, recent years have seen steady growth in the number of people seeking fertility treatments in tier 2 and tier 3 cities across India. This shift is largely driven by lifestyle changes, such as delayed marriages and increased alcohol consumption. In the past, couples from rural areas often traveled long distances—either to consult saints and visit temples out of faith or to metro cities for fertility treatments—facing the dual challenges of physical strain and financial burden. However, this has significantly changed. With technological advancements, more fertility clinics are expected to become accessible and conveniently located in these regions.
Factors driving the surge in demand
Evolving social dynamics: Infertility was once heavily stigmatised, especially in small towns, leaving couples to cope in silence. However, in recent years, media coverage, education, and awareness efforts have helped address these issues. For many people, infertility is now seen as a medical condition rather than a source of social disgrace.
Increasing focus on women’s health: A growing emphasis on women’s health and reproductive rights has played a critical role in driving demand. Residents of tier 2 and tier 3 cities are increasingly aware of their reproductive health and are addressing infertility with family support.
Rising disposable incomes: Rising economic status in smaller cities has enabled more couples to afford IVF treatments. The availability of financing options provided by IVF centers has further made these treatments more accessible.
Digital awareness and accessibility: The rise in internet and smartphone usage in smaller towns has expanded access to information about IVF treatments. Couples are now more aware of available options and success rates, giving them confidence to seek professional help.
Technology bridging the gap between expectation and reality: Technology has been crucial in meeting the growing demand for IVF. Automation and integration of patient care processes have significantly improved the patient experience at all stages. Communication technologies, electronic healthcare systems, and telehealth services have simplified IVF procedures and made them more efficient. With improved success rates driven by technology, patient confidence in IVF treatments has grown substantially.
How demand has shifted in recent years
The demand for IVF in tier 2 and tier 3 cities has not only increased but also evolved. Previously, most couples seeking IVF were older, having exhausted nearly all other options. Today, younger couples in their late 20s and early 30s are taking proactive measures, signalling a cultural shift. Additionally, there has been a significant increase in demand for advanced fertility options such as egg freezing, preimplantation genetic testing (PGT), and third-party donor programs. These options, once rare in smaller cities, are gaining popularity due to increased awareness and availability.
Addressing the challenges of rapid growth
With the surge in demand comes the responsibility to deliver high-quality care. The challenges in smaller cities include:
Educating patients – Many couples remain unfamiliar with the nuances of IVF. Misinformation and myths must be addressed through community outreach programs and transparent communication.
Building local expertise – While technological advancements have made IVF treatments more effective, training local medical professionals is essential to ensure sustainable services.
Balancing cost and quality – Patients in smaller cities are often price-sensitive. Innovative cost-management strategies are needed to maintain affordability without compromising on care quality.
The rapid transformation of the IVF industry in tier 2 and tier 3 cities highlights India’s progress toward equitable healthcare access. However, it is a work in progress, requiring continued community education, infrastructure expansion, and innovative ideas to make fertility treatments even more accessible and affordable.
This journey is not merely about expanding healthcare services—it is about bringing hope, empowering families, and creating a future where every individual has the opportunity to realise their dream of parenthood.