With the number of infertility cases rising in the country, health experts have pitched for an urgent need to include fertility treatments in health insurance plans to minimise financial risks of persons seeking help.



Currently, both private and public health insurers do not include fertility procedures and treatments under their cover plans, experts said. According to a study by a Bengaluru-based medical technology company, 27.5 million couples in India are suffering from infertility and are actively seeking children. The number is estimated to rise by more than 10 per cent by 2020.

Dr Archana Dhawan Bajaj, gynaecologist, obstetrician and IVF expert, Nurture IVF Centre, said health insurance plans providing cover for all fertility procedures, treatment and care would be a boon for affected couples who presently cannot afford advanced treatment.
"Infertile couples have now options such as in vitro fertilization (IVF) treatment where the eggs and sperm are combined and fertilised 'in vitro' (outside the body in controlled environment). It has come up as a boon for those who face difficulty in conceiving naturally.

"But the cost of IVF procedure in India varies from Rs 1 lakh to Rs 2.5 lakh which is expensive for many of the couples. Therefore, they either avoid treatment or take debt for the desire of a baby. We need to reduce both financial and physical risks. Experts can take care of physical and medical risks, however insurers can help in a big way to minimise financial risks," Dr Bajaj said.

Dr Bajaj said insurance companies face difficulties in providing mediclaim for IVF treatment because they provide cover mainly for illnesses and diseases which require hospitalisation. Only maternity costs are currently covered by health policies not IVF treatment, which is considered a pregnancy-related issue and not an illness, Dr Shweta Mittal Gupta, senior consultant, centre of IVF and human reproduction at Sir Ganga Ram Hospital.

Infertility affects about 10 to 15 per cent of married couples, Dr Gupta said. However patients seeking treatment for same are few. This could be attributed to lack of knowledge as well as high cost of treatments which are mostly available in the private sector and few hospitals in the government sector are offering advanced infertility treatment like IVF, said Dr Gupta.

"There are many countries in the world which are covering all fertility treatments under insurance. This helps couples in seeking timely investigation and treatment. 

"It is the need of the hour in India to cover infertility treatments like laparoscopy, hysteroscopy, fertility medications, intrauterine insemination (IUI) and IVF under insurance like any other medical or surgical conditions which are covered," Gupta said.

Dr Dhrupti Dedhia, consultant obstetrician and gynaecologist at Surya Hospitals, said currently only 1 per cent infertile couples seek any kind of fertility treatment in the absence of insurance coverage. "Paying out of the pocket, in the absence of adequate health insurance, is not a viable option for many. Hence, majority of infertile couples are compelled to stay away from fertility treatments. Sometimes people opt for loans which carry financial risks for the family and go through a lot of psychological and emotional trauma. Hence, we strongly recommend that insurers must include intrauterine insemination (IUI), in vitro fertilization (IVF), or frozen embryo transfer (FET) in their products," Dr Dedhia said.

Dr Dedhia further said if the insurance company pays for infertility treatments, there will be standardisation and transparency in the system. According to the experts, fertility treatments are complex, hence, it needs a comprehensive insurance coverage.  Dr Ranjana Sharma, senior consultant, obstetrics and gynaecology, Indraprastha Apollo Hospitals, said infertility commonly occurs due to an underlying disease such as endometriosis, pelvic inflammatory disease, ovarian failure. It is also a consequence of several factors such as conceiving after the age of 35 years, stress and smoking. In many cases, insurers refuse to cover treatment of even these underlying diseases if there is accompanying infertility, she said.