Why Is India Facing Increased Population And High Infertility Rate? Doctor Explains

India finds itself at a curious crossroads when it comes to population dynamics. On one hand, the country continues to experience a high overall population growth, remaining the most populous nation in the world. On the other hand, there is a silent crisis brewing, an alarming rise in infertility rates among couples, especially in urban areas. This paradox, driven by factors such as late marriages, lifestyle changes, pollution, stress and poor reproductive health awareness, presents a complex challenge for public health policymakers and medical professionals alike.

According to the UNFPA’s 2025 State of World Population Report, India’s Total Fertility Rate (TFR) has dropped to 1.9. TFR refers to the average number of children a woman is expected to have during her reproductive years. A TFR of 2.1 is considered the replacement rate, which is the level needed to keep the population stable across generations. In conversation with The Daily Jagran, Dr Rakhi Goyal, Fertility Specialist, Birla Fertility & IVF Chandigarh, explains that falling below the threshold of 2.1 might seem like a good thing in a densely populated country, but when viewed alongside another critical number, that is, India’s infertility rate, the picture becomes far less reassuring. WHO estimates that approximately 28 million couples in India face fertility challenges, which translates into millions of individuals who are unable to conceive despite wanting to.

And this battle usually goes unexpressed or unheard. Couples, newlyweds or even six to seven-year-olds, often turn up with a very emotional question: "Why aren't we able to conceive?" Often, they have already attempted home remedies, heard mixed suggestions from family, and procrastinated in seeking professional attention due to fear, stigma, or simple ignorance.

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There, of course, remains the myth that fertility problems are a woman’s issue. Dr Rakhi Goyal states, “Male factor infertility is equally prevalent, and lifestyle-driven fertility issues are being observed in couples in their late 20s.” Lethargic lifestyles, poor nutrition, excessive stress, greater exposure to endocrine-disrupting chemicals, and untreated infections all play a role in declining fertility.

Meanwhile, as couples increasingly opt to get married later or postpone having children in pursuit of a career or financial goals, age-related fertility loss is becoming increasingly difficult to disregard. Dr Rakhi Goyal states, “The fertility of a woman starts to decline when she is about 32 and falls rapidly after 35. However, most couples realise this only after they have spent years trying.”

Increased Population And High Infertility Rate In India (Image Credits: Canva)

The crisis is also geographical. Quality fertility care is largely present in urban centres, and most individuals in small towns or rural settings do not have access or knowledge of basic fertility screening in a timely manner. Dr Rakhi Goyal states, “Patients frequently present themselves after years of consultations with multiple gynaecologists without a diagnosis. The psychological load is severe, compounded by societal pressure and the absence of structured support.”

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The reality is hard-hitting: India is dealing with a silent reproductive health crisis that has the potential to disrupt its societal structure. It doesn't get banner headlines, but it appears in the faces of couples every day who are tired and bewildered.

Infertility is not only a medical condition but also an emotional and social one. Infertility must be recognised not just as a personal problem, but as a public one. It needs structured attention within national health programmes, fertility care must be widely accessible, and policies should look beyond population numbers to individual needs.