In a quiet lab on the outskirts of a metro city, an embryologist scrolls through time-lapse images of embryos, each frame captured every few minutes over five days. A few years ago, they would have relied almost entirely on her eye and years of training to pick which one to transfer. Today, an algorithm running quietly in the background has already flagged its own predictions — not to replace the judgment of the doctor, but to sit alongside it.
“AI does not create perfect babies, rather it helps us make a more informed choice among the embryos we already have,” says Dr. Hrishikesh Pai, consultant gynecologist & IVF Specialist, Lilavati Hospital Mumbai and Fortis Hospitals Delhi & Chandigarh. “AI tools now sift through thousands of embryo images, tracking cell division timing and growth patterns to estimate which embryo is most likely to implant — work that once depended solely on an embryologist’s eye under a microscope,” Dr Hrishikesh Pai said.Â
Newer systems can even go further, analysing genetic markers to generate a polygenic risk score, an estimate of the probability an embryo may develop certain conditions later in life. “A risk score is not a diagnosis, and patients need to hear that clearly before they put too much weight on a number,” Dr Hrishikesh Pai adds. However, a probability is not a diagnosis, and no algorithm can guarantee a healthy pregnancy.
Dr. Archana Dhawan Bajaj is the founder and director of The Nurture IVF Centre, “Patients sometimes come in expecting AI to guarantee an outcome. Our job is to be honest that it narrows the odds, it does not remove them,” she says.
That last factor, which is the sperm quality, is turning out to be one of the more overlooked stories in Indian fertility care. For years, IVF was spoken of almost exclusively as a woman’s journey. That is changing. “Five years ago, most men only came in after their partner had been through several tests. Now they are often the first ones to ask for an evaluation,” says Dr Vineet Malhotra, head of Urology, VNA Hospital.
As per available estimates, male factors now account for roughly 40-50 per cent of infertility cases nationally, either on their own or alongside female infertility, and fertility chains are expanding diagnostic and treatment offerings specifically to meet this demand. “Sedentary routines, stress, obesity, and simply delaying parenthood are showing up in sperm parameters we did not see as often a decade ago,” Dr Vineet says. Changing lifestyles, delayed marriages, obesity and stress are cited as key contributors, alongside a simple cultural shift: more men are willing to walk into a clinic and get tested, he added.
The numbers underline how large this story has become. India performs roughly 2 to 3 lakh IVF cycles a year. It is a US$1.4 billion market as per some estimates and more than 2,000 clinics. Some projects suggest that this may rise to around 400,000 cycles by 2030, driven increasingly by growth in smaller cities, not just metros.
That scale is precisely why regulators are stepping in. The National Commission for Women has constituted three expert groups to examine the legal, ethical, medical, and social dimensions of Assisted Reproductive Technology and IVF in India — an acknowledgment that innovation is outpacing oversight.Â
Dr. Archana Dhawan Bajaj said, “India’s existing framework, under the ART Act and the PCPNDT Act, already draws firm lines: genetic testing of embryos is permitted only to screen for serious inherited disorders such as Thalassaemia, Sickle Cell Disease or chromosomal abnormalities. Sex selection remains strictly illegal, and clinics cannot legally disclose or guarantee an embryo’s gender, with violations carrying imprisonment, fines and loss of medical licence”.
“The technology will keep improving. What has to improve just as fast is the regulation and the honesty in the consulting room,” says Dr. Hrishikesh Pai “If we get that balance right, more couples walk away with a healthy baby — and that’s the only outcome that actually matters.”
