The decline in fertility rates in India is a matter of concern and must be addressed properly by taking into account factors like urbanisation, education, and women's empowerment, said health experts on 27 March.

According to a recent study published in The Lancet, India’s total fertility rate saw a significant decline from 6.18 in 1950 to 1.91 in 2021. The study predicted that it may further drop to 1.3 by 2050 and 1.04 by 2100.

“Numerous factors such as education, religious beliefs, and the contraceptive prevalence rate (CPR), influence the total fertility rates of a country. In addition, delay in marriage and childbirth and change in social norms favouring smaller family size, financial independence, more and more women pursuing careers over motherhood, also result in a reduced fertility rate,” said Dr Rachita Munjal, Senior Consultant, at an IVF centre in Gurugram.

Other reasons that lead to infertility include rising levels of obesity, stress, smoking, pollution, and unhealthy lifestyles, said the doctor.

Infertility can affect the total fertility rate (TFR) by delaying childbearing age and reducing conception probability. TFR can be defined as the average number of children born to a woman in her lifetime.

“The psychological impact of infertility and related complications prompts couples to reconsider family plans, potentially leading to fewer children. The societal stigma surrounding infertility and fertility treatment further restricts couples from seeking medical help, contributing to a lower TFR by limiting access to treatment,” Dr Rachita said.

Dr Nisha Bhatnagar, Medical Director at Infinite Fertility, said that the declining fertility levels can have manifold ramifications for public health policy and society.

However, reproductive technology developments like egg freezing can provide personalised answers to infertility problems, the doctor said.

“Egg freezing has become a recognised technique for maintaining fertility, especially for those who choose to delay having children for personal or professional reasons,” Dr Nisha said.

However, these are not a cure-all for the general trends in population, the expert said, emphasising the need for more comprehensive public health policies that take into account “socioeconomic factors such as urbanisation, education, and women's empowerment.”

“Increased awareness to empower informed family planning, supportive maternity and paternity policies like paid leave and childcare support, and financial incentives such as childcare benefits are also a few measures that can help improve fertility rates in the country,” added Dr Rachita.