NEW DELHI: Infertility treatment in India is driving an overwhelming financial crisis for families, with a new multi-centre study showing that nearly 90% of couples undergoing IVF are pushed into catastrophic expenditure—even in public hospitals. The analysis, conducted across five major institutions, highlights the scale of the burden at a time when infertility affects an estimated 3.9–16.8% of Indian couples. The study found that out-of-pocket expenditure (OOPE) for one IVF cycle averages Rs 1.1 lakh in public hospitals and Rs 2.30 lakh in private hospitals, forcing more than half of couples to borrow money. Only 5% had any insurance coverage for IVF, and those who did received limited support. Researchers also estimated the health-system cost of one IVF cycle at Rs 81,332, irrespective of hospital efficiency. Based on this, the study recommends that Pradhan Mantri Jan Arogya Yojana (PM-JAY) consider adopting Rs 81,332 as the reimbursement package rate if IVF is added to the scheme.The study was conducted by the HTA Resource Hub at the Indian Council of Medical Research–National Institute for Research in Reproductive and Child Health (ICMR-NIRRCH), led by Principal Investigator Dr Beena Joshi. The financial strain extends beyond IVF. Among couples undergoing infertility treatment for conditions such as PCOS, endometriosis, tubal disease or male-factor infertility, 25% experienced catastrophic expenditure. The median OOPE for non-IVF infertility treatment was Rs 11,317, with private hospitals leading to higher medical costs, while public facilities imposed higher indirect and non-medical expenses.Quality of life was markedly poorer among couples seeking treatment, especially those undergoing IVF. Women reported significant pain, anxiety and depression, while men showed increased anxiety scores.The study was conducted across PGIMER Chandigarh, SRIHER Chennai, Maulana Azad Medical College (Delhi), SAT Hospital at Government Medical College Trivandrum, and Jawaharlal Nehru Medical College, Wardha. It assessed 30 IVF patients and 100 infertility patients at each site, along with detailed costing from hospital records.Among IVF couples, oligospermia and tubal-factor infertility were the leading causes, while among non-IVF groups, PCOS was the most common diagnosis.The researchers note that because most infertility expenses fall under OPD care, PM-JAY would need to revise its current structure—which excludes OPD costs—to make IVF coverage meaningful. They also suggest that, in line with earlier CGHS norms and NICE guidelines, up to three IVF cycles could be considered for reimbursement.