Why standardisation is becoming the next priority in India’s IVF Industry

A few weeks ago, a couple from Gwalior sat across my table with a plastic folder so full it wouldn’t close. Two IVF attempts. Two cities. Two clinics. The wife took the papers out one by one, smoothed each page with her palm, and then asked me the question that had clearly been sitting with her for months.

“Doctor, the first clinic never showed us any embryo report. The second one gave us photos and grades. Were we wrong to trust the first one?”

I didn’t have a comfortable answer for her.

She wasn’t wrong to trust. She was simply unlucky in where she started. And that, in one line, is why I believe standardisation is now the most urgent conversation in Indian fertility care.

Our IVF sector has grown faster than most of us imagined when we started out. There are now thousands of ART centres in the country, and they’re no longer only in the big metros. Couples in smaller cities can find treatment an hour from home instead of an overnight train away. That’s a genuinely good thing, and I say this as someone who meets patients from towns where, ten years ago, the word IVF was spoken only in whispers.

But growth has run ahead of consistency.

Walk into three clinics today with the same set of reports and you can walk out with three different protocols, three different price sheets, and three very different claims about your chances. For a field built almost entirely on trust, that’s not a small problem. It’s the problem.

Let me be clear about what standardisation means, because the word scares some of my colleagues. It doesn’t mean every clinic becomes identical, or that doctors stop using judgment. No two patients are the same. A woman of 28 with blocked tubes and a woman of 41 with low ovarian reserve should never be treated off the same template.

What it means is that the basics should never depend on luck.

The air quality in the embryology lab. The training of the person handling your eggs. Double-witnessing every time a sample changes hands, so there’s never a doubt about whose embryo is whose. Written protocols that are actually followed, not just filed. Counselling that happens before consent, not after payment. Records a patient can carry to any other doctor and have understood.

These are not luxuries. They’re the floor.

The ART Act of 2021 gave us a real start. Registration now tells us a clinic exists and meets minimum criteria, and that matters more than people realise. But registration answers the question “is this clinic allowed to operate?” Standardisation asks a harder one: does it do the same careful thing, the same careful way, every single time, even when nobody’s watching?

Nowhere does this matter more than in the lab.

Patients see the doctor. They sit with me, they ask me questions, they hold my hand on transfer day. But so much of their outcome is shaped in a room they’ll never enter, by people they may never meet. How stable is the temperature at the workstation? How long does a dish sit outside the incubator? How is each sample labelled, checked, and checked again? A small slip in there is invisible. Nobody may ever know it happened. Only standard operating procedures, regular audits, and a culture of checklists protect patients in that room. Culture, I’ve learnt, is just what a team does when it’s tired at 7 pm on a Saturday.

Then there’s the matter of numbers.

Ask five clinics their success rate and you may get five figures that can’t be compared, because one counts per cycle, another per transfer, another only its best-case patients. A couple spending their savings deserves better arithmetic than that. We need common definitions and honest reporting across the industry. I tell my patients plainly: no doctor on earth can promise you a baby. What a good clinic can promise is an honest process, honest numbers, and the truth at every step. Patients don’t break when they hear the truth. They break when they find out they weren’t told it.

Pricing needs the same daylight. A quoted package that quietly grows with add-ons erodes trust faster than any failed cycle does. A standard, itemised consent and cost framework would protect patients and, frankly, protect the ethical clinics too.

And we must talk about people. India doesn’t yet have enough formally trained embryologists, fertility nurses, and counsellors for the pace at which centres are opening. You can’t standardise care without standardising training. Structured programmes, certification, and continuing education for the whole team, not just the doctors, have to be part of this next chapter.

Why now? Because the stakes are rising. Insurers are beginning to look seriously at fertility cover, and they will only underwrite what they can measure. More first-time patients are arriving from smaller towns, often with little information and big loans. Patients from abroad are choosing India for treatment. Every one of them is extending us trust. Standardisation is how the industry earns it, at scale, every day.

That couple from Gwalior is in treatment with us now. I don’t know yet how their story ends, and I told them so on day one. But they understand every step, they’ve seen every report, and they know exactly what we’re doing and why.

Whatever the outcome, they will never again have to ask whether they were wrong to trust.

That is what standardisation really buys us. Not a guarantee, because biology doesn’t offer those. It buys every patient, in every city, the same careful chance.

They deserve nothing less.