By:-  Dr. Sabia Mangat, Consultant – Gynaecologist, Reproductive Medicine and IVF, Milann Fertility Hospital, Chandigarh

India is witnessing a striking paradox: even as medical technology advances, more young couples are struggling to conceive. Fertility specialists across the country report a steady rise in infertility cases often in couples in their late 20s and early 30s. While medical conditions such as PCOS, endometriosis, low ovarian reserve, and poor sperm quality remain important causes, a growing body of evidence suggests that infertility today is increasingly shaped by modern lifestyle choices. From stress and screen addiction to delayed childbirth and dietary habits, infertility is rapidly emerging as a lifestyle disorder.

According to the latest Sample Registration System (SRS) data, the country’s Total Fertility Rate (TFR) has fallen to 1.9, below the replacement level of 2.1. Eighteen states and union territories including Delhi, Karnataka, Punjab, and West Bengal are now below replacement fertility. For the first time, even rural India has touched a TFR of 2.1, while urban areas have dipped to 1.5, reflecting shifting social patterns. Fertility is declining most sharply among younger women (15–29 years), while increasing marginally among women aged 30 and above, clear evidence of delayed parenthood making it the biggest contributor.

An increasing number of couples are choosing to postpone pregnancy while they build careers, achieve financial stability, or pursue personal goals. Although empowering, this trend collides with biological reality. Women are born with all the eggs they will ever have, and both egg quality and egg quantity begin to decline sharply after the age of 32. For men, long working hours, erratic meals, smoking, alcohol consumption, and chronic stress are linked to reduced sperm count and motility. Together, these factors are pushing infertility into the mainstream as a lifestyle-driven phenomenon.

The urban lifestyle is another major catalyst. Long workdays, high-pressure environments, sedentary habits, and chronic screen exposure are now common across age groups. Stress has become a new normal in today’s life. And, stress triggers hormonal imbalances that affect ovulation in women and testosterone levels in men. Again, the increase in desk jobs has also led to an epidemic of obesity, and other other risk factors for ovulatory issues, insulin resistance, erectile dysfunction, and poorer IVF outcomes.  Even the non-uniform working hours lead to sleep deprivation, excessive social media use, or irregular routines, disrupting hormonal cycles essential for fertility.

Diet, too, plays an increasingly important role. The growing dependence on processed foods, sugary beverages, refined carbohydrates, and high-salt snacks fuels inflammation and metabolic disorders that interfere with reproductive health. According to fertility experts, a Mediterranean-style diet, supports better hormonal balance and improves both egg and sperm quality. However, for many urban Indians, convenience often takes precedence over nutrition, leading to deficiencies in essential vitamins, minerals, and antioxidants.

Environmental factors have also been linked to declines  in fertility. Air pollution, endocrine-disrupting chemicals in plastics, pesticides in food, and everyday exposure to cosmetics and household products containing harmful chemicals have been linked to declining fertility rates globally. These disruptions mimic or interfere with the body’s natural hormones, affecting menstrual cycles, sperm development, and embryo implantation.

What makes infertility particularly complex is the emotional landscape surrounding it. Modern lifestyles leave little room for rest, reflection, or interpersonal connection, creating a sense of isolation among couples facing fertility challenges. The added pressure of societal expectations, competitive careers, and financial commitments only intensifies the emotional burden. Mental health issues such as anxiety, burnout, and depressive symptoms, create a vicious cycle, further affecting hormonal and reproductive health.

Recognising infertility as a lifestyle disorder is the first step toward prevention. Time has come to take proactive approaches, such as: regular health screenings, maintaining a healthy diet, staying physically active, reducing smoking and alcohol consumption, managing stress through yoga or mindfulness, and prioritising 7–8 hours of sleep. For couples planning to delay pregnancy, fertility preservation options such as egg or sperm freezing offer greater reproductive flexibility. 

Infertility is caused by genetic and biological factors, but the rise in number reflects a deeper lifestyle shift. As work pressures intensify, diets become more processed, and stress becomes a constant companion, reproductive health inevitably takes a hit.