The long wait for affordable fertility care in Southern Tamil Nadu

As private fertility clinics multiply across Madurai and throughout the State, offering a range of Assisted Reproductive Treatments (ART), there lies a huge question of why such services are absent at Government Rajaji Hospital (GRH) and other major government medical college hospitals in districts other than Chennai? Despite a steady flow of couples seeking infertility care, the hospitals are yet to introduce fertility treatment facilities, leaving economically weaker patients with limited options.

Madurai has emerged as a key medical hub for southern Tamil Nadu, inviting patients from neighbouring districts for specialised care. In recent years, however, infertility treatment has largely remained within the private sector, and the high cost of treatment makes it unaffordable for many families.

Veronica Mary, health activist, says the absence of fertility treatments at Madurai GRH — which serves a predominantly rural and low-income population — highlights a significant gap in reproductive healthcare delivery.

When asked about the rise in fertility treatment offered by private hospitals in cities, especially in the southern region, she said continuous advertising across multiple platforms was drawing vulnerable couples towards such clinics. She also pointed out that several private fertility centres did not appear to be fully complying with provisions of the Clinical Establishments (Registration and Regulation) Act, 2010, which mandates transparency in fees, including the display of approved charge ranges and adherence to prescribed fee structures.

She also noted that even if fertility treatment facilities were to be established at the GRH, the availability of trained manpower would be a critical factor in ensuring that the services function effectively and are accessible to all sections of the population.

She added that, similar to private fertility centres, any fertility treatment facility at the GRH would require a dedicated team of doctors and trained staff to monitor patients on a round-the-clock basis. Continuous medical supervision, she said, was essential for such treatments, which involve multiple stages and close observation, and would be key to ensuring effective outcomes.

Regarding this, a public interest litigation (PIL) was filed in 2023 seeking the introduction of fertility treatment services at Madurai Government Rajaji Hospital and Egmore Government Hospital. While the facility has since been established at the Egmore GH and is reported to be receiving a positive response from patients, similar services are yet to be introduced at the Madurai GRH.

It has been nearly three years since Health Minister Ma. Subramanian announced that steps had been initiated to establish fertility clinics at Government Rajaji Hospital and the Institute of Obstetrics and Gynaecology in Chennai, at an estimated cost of ₹2.5 crore each. While the centres in Chennai have since become operational, the facility proposed at the Madurai GRH is yet to be opened.

Explaining the classification of infertility care, a doctor from a private hospital said that fertility treatments are broadly categorised as ART I and ART II, based on the level of intervention involved. ART I comprises basic procedures. “These procedures are relatively simple, span about a month, and outcomes are assessed in the subsequent menstrual cycle,” the doctor said. More complex and laboratory-intensive procedures are classified under ART II and are considered when initial interventions do not yield results.

Elaborating on ART II procedures, the doctor said that this category includes advanced treatments and technologies. “Here in this procedure, the treatment cycle usually spans between one and three months, after which outcomes can be assessed,” the doctor explained.

Success rates

On success rates, the doctor cautioned that fertility treatments do not guarantee results. “None of these procedures can assure a 100% success rate,” the doctor said, adding that ART I procedures typically record success rates in the range of 20–30%, with ART II procedures showing relatively higher outcomes, depending on individual clinical factors.

Addressing treatment failure, the doctor said that outcomes are reviewed to identify possible reasons for the lack of success. “We analyse where the procedure may not have worked as expected and, if required, plan subsequent cycles with suitable modifications,” the doctor explained.

On which treatment yields better results, the doctor said, outcomes vary widely based on individual health factors. “The choice of treatment depends on the patient’s clinical profile. While some conceive with ART I procedures, others may require advanced treatments such as IVF,” the doctor explained.

Constant monitoring for these time-consuming procedures needs manpower, and without adequate personnel, Veronica Mary says that mere opening of fertility centres in Government Hospitals will not achieve the desired results.

L. Arul Sundaresh Kumar, Dean of Government Rajaji Hospital (GRH), stated that since the implementation of Level 1 fertility procedures in 2023, the hospital has handled a total of 4,000 outpatients. Out of these, 553 patients have undergone detailed investigations and received consultations for advanced treatments.

“Among the 553 consulted, 26 patients have already undergone treatments prescribed under the Level 1 protocol. This has resulted in 10 successful deliveries, while 15 women are currently in various stages of pregnancy,” he added.

The Dean noted that because the IVF process is often long and tedious, GRH is striving to meet the needs of the public across the entire Southern districts, given the current availability of specialists and equipment.

Currently, initial procedures such as intrauterine insemination (semen injection) and other medications are available at GRH. However, for specialised laboratory procedures, patients are still being referred to the Government IVF facility in Chennai.

Steps are now being taken to bridge this gap. Arrangements to begin Level 2 treatments are nearly complete. “Equipment will be procured through funding from the Tamil Nadu Medical Service Corporation (TNMSC). Following this, we will proceed with recruiting specialized technicians and completing other essential groundwork,” the Dean noted.

Once the inspection of the officials from Chennai was over, the necessary procedures to begin the total IVF setup would begin, he noted.

Published – February 08, 2026 07:58 pm IST