Over the last two decades, fertility care in Northeast India has
changed in ways that are visible not only in laboratories and treatment
options, but also in the people seeking help. At the Institute of Human
Reproduction (IHR), Guwahati, Dr Deepak Goenka
has watched that shift. Associated with IHR since 2000, he is Director and Head
of the Department of Reproductive Medicine, with his practice spanning
reproductive medicine and infertility, obstetrics and gynaecology.
Fertility Patients Are Getting Older
One of the clearest changes has been the age of women approaching
fertility specialists. Around 20 years ago, the average female partner seeking
fertility treatment at IHR was generally between 25 and 30 years old. Today,
the institute increasingly sees women in the 35–40 age group.
IHR associates this shift with later marriages, delayed childbearing,
career priorities, and changing social choices. Clinically, age matters because
ovarian reserve and egg quality decline over time. Reproductive medicine now
offers couples more options than it once did, but awareness of age-related
fertility decline and timely family planning remains important.
Infertility Is Not Just a Women’s Health Issue
The infertility profile seen at IHR is also varied. The team reports
male-factor infertility, polycystic ovary syndrome (PCOS), and diminished
ovarian reserve among common patterns. Poor ovarian reserve and reduced egg
quality are being observed particularly in women seeking pregnancy at a later
age.
A persistent misconception is that infertility automatically indicates
a problem with the woman. In practice, male-factor infertility is an important
part of fertility evaluation.
Why Both Partners Need to Be Evaluated
Rather than beginning with assumptions about either partner, fertility assessment
needs to consider both. IHR offers procedures including ICSI and TESA in
relevant male-factor cases, alongside genetic and fertility-preservation
services.
IVF itself is surrounded by misconceptions. It
does not guarantee pregnancy or a live birth; it is not always the first
treatment for infertility, and it is not intended only for older couples.
Similarly, transferring more embryos does not necessarily produce a better
outcome.
Treatment depends on the case, including age, ovarian reserve, sperm
parameters, medical history, and previous treatment.
IVF Has Changed — and So Has the Way It Is Used
The technology available to fertility specialists has changed
substantially during Dr Goenka’s career. Advances listed by IHR include ICSI,
improved embryo culture and blastocyst development, vitrification and modern
cryopreservation, preimplantation genetic testing, next-generation sequencing,
non-invasive chromosomal screening, fertility preservation and more precise
ovarian-stimulation and embryo-transfer strategies.
IHR states that it has offered PGT-A since 2009 and later introduced
non-invasive chromosomal screening, or NICS, in Northeast India under the
guidance of Dr Goenka and Chief Embryologist Rashmi Goenka. Dr Goenka has also
written publicly about the potential role of NICS in embryo selection.
From Standard Protocols to Personalised Fertility Treatment
Modern IVF increasingly takes the individual patient’s reproductive
and medical profile into account rather than applying the same protocol to
every couple.
Age, ovarian reserve, sperm parameters, previous IVF outcomes, embryo
development, genetic risk and medical history can all influence the treatment
strategy. Depending on circumstances, IHR currently provides IVF, ICSI, genetic
testing, fertility preservation, cryopreservation and donor programmes.
The Growing Role of Genetics and Fertility Preservation
Genetics and preservation have become important parts of modern
reproductive medicine. In appropriate cases, genetic testing can help identify
chromosomal abnormalities or specific inherited conditions.
Fertility preservation, meanwhile, can involve freezing eggs, sperm or
embryos for possible future treatment. Cryopreservation therefore has a role
beyond an individual IVF cycle, allowing reproductive material to be stored
where clinically appropriate.
For couples considering treatment, these developments expand the
available options, but they do not replace diagnosis. The choice of treatment
still begins with understanding why conception has not occurred.
Northeast India Has Made Progress, but Access Gaps Remain
Access to specialised reproductive medicine in Northeast India has
improved as ART facilities have developed within the region. IHR currently
provides IVF, ICSI, IUI, genetic testing, fertility preservation,
cryopreservation, laparoscopy and hysteroscopy in Guwahati.
Yet access to technology does not resolve every challenge. IHR
identifies lack of awareness, delayed referral, and limited insurance coverage
as important concerns in Assam and the Northeast. Some patients reach fertility
specialists later, when age-related decline or underlying conditions can make
treatment more challenging. The financial burden is another concern because
fertility treatments are generally not adequately covered by health insurance.
IHR’s supplied information does not provide enough region-wide data to
quantify gaps outside major urban centres. However, affordability, awareness,
specialist availability and timely referral remain areas requiring attention.
Research Alongside Clinical Practice at IHR
Clinical practice at IHR is accompanied by academic activity. The
institute runs a Fellowship in Reproductive Medicine and short-term infertility
courses.
Dr Goenka has also been involved in published clinical work. A 2016
paper by Kanchan Murarka, Deepak Goenka and M. L. Goenka documented an unusual
abdominal pregnancy after bilateral tubal block. Another publication from 2025
involving Dr Goenka examined hyperlipidemia as a rare complication following
IVF. His academic contributions also include commentary on NICS and embryo
selection.
What the Next Phase of Reproductive Medicine Could Look Like
The changes seen at IHR illustrate a broader movement in fertility
medicine: more sophisticated laboratory tools, greater use of genetics and
preservation, and treatment decisions increasingly shaped around individual
patients.
But technology is only part of the picture. Timely evaluation remains
important. A commonly used benchmark is evaluation after 12 months of regular
unprotected intercourse without conception when the woman is under 35, with
earlier evaluation generally recommended at 35 or above or when known fertility
concerns exist.
For Northeast India, the next phase of reproductive medicine will
therefore depend on more than new procedures. Better awareness, earlier
assessment, realistic expectations and wider access will matter alongside
scientific advances. After more than two decades at IHR, Dr Goenka’s experience
reflects that changing balance: technology continues to expand what fertility
specialists can do, while careful evaluation determines when and how those
tools should be used.