How Reproductive Medicine Is Changing in Northeast India: Dr Deepak Goenka on the Evolution of Fertility Care

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.