In an exclusive interview with Dr. Hrishikesh Pai, one of India’s leading IVF specialists, explores the changing landscape of fertility care in India. With over four decades of experience in Obstetrics, Gynecology and Reproductive Medicine, Dr. Pai has been closely associated with the evolution of assisted reproductive technologies in the country. His work has included the adoption of advanced technologies such as embryo assessment, vitrification, laser hatching and AI-based embryo evaluation.
In this conversation, Dr. Pai shares his perspective on emerging fertility trends, the role of technology in IVF, changing patient expectations and what the future of reproductive medicine could look like.
1. With fertility awareness increasing across India, what are some of the biggest misconceptions about infertility and IVF that need to be addressed?
Dr. Hrishikesh Pai: One of the biggest misconceptions is that infertility is primarily a woman’s issue. In reality, male factors contribute significantly to infertility, and both partners should be evaluated as part of the fertility journey. Another common misconception is that IVF is always the first or only solution. Fertility treatment should be personalised based on the couple’s age, medical history, fertility parameters and the underlying cause.
It is also important to understand that IVF is not a guarantee of pregnancy. Success depends on several factors, particularly age, egg and sperm quality and embryo health. The focus should therefore be on timely diagnosis, appropriate treatment and realistic expectations rather than simply looking at IVF as a last resort.
2. You have witnessed more than four decades of evolution in reproductive medicine. What are the most significant changes you have seen in IVF?
Dr. Hrishikesh Pai: The transformation has been remarkable. When IVF began, the technology and laboratory capabilities were far more limited. Today, we have sophisticated embryo culture systems, vitrification, time-lapse embryo monitoring, genetic testing and AI-assisted embryo assessment.
The biggest change, in my view, is the shift towards greater precision and individualisation. We are increasingly able to use data and technology to support clinical decisions rather than relying on a single parameter. Techniques such as cryopreservation and blastocyst culture have also expanded the possibilities available to patients.
However, technology should always remain a tool. The experience and clinical judgement of the fertility specialist and embryology team continue to be central to good patient care.
3. AI is increasingly becoming part of fertility treatment. How do you see AI transforming IVF?
Dr. Hrishikesh Pai: AI has the potential to bring an additional level of precision and consistency to IVF. Embryo selection, for example, involves analysing multiple characteristics and developmental patterns. AI can analyse large amounts of data and identify patterns that may not always be apparent to the human eye.
At Bloom IVF, we have adopted AI-based technology for embryo assessment across our clinics. The objective is not to replace embryologists or doctors but to provide them with another layer of information when making clinical decisions.
I believe the future will be about combining the strengths of technology with human expertise. AI can assist us in making more informed decisions, but the final treatment strategy must always consider the individual patient.
4. Egg freezing and fertility preservation are becoming increasingly relevant. What should individuals understand before considering fertility preservation?
Dr. Hrishikesh Pai: Fertility preservation gives individuals an opportunity to plan for their reproductive future, but it should not be viewed as an absolute guarantee of a future pregnancy. The age at which eggs are frozen, the number of eggs retrieved and the individual’s ovarian reserve are important considerations.
Egg freezing can be particularly relevant for women who wish to delay childbearing for personal or professional reasons, as well as for patients who may undergo treatments such as chemotherapy or radiation that could affect fertility.
My advice is that individuals should not wait until fertility becomes a concern before learning about their options. A consultation with a fertility specialist can help them understand their reproductive health and make an informed decision based on their circumstances.
5. Looking ahead, what do you believe will be the next major breakthrough in reproductive medicine?
Dr. Hrishikesh Pai: I believe the future of reproductive medicine will be increasingly data-driven, personalised and preventive. AI, advanced embryo assessment, genetic testing, improved cryopreservation and better understanding of reproductive biology will continue to influence how we approach fertility treatment.
We are already seeing the convergence of technology and reproductive medicine, and this will only become stronger. My hope is that these advancements will not only improve outcomes but also make fertility treatment more accessible, affordable and less stressful for patients.
India has a strong pool of medical and scientific talent, and with continued investment in research, technology and clinical expertise, I believe the country has the potential to become a global leader in reproductive medicine.
