With rising infertility linked to lifestyle changes, fertility centres are expanding across the country, offering both advanced procedures and lifestyle-based care
When Sami and his wife began their journey in 2022, they could not have imagined how long and arduous the road ahead would be. His wife had been diagnosed with severe complications related to polycystic ovary syndrome (PCOS), a condition that makes it difficult for many women to conceive.
"We consulted eight to nine gynaecologists, but none of their treatments brought any noticeable improvement," Sami recalled.
Frustration grew with each failed attempt, but hope arrived when they met Dr Hasna Hossain Akhee.
"Under her treatment, we began to see gradual improvement, and my wife's health kept getting better," he said. After three years of patience, Sami's wife finally conceived.
"A few months ago, an ovulation test confirmed that my wife had conceived. Further tests later confirmed the pregnancy. So far, the baby is healthy in the womb without any complications, and the mother is also doing well. It has been a long journey of three years. Today, both my family and I are very happy," Sami said.
But while it took Sami only three years, the wait is even longer for many.
Rubina, a 33-years-old woman, said that she waited seven years for a baby. "I faced constant remarks from people around me for not having children. Many nights ended in tears before I could fall asleep."
She added, "I had consulted many doctors, and even sought help from a kabiraj in my village. Nothing worked. Then one day, a neighbour told me about a doctor in Dhaka. I decided to try once more. After some months under her care, I finally conceived through IVF and gave birth to my first child last year."
Stories like Sami's or Rubina's are becoming increasingly common nowadays. In Dhaka, a growing number of fertility centres are helping couples find joy after years of uncertainty.
For many couples in Bangladesh, infertility was once a taboo topic -- a subject spoken about only in whispers. It was often hidden under layers of social stigma.
However, fertility centres are gradually changing the way the society deals with infertility. These centres offer scientific solutions and emotional support for those who face difficulties in starting a family.
Prof Dr Rashida Begum, founder and chief consultant at the Infertility Care and Research Centre (ICRC), has witnessed this change first-hand, as she is one of the very few pioneers in this field.
"After many years of practice, doctors in the country have learnt how to carry out fertility treatments. However, the opportunities in government hospitals are very limited, hence, many doctors have opened fertility centres on their own initiative. Today, many private hospitals also run fertility units," she explained.
These centres now provide a wide range of treatments, from basic consultations and lifestyle guidance to advanced procedures like intrauterine insemination (IUI) and in-vitro fertilisation (IVF).
According to Dr Akhee, most patients typically need four types of treatments. The most common is conservative treatments, which are just oral medications and maintaining a controlled lifestyle.
Then comes IUI, a fertility treatment where specially prepared, active sperm are placed directly into the uterus during the woman's ovulation period.
Laparoscopic surgery is another minimally invasive procedure that uses small incisions to access the abdomen or pelvis with a camera and specialised instruments. It allows for diagnosis and treatment of internal conditions with less pain, smaller scars, and faster recovery than traditional "open" surgery.
Lastly, IVF is another process where an egg is fertilised by sperm in a test tube or elsewhere outside the body.
A few centres also provide fertility assessments, genetic testing, and cryopreservation services for eggs, sperm, or embryos as a means of future family planning.
Infertility is no longer a rare problem in Bangladesh. According to specialists, the main reason for the rise in patients is PCOS, a condition closely linked to modern lifestyle.
"The main reason behind the rise in infertility is polycystic ovary syndrome, or PCOS. In most cases, it develops due to food habits and lifestyle factors," said Dr Akhee. "Sometimes there are genetic causes as well. For genetic issues, we cannot do much. But food habits and lifestyle can be changed."
Changes in how young women live and eat are believed to be important driving factors in the case of infertility. "If we look back 20 years, girls were far more physically active. They walked to school, ran and played games," she said.
"But today, most are dependent on devices and far less active. Our food habits have also changed. Earlier, we ate mostly natural food. Now most people consume processed food. Twenty years ago, chips or junk food were not common. As soon as these became part of our daily diet, hormonal imbalances started to increase," Dr Akhee noted.
Moreover, the problem of infertility, long regarded as a struggle solely for women, is just as prevalent among men.
According to the US National Institutes of Health, in one-third of infertile couples the problem lies with the man. Another third remains unexplained or involves factors from both partners. The remaining third is attributed to the woman.
"Male infertility presents itself in many forms," Dr Akhee described. "The most common cases we see are oligospermia, which is a low sperm count, asthenozoospermia, meaning poor sperm motility, and teratozoospermia, where the sperm shape is abnormal.
"In a smaller group of men, there is azoospermia, which means a complete absence of sperm. The treatment for these conditions usually involves procedures such as IVF or IUI."
The shift in lifestyle and food habits has meant more patients coming forward with reproductive health concerns. The response has been the establishment of fertility centres across the country.
"Across Bangladesh there are about 25 centres. Among these, three are in Chattogram, one in Khulna, and one in Sylhet, with the majority based in Dhaka," said Dr Rashida.
After many years of practice, doctors in the country have learnt how to carry out fertility treatments. However, the opportunities in government hospitals are very limited, hence, many doctors have opened fertility centres on their own initiative. Today, many private hospitals also run fertility units.
Several leading private hospitals in Dhaka, including Labaid, Apollo, United and Square, operate their own dedicated units for fertility treatment. Alongside these, Nova IVF Fertility has expanded with multiple branches across the city. India's Chennai Fertility Center has also set up a branch in Dhanmondi.
The growing presence of these centres reflects not only rising demand but also a professional community of doctors who have gained expertise in fertility treatment, according to her.
In case of infertility, success is far from guaranteed, and much depends on the age of the patient. "The success rate largely depends on age. For patients aged 40 to 44, the average success rate is about 9%. For those aged 18 to 34, the success rate is around 41%," said Dr Rashida.
"These are data from a research in the UK, but from my own experience, the results in Bangladesh are pretty much consistent with these global averages," she explained.
This reality often shapes patient expectations. Some couples succeed after the first attempt, while others go through multiple cycles of treatment.
The costs vary. While IVF can reach Tk3.7 lakh, according to Dr Rashida, conservative treatments for PCOS may cost as little as Tk10,000 to Tk15,000. In some cases, compassionate discounts are also offered, which of course, are not available for all.
"For poorer patients who need IVF, I sometimes only charge for medicine and equipment, which can bring the total down to as little as Tk2 lakh," she said.
For families like Sami's or Rubina's, the expenses are worthwhile. "In terms of cost, the treatment over three years has been less than Tk1 lakh. Before that, when we were seeing other doctors, we had spent around Tk3 lakh within just a few months," Sami noted.
While medical intervention is essential for many couples, both the doctors stressed that prevention and lifestyle management play a critical role.
"In cases of PCOS, about 90% can be managed with lifestyle changes and conservative treatment," said Dr Akhee. Exercise, balanced diets, and reduced dependence on processed foods are some preventive measures that she highlighted.
Awareness is also key. Many couples still seek help late, sometimes after years of trying in silence. Fertility specialists encourage early consultation to improve outcomes.
"It is the middle class among which the infertility problem is the most severe. Families from poorer backgrounds are often less affected. I have observed a pattern -- many of the couples where the husband works abroad as an expatriate face this struggle most," she said.
"The cost of these treatments are much lower in Bangladesh than the neighbouring countries like India, Singapore, or Thailand," according Dr Akhee. When treatment expenses are combined with travel and accommodation costs, very few people can afford to go abroad.
These financial and logistical challenges have led many to choose local fertility services instead, giving this niche industry a significant boost.
However, it is still out of reach for many.
"Government hospitals do not offer much scope in this area," said Dr Rashida, noting that Dhaka Medical College is currently the only public institution officially offering IVF.