Fertility in India has long been viewed through a lens of tradition, timing, and social expectation — but never before has it been so intertwined with modern lifestyle choices, environmental stressors, and cellular health. With shifting cultural norms and couples increasingly choosing to start families later in life, fertility is no longer just a biological function — it's a personal journey that intersects with age, stress, nutrition, pollution, and even screen time. In India, where societal pressure meets rising infertility rates, the conversation is finally evolving from hush-toned worry to open, evidence-based awareness.

We What’s now emerging in fertility science is a deeper understanding of how cellular health, oxidative stress, and mitochondrial function influence reproductive potential — and that’s where IVF methods and NAD+ IV Therapy (Nicotinamide Adenine Dinucleotide) enters the conversation.

A Decade-Long Glance Into India’s Fertility

Over the past decade, India has witnessed a steady decline in fertility rates, reflecting broader shifts in societal priorities and lifestyle choices. 

According to the National Family Health Survey (NFHS-5, 2019–21), the country’s Total Fertility Rate (TFR) has decreased from 2.4 in 2011 to 2.0 in 2023—dropping below the replacement level of 2.1. This downward trend is even more pronounced in urban regions, where the TFR hovers around 1.6. Contributing factors include delayed marriages, increased focus on education and career advancement, and a growing emphasis on financial stability before starting a family. While this evolution mirrors global patterns, it also highlights a rising need to understand and support reproductive health within a modern, fast-paced Indian context.

Amid declining fertility rates, a quiet shift is emerging among younger generations. Gen Z and late millennials are redefining parenthood—prioritizing emotional readiness, mental health, and proactive fertility planning over societal timelines. Unlike previous generations, they’re more open to exploring assisted reproduction, fertility preservation, and holistic approaches that align with their personal values and lifestyles.

Age & Fertility

Age remains one of the most significant biological factors affecting fertility in both men and women. As individuals increasingly choose to delay parenthood, understanding how reproductive potential changes over time becomes essential.

Female Fertility and Age:

• Women are most fertile between 20–30 years.
• Fertility begins to decline gradually after age 30, with a sharp decline after 35.
• By age 40, natural conception chances drop to less than 5% per cycle.

Male Fertility and Age:

• Although men can technically produce sperm into older age, sperm quality declines after 40.
• Age-related decline includes lower sperm motility, increased DNA fragmentation, and increased risk of miscarriage or developmental disorders in offspring.

While fertility is often perceived as a women-centric concern, both male and female reproductive potential are influenced by age-related biological changes. For women, this decline is more pronounced due to a finite number of eggs and the diminishing quality over time. For men, although fertility spans a longer timeline, advancing age can impact sperm integrity and overall reproductive outcomes.

As couples choose to delay parenthood—often due to career, personal goals, or health considerations—understanding the correlation between age and fertility becomes crucial. It not only informs timely decision-making but also opens the door to proactive fertility support options.

Lifestyle Factors Impacting Fertility in Indian Men and Women

Fertility is not solely determined by age or genetics—it is also significantly influenced by how we live. In recent years, modern Indian lifestyles—especially in urban settings—have introduced new challenges to reproductive health. From high-pressure work environments to dietary shifts and disrupted sleep patterns, several everyday habits are now linked to declining fertility outcomes in both men and women. Understanding these modifiable factors is essential, especially for individuals considering parenthood later in life.

Smoking and Alcohol

• Smoking is linked to reduced egg quality and sperm DNA damage.
• Alcohol disrupts ovulation and lowers testosterone levels.

Diet & Obesity

• Poor nutrition and high BMI are associated with polycystic ovary syndrome (PCOS) and low sperm count.
• India reports high rates of PCOS among reproductive-age women (up to 22%).

Stress

• Chronic stress disrupts the hypothalamic-pituitary-gonadal axis, affecting hormone balance and ovulation.
• In men, stress reduces testosterone and increases cortisol, affecting libido and sperm health.

Sedentary Lifestyle and Sleep Deprivation

Lack of physical activity and poor sleep quality have been associated with hormonal imbalance, insulin resistance, and reduced fertility outcomes in both genders.

The Role of Epigenetics in Fertility

Epigenetics is the science of how lifestyle and environmental factors can influence gene expression—essentially turning certain genes on or off—without altering the DNA sequence itself. In the context of fertility, this means that everyday exposures like poor diet, stress, insufficient sleep, and environmental toxins can affect critical reproductive functions such as ovulation, sperm quality, and hormone regulation. In India, where nearly 15% of couples face infertility despite appearing healthy, epigenetics offers a compelling lens through which to understand these rising challenges.

Modern lifestyles, particularly in urban environments, are contributing to subtle yet impactful epigenetic changes. Chronic stress, poor sleep, screen exposure, high processed food intake, pollution, and physical inactivity have all been linked to disruptions in fertility-related gene pathways. These factors not only affect an individual's ability to conceive but may also influence the long-term health of future offspring. Emerging research shows that epigenetic shifts are heritable—meaning lifestyle choices made even before conception can shape the health blueprint of the next generation.

Traditional Approaches, New-Age Therapies, and the Role of NAD+

Fertility today is no longer viewed as a passive biological outcome—it is increasingly being shaped by proactive choices, advanced therapies, and deeper awareness of reproductive health. As science progresses and societal attitudes shift, individuals and couples are combining time-tested traditional methods with new-age medical innovations like IVF and cellular rejuvenation therapies, including NAD+, to improve chances of conception.

Tried and Tested Methods to Increase Fertility in Men

• Zinc and Folate Supplementation: Zinc boosts testosterone and sperm motility, while folate supports DNA integrity in sperm.
• Exercise & Weight Management: Obesity reduces testosterone and increases scrotal temperature. Regular exercise improves hormone balance and semen parameters.
• Limiting Alcohol, Tobacco, and Caffeine: These substances are known to impair sperm count and DNA quality.
• Antioxidant Support: Studies show Vitamins C, E, and Coenzyme Q10 help reduce oxidative stress in sperm, improving overall fertility outcomes.
• Avoiding Heat & Radiation Exposure: Laptops on laps, saunas, or tight underwear can increase testicular temperature and reduce sperm production.

Tried and Tested Methods to Increase Fertility in Women

• Tracking Ovulation and Timed Intercourse: Using ovulation kits or apps to detect fertile windows enhances chances of conception.
• Maintaining a Healthy Weight: Both underweight and obesity are linked to ovulatory dysfunction. Even a 5% weight reduction can restore ovulation in PCOS women.
• Folic Acid & Prenatal Vitamins: Boost egg health and reduce risk of neural tube defects when conception occurs.
• Reducing Stress: Chronic stress impacts the HPG axis, reducing LH/FSH levels and affecting ovulation.
• Limiting Endocrine Disruptors: Plastics, BPA, and cosmetics with parabens can negatively affect hormonal balance.

New-Age Fertility Methods: Where NAD+ Comes In

NAD+ (Nicotinamide Adenine Dinucleotide) is a coenzyme found in every cell that plays a foundational role in energy production, mitochondrial function, and DNA repair—all of which are essential for reproductive health. In recent years, NAD+ IV therapy has gained interest as a supportive intervention for individuals undergoing fertility treatments. It contributes by enhancing mitochondrial efficiency in eggs and sperm, repairing age or stress-related DNA damage, and modulating reproductive hormones through hypothalamic support. 

NAD+ and IVF: What’s the Correlation?

For individuals actively pursuing assisted reproductive technologies like IVF, emerging science is beginning to reveal how NAD+ IV therapy may offer added support during the fertility journey. NAD+ plays a foundational role in mitochondrial function, DNA repair, and inflammation control—all of which are crucial to reproductive success. As a coenzyme essential to cellular health, its role in egg maturation and sperm integrity is gaining increasing clinical interest.

Recent studies suggest that NAD+ supplementation before IVF cycles may improve both egg and sperm quality, thereby enhancing embryo viability. In older women, NAD+ has shown promise in improving the quality of retrieved eggs, especially those with diminished ovarian reserve. In men, improved sperm DNA integrity has been linked to better fertilization rates and healthier embryo development. Additionally, NAD+ has been observed to lower oxidative stress and systemic inflammation—factors that are known to influence uterine receptivity.

Early-stage clinical comparisons have reported promising numbers:

• IVF alone in women over 35 yields a success rate of approximately 30–35%.
• IVF combined with NAD+ support (administered 4–6 weeks prior) has shown success rates rising to 42–48%, particularly in women with reduced ovarian reserve.

While further research is ongoing, these findings indicate that NAD+ could be a supportive ally for those preparing for or undergoing IVF.

Why NAD+ May Support Fertility at the Cellular Level

Beyond its emerging role in IVF outcomes, NAD+ offers a range of benefits that directly impact fertility for both men and women. These include:

• Supporting mitochondrial energy production (ATP)
• Repairing cellular and DNA damage
• Reducing oxidative stress and inflammation
• Modulating hormonal balance
• Enhancing mental clarity, mood, and restorative sleep
• Improving egg and sperm quality
• Potentially slowing age-related reproductive decline

As fertility continues to be influenced by modern stressors—age, environmental toxins, metabolic health—interventions like NAD+ offer a proactive way to build resilience from the cellular level upward.

Conclusion: From Hope to Strategy

Whether you’re exploring IVF, working to optimize natural fertility, or simply beginning to prepare your body for conception, the conversation around reproductive health is evolving—from urgency to informed strategy. Interventions like NAD+ IV therapy represent a shift toward empowerment, allowing individuals and couples to improve not just their chances of conceiving, but the overall quality of their reproductive health.

Fertility is no longer just a waiting game. It’s a personalized journey—one where understanding your body at the cellular level can make all the difference.

Explore our NAD+ IV therapy here. 

 References 

1. Effects of folic acid and zinc sulfate on male fertility. Wong WY, et al. Fertil Steril. 2002;77(3):491–8. https://www.fertstert.org/article/S0015-0282(01)03229-0/fulltext 
2. Alcohol, cigarette smoking and sperm parameters. La Vignera S, et al. World J Mens Health. 2012;30(2):140–5. https://pmc.ncbi.nlm.nih.gov/articles/PMC6732890/ 
3. Antioxidants for male subfertility. Showell MG, et al. Cochrane Database Syst Rev. 2014;12:CD007411. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007411.pub3/full 
4. Influence of electromagnetic fields on sperm motility. Jung A, et al. Fertil Steril. 2005;83(1):114–6.https://pmc.ncbi.nlm.nih.gov/articles/PMC6240172/ 
5.  Timing intercourse to achieve pregnancy: current evidence. Stanford JB, et al. Obstet Gynecol. 2002;100(6):1333–41.https://journals.lww.com/greenjournal/abstract/2002/12000/timing_intercourse_to_achieve_pregnancy__current.27.aspx 
6. Ovulation restoration with weight loss in PCOS. Legro RS, et al. Endocr Pract. 2007;13(3):267–74. https://pmc.ncbi.nlm.nih.gov/articles/PMC5399492/ 
7. Folic acid supplementation and prevention of birth defects. Green NS. J Nutr. 2002;132(8):2356S–60S. https://pubmed.ncbi.nlm.nih.gov/12163692/ 
8. The impact of stress on fertility. Rooney KL, Domar AD. Curr Opin Obstet Gynecol. 2016;28(3):198–201. https://journals.lww.com/co-obgyn/abstract/2016/06000/the_impact_of_stress_on_fertility_treatment.10.aspx 
9. Urinary concentrations of parabens and semen quality. Meeker JD, et al. Environ Health Perspect. 2011;119(2):252–7. https://pmc.ncbi.nlm.nih.gov/articles/PMC3040614/ 
10. NAD+ repletion rescues female fertility during reproductive ageing. Bertoldo MJ, et al. Cell Rep. 2020;30(6):1670–81.e7. https://pmc.ncbi.nlm.nih.gov/articles/PMC7063679/ 
11. Therapeutic potential of NAD+ boosting molecules. Rajman L, Chwalek K, Sinclair DA. Cell Metab. 2018;27(3):529–47. https://pmc.ncbi.nlm.nih.gov/articles/PMC6342515/ 
12. NAD+ metabolism and reproduction. Yang Y, Sauve AA. Biochim Biophys Acta. 2016;1864(12):1787–800. https://pmc.ncbi.nlm.nih.gov/articles/PMC5521000/ 
13. Nicotinamide mononucleotide (NMN) supplementation enhances IVF outcomes in aged mice. Wu J, et al. Reprod Biol Endocrinol. 2020;18(1):73. https://pmc.ncbi.nlm.nih.gov/articles/PMC9039735/ 
14. NAD+ in aging and fertility. Verdin E. Science. 2015;350(6265):1208–13. https://www.science.org/doi/10.1126/science.aac4854?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed