How do social, economic, and cultural factors mediate fertility decisions among urban middle-class women Northwest India?

Worldwide infertility is a major concern, 48.5 million couples are unable to have a child. Global trends of infertility shows that nearly 19.2 million couples suffer with primary infertility and 29.3 million couples face issue with secondary infertility (Mascarenhas et al. 2012; WHO 2020 ). In reproductive health, infertility is a critical component, but it has been neglected. Indian society carries associated stigma wit h infertility. There is a cultural significance of motherhood in Indian society. Indian women's status in society is determined by how well she accomplishes her maternal and familial responsibilities. Women who have successfully given birth are considered "fully female" and fully incorporated into their husbands' kin group to fulfill their role. Additionally, due to patriarchal values, women in Indian society are pressured to carry a male child and is considered infertile if she fails to produce a male child. The assisted reproductive technologies have brought new hope for those couples who are struggling to be parents. India is the fasted growing ART market. The studies in the past have been done looking at the ethics-related process and other associated medical issues. However, not many studies have done looking at what ART means to women and challenges for women to the notion of biological kinship and motherhood. The study will take into account a crossed demographical and anthropological approach. It aims to conduct ethnographic study with focus on the diversity of "explanations" and "therapies" about infertility by women. Who is blamed for infertility? What is blamed for woman or man's physiology, medicine side effects, stress, pollution, previous life, vastu (architecture of house), sorcery attack etc. Which idioms people use to explain and treat infertility: biomedicine, ayurveda, Karma, astrology, environmental pollution, etc. How do these different idioms interact? Who are the practitioners consulted (gynecologists, guru, priests, astrologers, vaidyas, etc.)? Are the therapeutic choices and explanations related to socio-economic status, to caste, to religion, etc.?