Chapter Seven — Indira IVF: The House Named for a Wife, Built on a Taboo

How Dr Ajay Murdia left a government job with five thousand rupees, opened a male-infertility room on the ground floor of his Udaipur house, named the work after his wife, and with two sons turned a whispered shame into India’s largest chain of hope.

This chapter belongs in the same book. It is not a cathedral of hearts or a temple of the eye. It is a smaller room, at first — two rooms, a cash counter, a truth nobody wanted spoken in a Rajasthani drawing room: sometimes the problem is the man.

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A pathologist and a paper in The Lancet

He was born in Udaipur on 12 November 1952. Not a gynaecologist. A pathologist — Bombay Hospital, then teaching at RNT Medical College, government service. In August 1978, the same year Louise Brown’s birth announced that a child could begin in a dish, a paper of his on male reproduction appeared in The Lancet.

Ten years later he walked out of the job.

Five thousand rupees in the pocket. A two-room house. The ground floor became Indira Infertility Clinic and Research Centre — Indira for his wife. He has said there was no company in the mind. There was a campaign.

The campaign’s enemy was a sentence older than any lab: If there is no child, it is the woman’s fault.

He opened one of the country’s first commercial sperm banks when donation itself was barely a concept. He mixed media that kept sperm alive — survival, in the family telling, climbing from a miserable fraction toward something like eighty percent — and sold the medium to other doctors so the science would travel faster than his own two rooms.

Society did not welcome him.

“When my father started,” Dr Kshitiz Murdia would say years later, “he was not much welcomed. Speaking about male infertility was a taboo. Things changed when parents saw results.”

He answered the taboo with mileage. Nishsantanata Bharat Chhodo — childlessness, quit India. In his own count: 3,242 free consultation camps in 752 cities across twenty-five states, more than 75,000 couples spoken to before the brand had a national logo.

Family manned the reception and the till. He sat in counselling. The house smelled of disinfectant and of the particular silence that arrives when a man is asked, for the first time, to give a sample.

2011: the sons rebuild the lab

Nitiz, the elder, had gone to IIT Kharagpur and to Schlumberger, offshore rigs, a life of engineering far from Udaipur. Kshitiz was a doctor in the United States. In the late 2000s Nitiz came home to marketing and process. Kshitiz came home, added gynaecology, and in 2010–11 they gutted the old clinic into a proper IVF laboratory — ten to fifteen cycles a month, then a climb that startled even the father.

That renovation is the date the chain uses for Indira IVF as the country now knows it. The 1988 room was the argument. The 2011 lab was the factory.

By 2013 the small unit was doing hundreds of cycles a month. Pune opened in 2014 and, within months, ran two hundred cycles. Delhi followed. Between 2016 and 2018 they opened centre after centre across the north and the east — forty-seven in that burst — not in a leisurely metro pattern but in the towns where a couple would otherwise take a train to Delhi and lose a month’s wages.

The price was part of the theology. IVF that cost five or six lakh was cut, in the founder’s telling, toward one and a half or two. Geography was the next wall. Seventy percent and more of the later centres sat outside the biggest cities. Hub and spoke: a full lab where the volume justified it; a lighter spoke in a smaller town so that Sultanpur and Bathinda did not have to become pilgrims.

The hundredth centre opened in 2021. The count kept walking — past 115, toward 150, toward 180 and the ambition of two hundred. Private equity arrived: TA Associates in 2019, a large minority that professionalised a family shop into a data-led machine; EQT in 2023, a majority that valued the Udaipur name in thousands of crores. Turnover stories moved from hundreds of crores toward a thousand and beyond. The Murdias remained on the floor. The funds wanted scale. Scale, in this business, is a waiting room in a tier-two city.

Technology as a kind of courtesy

Nitiz talks like an engineer who married a clinic. Closed working chambers so the dish does not breathe the room’s accidents. RI Witness so one couple’s cells cannot be confused with another’s — a nightmare that haunts every honest lab. Microfluidics. AI that grades embryo images and tries to steal a little luck from the embryologist’s tired eye.

Kshitiz talks like a CEO who is still a doctor: cycles per year in the tens of thousands, the highest volume of any single Indian chain, more than a hundred thousand couples helped across the life of the work if you add the long tail of the father’s camps to the sons’ theatres.

None of that language matters in the counselling room.

A woman from a small town in Uttar Pradesh sits with her mother-in-law. The mother-in-law has already decided whose womb is at fault.

Ajay Murdia, in the early years, would have said the sentence he built the house to say.

“We will test both of you. That is the first respect.”

Sometimes the report sent the shame across the table. Sometimes it did not. Either way, the child — when the child came — ended an argument that no dowry had been able to end.

What this chapter is doing in the book

The earlier hospitals in these pages saved hearts, guts, eyes. They argued with the state, with America, with price.

Indira IVF argued with a family.

It is closer to Aravind than to Medanta: a specialised machine, volume as mercy, spokes in towns the metros forget. It is closer to Apollo than to Sankara: a company, investors, an asset-light rush across the map. It is unlike all of them in one tender, difficult way. The “patient” is often two people and a silence. Success is not a discharge summary. Success is a cry in a corridor nine months later.

A pathologist started it. That detail is the plot. He did not own the uterus. He owned the laboratory honesty that said the sperm must be counted before the woman is blamed.

A reconstructed evening in Udaipur

The ground-floor rooms are gone into memory. A newer façade carries the red letters. A couple waits. They have come from a town whose name will never appear in a Harvard case.

Kshitiz, if one imagines him pausing between reviews of a new spoke, might say what the numbers already say: the chain is a process now. Protocols. AI. Private equity on the cap table.

Ajay, if one imagines him still in counselling, would say the older sentence.

“We started when the myth was that childlessness sits only in the woman. We put science ahead of that myth. The rest is centres.”

Nitiz would talk about chambers and witness systems, the engineering of not making a tragic mistake.

Outside, Udaipur is a tourist city. Inside, a technician labels a dish as if it were a legal document, which, in this work, it is.

That is how Indira IVF was planned: five thousand rupees, a wife’s name, a taboo, a sperm bank before the country had language for one.

That is how it was executed: camps that treated shame as a public-health problem, a 2011 lab the sons rebuilt, a price cut that let a clerk attempt a cycle.

That is how it expanded: Pune, Delhi, then the small cities; hub and spoke; investors who understood that infertility is a market only after a doctor has spent thirty years calling it a cruelty.

The book of Indian doctors is full of men who opened chests and skulls. This chapter is for the man who opened a conversation that a joint family would have preferred to leave closed — and then built, with his sons, enough rooms that a couple in Sultanpur does not have to take that conversation to another state.