Rewriting Fertility: A Conversation with Nidhi Panchmal

 Nidhi Panchmal is the pioneering co-founder of Arva Health, a company reimagining modern fertility care in India. As one of the few female leaders in India’s fertility tech space, she is disrupting the IVF landscape with a bold, empathetic, and patient-first approach.

Q: So what exactly prompted you to start Arva? Was there a personal story behind it, or something that inspired you?

A: I think I was around 25 at the time, right after COVID, and honestly, I had never really thought about my health much before then.

I’d always been really fit. I was an athlete, so I assumed that meant I was healthy. But I never actually stopped to understand what my health looked like beyond that. And when you’re younger, it just doesn’t feel urgent. No one really tells you it should be. You’re not taught to take it seriously until it suddenly starts to matter.

Around that time, my co-founder Deepalie, who’s also been a close friend since we were kids, and I kept getting asked the usual questions at every wedding or gathering: When are you getting married? Are you planning to settle down? That pressure was definitely more on her than me, but it made both of us stop and think.

We realized we didn’t know anything about our own health, especially our reproductive health. No one teaches you this stuff. Sure, we learned basic biology in school, maybe a bit of sex ed, but nothing about how our bodies actually work when it comes to fertility. We’re never told about things like the biological clock, and what it really means, how it affects your choices, especially when you’re focused on your career and not looking to settle down anytime soon.

And that’s when we started to realize: we’re all operating on two timelines. There’s the biological one, and then there’s the one we’re trying to live — our careers, our ambitions, our plans. And sometimes those don’t line up. That disconnect is what got us curious.

We didn’t set out to build a company right away. It started with just talking to women — asking questions, listening to their stories. And we kept hearing the same things: that the care system felt cold, that people felt judged or dismissed, and that no one really explained anything properly. It all felt overwhelming and kind of isolating.

That’s really where Arva began. It came from that shared feeling of “Why does it have to be this way?” and the belief that it could be better — more informed, more compassionate, and a lot more empowering.

Q: Could you give me a brief idea of what the early days of Arva were like? What was the first thing you did as a startup addressing female fertility and reproductive autonomy?

A: Honestly, we didn’t even start out thinking this was going to become a startup. There wasn’t really a blueprint, especially in India, because fertility and reproductive autonomy just aren’t talked about enough. It really began with a personal question: Are we going to be okay?

I was 25, and not even close to thinking about kids in the next five years. But I did the mental math and thought, what if I wake up at 35 and suddenly decide I’m ready, and it’s too late? That fear made me pause and take my own fertility seriously for the first time.

So Deepalie and I started by doing research online. Then we spoke to multiple doctors, both in India and abroad, just to verify if what we were reading was accurate. Is the biological clock real? Can we actually measure it?

Because think about it, we track our sleep, our steps, our finances... everything. But this one thing that plays such a huge role in our lives as women, fertility, isn’t something we track. And yet, it declines with time. We learned that women are born with all the eggs they’ll ever have, and that by 30, about 90% of them are already gone. That number shocked us — especially since 30 is the age when many women today are just starting to think about having kids.

So we asked more questions. What is ovarian reserve? How do you measure it? Turns out, it’s a simple blood test. We booked it through a regular diagnostic partner. Someone just came home and collected the sample.

But then came the next hurdle: interpreting the results. We were nervous about what we might find, and once we had the results, we couldn’t even understand them. We didn’t have a baseline. We didn’t know what was good or bad. So we had to go back to the doctors, ask more questions. It was a whole cycle of confusion, stress, and uncertainty.

And that’s when it really clicked. First, we didn’t even know this information. Then, once we did, we didn’t understand how to use it. And while there are more women’s health startups now, no one was really talking about fertility as a core issue. There’s this false assumption that because India has a large population, we don’t have fertility problems. But that’s just not true. So many women are silently struggling, and it’s just not acknowledged.

That’s where Arva really began. But before we made anything official, we wanted to validate if this was just our personal anxiety or a broader issue. So we spoke to 200 women, did a small pilot study, just to see if others felt the same way. And almost everyone did. Women in their 20s and 30s were all asking the same questions: Will I be able to have kids when I’m ready? Will my body cooperate?

That was our turning point. It felt real — not just as a social problem, but something women would actually pay for, which matters if you’re trying to build a sustainable business. After that, we quit our jobs and officially started Arva. Until then, it was just a side project we worked on during weekends and in the evenings.

Q: Knowledge and awareness are clearly huge. But setting up a system that lets women test fertility markers from home — that’s a pretty big leap. How did you build that ecosystem, especially when it came to working with diagnostic labs and ensuring a smooth experience?

A: Yeah, I think at the time, that part felt like the hardest — but mostly because we’d never done it before. Neither of us came from healthcare. I was working in finance; Deepalie was in tech. We didn’t even know how the Indian healthcare system worked.

But like with most startup things, you just figure it out. We started by cold messaging diagnostic partners — on email, on LinkedIn, even Instagram. Just telling them, Hey, this is what we’re building, can we talk? Eventually, we were able to negotiate with a few of them and build a system that worked.

From day one, our guiding principle was: How do we make this as easy and seamless as possible for the customer? It didn’t matter how messy things were behind the scenes — the user experience had to feel simple, legit, and trustworthy. Especially because it’s healthcare. People need to know they’re being taken seriously.

So yeah, it was a lot of cold reach outs, a lot of figuring things out as we went. But once you're in that mindset of I have to make this happen, you’ll try every possible door until one opens.

Q: While building Arva’s ecosystem, you clearly prioritized privacy, speed, and accuracy. But how did you actually go about incorporating those values?

A: That’s a great question, and honestly, something we took seriously from day one. We asked ourselves: How do we ensure that someone’s health data is private and secure? And how do we also account for the emotional and mental toll of going through something like this?

In the U.S., there’s HIPAA compliance — strict guidelines around healthcare data. But in India, there isn’t an equivalent that’s as thorough. So our approach was: Let’s meet the highest global standard anyway. We made sure our systems were HIPAA-compliant from the start, so if and when India enforces similar regulations, we’re already there.

Luckily, a lot of the privacy tech is already built, so you just have to use the right platforms and tools. And honestly, a big learning from building this has been: you don’t need to have all the answers yourself. You just need the right people on your team — a solid tech team, experienced lawyers, people who know how to get things done.

But it’s not just about data privacy. It’s also about care. How do you make sure the experience is non-judgmental and emotionally supportive?

So we brought in trained counselors, people we upskilled in-house, who guide users through the process. Whether it’s answering basic fertility questions or offering mental health support, we made sure no one is going through this feeling confused or alone.

Traditionally, you'd walk into a doctor’s office, and they might not have the time to walk you through everything — especially the basics like PCOS or hormone levels. So at Arva, we built a system where everyone gets a one-on-one call with a counselor first. That way, they walk into the doctor’s consultation informed, confident, and ready to talk about their specific situation.

This made our whole service flow smoother, and a lot of it is powered by telemedicine. We use HIPAA-compliant platforms like Google Meet, and because neither Deepalie nor I are engineers, we didn’t build custom tech from scratch. We just integrated existing tools. Our philosophy was: don’t reinvent the wheel, just connect the right pieces.

So yeah... privacy, emotional support, and usability were always baked into our model from the start.

Q: IVF is incredibly personalized. How do you ensure that level of personalization for each person going through it?

A: IVF is not just personalized, it’s personal. It’s one of the most emotional and invasive decisions someone can make. And in India, it’s often a huge financial decision too. Many families take out loans to afford it.

So our approach to personalization is holistic. IVF is about 50% clinical, and 50% emotional and mental. It’s often a last resort, when everything else hasn’t worked, and people come in with fear, anxiety, and uncertainty.

We start by making sure that no one is pushed toward IVF if they don’t need it. That’s a strict internal policy. We’re not here to sell treatments, we’re here to guide.

If someone does need IVF, we support them through every step. That means early access to counselors, constant availability for questions, and emotional support for both the woman and her partner. Historically, men have been completely left out of this conversation, and that has to change. IVF impacts both people in a couple.

We also emphasize mental health support. The emotional toll is often overlooked, but for us, it’s critical that our users have access to therapists and counselors if they need them.

And of course, on the clinical side, we work with a highly vetted network of doctors — ones we trust completely. That alignment with the right doctors is key when you’re building a serious healthcare company.

So, in short, personalization for us means integrating all three layers: clinical care, emotional support, and mental health. That’s what makes the IVF journey feel supported, not isolating.

IVF can feel lonely and isolating. I know Arva’s building a community around this, but overall, would you say the stigma in India has decreased? Are women more open to talking about it now? And how do you balance cultural sensitivity with raising awareness?

A: I’ll start with that last part because I truly believe the only way to normalize something is to talk about it. Over and over. That’s the only reason we even talk openly about menstruation today because people started speaking up. So that’s what we did. We just began talking about fertility and IVF normally, online — no euphemisms, no shame. And that struck a chord. We went viral, and that gave the conversation real momentum.

Now, is the stigma still there? Yes, absolutely. It’s definitely better than before, but it hasn’t gone away. Most women still don’t talk about their IVF journey until after it’s “successful.” Very few are open while they’re going through it, because it’s scary, and they feel incredibly vulnerable.

There’s also a deep-rooted belief that a woman’s main role is to reproduce, and if she can’t do that, it feels like a failure. That’s not something most people are ready to talk about openly. The shame and fear are real.

But I do think that’s changing slowly. People like you, who are asking these questions and having these conversations, are part of that change. Awareness is growing. There’s more empathy. And the more we say it out loud, infertility is not a disease, and it’s not a personal failing, the more we make space for honesty.

At Arva, we don’t even position ourselves as an infertility company. We’re a fertility company. That framing is important to us. We don’t believe anyone is “broken.” Everyone’s path is just different. And our job is to give people the knowledge, tools, and support they need to walk their path, whatever that looks like.

Q: Could you briefly explain what the typical Arva user looks like — in terms of age, demographics, and city-wise distribution?

A: Yeah, the typical person who comes to Arva is usually between 25 and 40 years old. About 65–70% of them are from Tier 1 cities — places like Bangalore, Mumbai, Delhi, Hyderabad, and Chennai. Occasionally from Kolkata too, though not as much. The rest are mostly from larger Tier 2 cities across India.

The majority of our users are women, but what’s been interesting to see is how many are coming in with their partners. That shift is encouraging. It shows that more men are acknowledging they need to be part of this conversation too, which is a great starting point.

As for the audience more broadly, we tend to see women who are educated and informed in other areas of their lives, who are either curious about their reproductive health or self-aware enough to ask questions. Many come from backgrounds where they’ve had the privilege and exposure to even begin those conversations. And that curiosity is where things really start.

Q: Do you think IVF is becoming the new normal, especially as more women delay pregnancy due to career priorities?

A: I wouldn’t say IVF is the new normal, and I’m not sure it should be. I think IVF should be treated as one of many tools in the toolbox — available, affordable, and accessible for those who genuinely need it.

But it shouldn’t be the default. And unfortunately, there’s a growing misconception, partly because IVF is a business, that it’s the automatic next step for anyone struggling with fertility. That’s not always true.

Our goal is to make sure that if someone does need IVF, they feel informed, supported, and empowered to go through it with the same normalcy and respect as any other medical treatment. And that includes acknowledging how intense the process can be physically, emotionally, and mentally.

It’s not about glorifying IVF or making it universal. It’s about integrating it into people’s lives in a way that doesn’t make it feel like a burden or a problem that needs to be “fixed.” It should be an option, not the only one.

Q: How can individuals contribute to raising awareness — both generally, and in support of Arva’s mission to make female reproductive health more accessible?

A: Start by asking questions. That’s really where it all begins.

Be curious: whether it’s about your own health or someone else’s. Talk to people around you: friends, teachers, family, anyone you trust. And once you find the answers, don’t keep them to yourself. Share them.

That act of asking and sharing is how awareness spreads. That’s the ripple effect. And even if this isn’t your issue today, just acknowledging that the problem exists, and that it deserves empathy and sensitivity makes a difference.

Everyone has a unique perspective, and when you bring that into a conversation around reproductive health, it adds to the collective understanding. So yeah… stay curious, speak up, and help keep the conversation going.