The National ART Registry and ART clinic levels explained

Every fertility clinic that offers assisted reproduction in India is meant to appear in one national register, under one of two levels. The register and the levels are the most reliable facts available about a clinic, because they come from a regulator rather than from the clinic's own marketing. They are also widely misunderstood. A level describes what a clinic is registered to do, not how well it does it, and a registry entry can be incomplete in ways that matter.

This guide explains what the National Assisted Reproductive Technology and Surrogacy Registry is, what the two clinic levels and the separate ART banks mean, which treatments belong to which, and how to read the registry details shown on every clinic page in this directory. It is written for patients and for doctors who refer them.

The law behind the registry

The Assisted Reproductive Technology (Regulation) Act, 2021 made registration compulsory. Section 15(1) says “No person shall establish any clinic or bank for undertaking assisted reproductive technology or to render assisted reproductive technology procedures in any form unless such clinic or bank is duly registered under this Act.”

The Act defines the two kinds of establishment it registers. An “assisted reproductive technology clinic” means “any premises equipped with requisite facilities and medical practitioners registered with the National Medical Commission for carrying out the procedures related to the assisted reproductive technology”. An “assisted reproductive technology bank” means “an organisation which shall be responsible for collection of gametes, storage of gametes and embryos and supply of gametes to the assisted reproductive technology clinics or their patients”.

Registration is not automatic. Under section 15(4), no clinic or bank is to be registered “unless the appropriate authority is satisfied that such clinics and banks are in a position to provide such facilities and maintain such equipment and standards including specialised manpower, physical infrastructure and diagnostic facilities as may be prescribed.” Section 16(5) adds that “No registration shall be granted unless the State Board has inspected the premises of the applicant.”

What the National Registry is

Section 9 of the Act provides for a body “to be called the National Assisted Reproductive Technology and Surrogacy Registry”, serving both the ART Act and the Surrogacy Act. Applications for registration are made to it through the appropriate authority in each state, and it is meant to hold the national picture. Section 11(a) describes its first function: “it shall act as a central database in the country through which the details of all the clinics and banks of the country including nature and types of services provided by them, outcome of the services and other relevant information shall be obtained on regular basis”.

Clinics have duties towards it. Section 23 requires that “all clinics and banks shall maintain detailed records of all donor's oocytes, sperm or embryos used or unused, the manner and technique of their use in such manner as may be prescribed”, and that those records “shall be maintained for at least a period of ten years”. The registry therefore receives far more than it publishes. In particular it does not publish clinic-level results, which is one reason this directory shows no success rates.

The two levels of ART clinic

The Assisted Reproductive Technology (Regulation) Rules, 2022 set out the levels in paragraph 10.1.

A Level 1 clinic is one where “preliminary investigations are carried out including diagnosis of type, cause of infertility and only IUI is carried out as part of treatment.”

A Level 2 clinic is one where “all/advanced investigations, diagnostic and therapeutic procedures in ART are carried out.” The Rules add: “Such clinics may also undertake research.”

The difference is mostly about the laboratory. A Level 1 clinic can investigate infertility and offer intrauterine insemination, in which prepared sperm is placed in the womb and fertilisation happens inside the body. Anything that handles eggs or embryos outside the body, which is the core of IVF, is Level 2 work. The 2022 Rules also set minimum staff and equipment for each level, and the Level 2 lists are the longer ones, because an embryology laboratory needs people and equipment that an insemination service does not.

Which treatments belong at which level

Read against the Rules, the treatments described in this directory fall into three groups.

• Either level: IUI, the one treatment the Rules allow a Level 1 clinic to carry out. Investigations such as semen analysis are part of the work at both levels.
• Level 2: IVF, ICSI, blastocyst culture, embryo freezing, egg freezing, PGT, treatment with donor eggs, and the surgical collection of sperm for ICSI, by TESA or PESA or by micro-TESE.
• Outside the level system: surrogacy, which needs its own registration under the Surrogacy (Regulation) Act, 2021, and surgery such as hysteroscopy or laparoscopy, which the level does not describe.

The treatments index has a page for each of these, and each page shows how many of the clinics naming it are recorded at each level. When a Level 1 clinic names a Level 2 treatment on its website, it may be referring patients to a partner Level 2 laboratory, or describing something it does not do on site. The way to find out is to ask the clinic where that part of the treatment is actually done.

ART banks

Banks are registered separately from clinics, and the distinction matters for donor treatment. Section 27(1) of the Act says “The screening of gamete donors, the collection, screening and storage of semen; and provision of oocyte donor, shall be done only by a bank registered as an independent entity under the provisions of this Act.” A clinic cannot recruit its own egg donor; the donor has to come through a registered bank. The Act also sets limits on donors themselves, and the egg donation and sperm donation pages quote them.

Some clinic entries in the extract also carry a bank registration number, showing that the same organisation holds a bank registration alongside its clinic one. Where a clinic page shows one, it is shown as the registry records it.

How long a registration lasts

A registration is time-limited and must be visible. Section 16(6) says the registration “shall be valid for a period of five years from the date of registration granted by the appropriate authority.” Section 17 allows renewal “for a further period of five years”. Section 16(7) requires that “The certificate of registration shall be displayed by the clinic or bank at a conspicuous place and such certificate shall contain the duration of validity of such registration.”

A registration can also be withdrawn. Under section 18(1), the appropriate authority “may on receipt of a complaint, issue a notice to the clinic or bank to show cause as to why its registration should not be suspended or cancelled for the reasons mentioned in the notice.” That is why the certificate, with its validity, is the thing to check on a visit.

How to read a registry entry in this directory

Each clinic page shows the registry details from the extract this directory holds. Read them with four points in mind.

• The registration number. Every listing carries one. The numbers follow no single national format: some carry a state code, a year and the level inside them; others carry only a district code and a serial. A number on its own does not prove what a clinic is registered to do.
• The level. Many entries record Level 1 or Level 2, but a large share record no level at all, and every listing in Tamil Nadu is in that position. A blank level is a gap in the extract, not evidence against the clinic. Ask the clinic which level its certificate states.
• The registration year. Most entries record the year a registration was granted, which tells you roughly when its current term began.
• No expiry date. The extract carries no validity date for any listing, so this directory cannot tell you whether a registration is still current. The displayed certificate can.

You can browse clinics by state from the clinics index, or go straight to a city such as Chennai, where no listing carries a level, or Bengaluru, Delhi or Mumbai, where most do.

What a level does not tell you

A level is a statement about scope. It does not say whether a clinic is good at what it does, how experienced its doctors are, or what its results are. A patient who needs IUI is not better served by a Level 2 clinic simply because it is registered for more. For that reason this directory shows the level on every clinic page as a fact and gives it no weight in how clinics are ordered; the page on how we rank explains this in full.

A level also says nothing about surrogacy. A clinic's ART registration does not show whether it is registered as a surrogacy clinic, and this directory does not hold surrogacy registrations, so ask to see that registration separately.

For doctors referring a patient

When referring for IVF or any other Level 2 treatment, confirm the receiving clinic's level from its certificate rather than from a listing, since the extract is silent on level for many clinics. Where a Level 1 clinic shares care with a Level 2 laboratory, ask which laboratory, and where egg collection and embryo transfer happen. The fertility doctors index lists the doctors clinics name on their own websites, with the source of each detail. If a registry detail shown here is wrong, the corrections form is the way to have it checked.

Where this guide comes from

Statements about the law are quoted from the Assisted Reproductive Technology (Regulation) Act, 2021 and from paragraph 10.1 of the Assisted Reproductive Technology (Regulation) Rules, 2022. Descriptions of registry entries come from the National ART & Surrogacy Registry extract this directory holds, and describe that extract as it stands, gaps included. The companion guide on how to choose an IVF clinic in India turns these points into a checklist. Nothing in this guide is legal or clinical advice, and nothing in it is sponsored.