ART regulation has increased investor’s confidence significantly: Vinesh Gadhia, ET HealthWorld

Vinesh Gadhia, CEO, Ferty9 Fertility Centre in an exclusive interaction with ETHealthworld’s Rashmi Mabiyan Kaur elucidates on the important aspects contributing to the growing private equity investments in Indian IVF businesses. He also talks about the role of technological advancements helping in to increase fertility success rates and the impact of ART regulation on businesses. Edited experts:What are the factors enabling the fertility industry to become the sunshine sector for many?
This is going to be the golden decade for the IVF business in India. We have the highest young population, higher than China. Second, India has one of the highest urge of parenthood among the large economies in the world. Third, is the changing lifestyle. We choose to marry late or delay our plan of parenthood. We all understand it is going in that direction and we all have to accept it.

In Indian ethnic DNA, the peak potential of fertility of a woman is 25 years whereas for a Caucasian woman, it is 31 years. It’s okay for a Caucasian woman to marry late and have a late pregnancy, they will not face issues with fertility. Whereas in India, when we shift our lifestyle, and we delay our pregnancy or parenthood plan, we are crossing way beyond our peak fertility potential age. It is one of the reasons why there are millions of couples in India today who are suffering from infertility and need help to achieve the dream of parenthood.

How has technology played an enabler in the transformation of the IVF industry in India?
Any IVF treatment takes about 1.5 lakh rupees for a cycle. In 2010, the average success results was 30 per cent whereas today, we boast about 60 per cent. So results have improved by leaps and bounds. One of the biggest contributors to this improvement in the result is the improvement in technology adoption in the embryology lab. The way we handle our gametes has completely changed from what it used to be 10 years ago.

The biggest challenge in improving results was to grow the embryo in our lab for five days, which was not possible 10 years before. Today, it is normal, most organized chains do only day five transfer and not day three transfer because our lab culture or incubators have improved so much in the last 10 years. Now we can culture an embryo till the fifth day, which delivers a better pregnancy rate.

Second, the way the embryo was frozen and then thawed for subsequent frozen embryo transfer is very different now, because of the technological advancement. Now, we do the vitrification technique, which is fast freezing and fast growing. So, the biggest contributor to result improvement in IVF practice is because of technology.

You have worked with three IVF chains backed by Private Equity (PE) in India. In your experience, how do investments impact the functioning of IVF chains?
All IVF chains backed by PE are making a maximum of 25 per cent of profitability EBITDA. Whereas, most of the doctor-owned clinics make 50 per cent profit. The myth that PE investors do not focus on science and only look at business to improve profitability needs to be busted.

Another aspect is that a single doctor-owned clinic will have one embryologist, many don’t have even one embryologist whereas all PE-backed IVF chains have two to three embryologists per lab. This is for better protocol execution, data management and clinical research to be done. After doctors, embryologists are the most costly resource in IVF clinics. So, all the development in science which has happened in the last 10 years is because of machines, equipment, men and protocol.

All the investments that have happened in the last 10 years in an organized IVF chain have demonstrated better clinical outcomes, more transparent protocols and very high standards of ethics, and are led by PE. Today, the industry is making rapid strides due to PE investment.

How does robust IT Infrastructure help in improving patient satisfaction?
When you have a robust IT infrastructure, your patient journey can be mapped very well. By this, patient satisfaction goes up because the patients see the data and they have a transparent understanding of their journey. Whether it is patient satisfaction, clinical outcome or connecting with the target group through marketing, everywhere investment is required to do it right.

How have India’s ART regulations impacted investor sentiment?
Can give you three data-led examples: The investment of Kidaara in Oasis, Verlinvest in Ferti9, and BPEA acuity in Indira would not have happened with such robust sentiment if regulation had not been there. So, ART regulation has increased investors’ confidence significantly because when there is regulation in place, we know that it has to be followed and hence this fear of the capability of doing the wrong things goes away. Seeing from the other side, it has also increased consumer confidence in IVF practice because there is regulation in place.

Which aspects of IVF are going to be growth drivers in the coming future?
India will become the fertility treatment capital of the world. It will do around 500,000 cycles in the next five years, which is growing by 70- 80 per cent CAGR. But from 500,000 cycles to one million cycles is going to be a journey, which is outside infertile patients. Today, social freezing is the answer to the empowerment of the current generation. It will take off in India big time in the next 5 to 7 years.

We need to create very robust awareness around onco freezing. Millions of people in India would be going through chemotherapy in the reproductive age. While most of them will survive cancer but 90 per cent of them don’t know that their gametes will not survive chemotherapy. The gametes should be frozen whether it is sperm or egg before you go through your chemotherapy. Also, single gene disorder needs focus as preventing a genetic disorder in your child is a boon which IVF can offer.