India can be the world’s capital for IVF treatment in the next five years

“We have the best infrastructure and facilities in the country, but we are not premium-charged clinics. Our aim is to provide world-class services at an affordable price,” informs Vinesh Gadhia, CEO, ART Fertility clinics, India, to Akanki Sharma, while also talking about the various opportunities in the Indian IVF market

What options are available at the moment for infertility treatment in India? Do they suffice? Give reasons to support your answer.

Medical science has provided us with various options in the field of infertility treatment for males and females. As any other field in medical science, fertility disorders and treatments are ever advancing with breakthroughs in research.

We have all the latest treatments currently available across the globe at our clinics. The only service that we do not offer is surrogacy.

Treatments available in India for fertility are IUI, IVF, ICSI, ovum, sperm, embryo donation, Testicular Sperm Extraction (TESE) and Percutaneous Epididymal Sperm Aspiration (PESA). The diagnosis available for females are ultrasound, hysteroscopy, diagnostic laparoscopy, ovarian reserve testing, hysterosalpingography, preimplantation genetic screening and testing, endometrial receptiveness genome assessment; and for males, there are semen analysis and testicular biopsy.

Tell us about your role in advancing the fertility industry in India.

I have 28 years of experience in the Indian healthcare industry with most of it in the fertility sector. I have been one of the founding members of Nova IVF Fertility where I was responsible for leading the transition from the development stage to the commercial launch. With my decade-long career in the field, I have been instrumental in advancing the fertility industry in India. I have built commercial teams, developed strategies, and expanded scientific partnerships throughout the healthcare market.

During my stint with Serum Institute, we were still importing fertility hormones and costly lab apparatus. Above all, there was a lack of knowledge amongst the gynaecologists regarding proper treatments and procedures. In the 1990s, we organised several seminars and training sessions for gynaecologists to be proficient in IUI and they were sent abroad to secure information on the best practices available to treat infertility. The biggest challenge was of making IVF treatment commercially viable as obstetrics could earn more without doing IVF.

Later, at Nova, we didn’t compete, rather partnered with various obstetrics in the region, thereby, enlarging the industry of fertility treatments and creating awareness amongst the people of the industry.

What is the current market scenario of IVF in India and how do you see its future?

Over the years, India’s IVF treatment landscape has improved. It is the third-largest consumer of IVF treatment in the world after China and Japan. Today, it does somewhere around 2,50,000 cycles annually in over 1,750 IVF centers. Each cycle averages at around $2,500 which makes the current industry size to be about $625 million. With this growing pace, India has the potential to become the world’s capital for IVF treatment in the coming five years.

Demand and need of IVF is increasing in India, but due to COVID and its restrictions, this demand has been impacted. During the first wave of the pandemic, the industry lost 90 per cent cycles in the first quarter of FY 2020. In the second quarter, the industry operated at 25 per cent of the pre-COVID levels. Subsequently, in the third quarter, it jumped back to 60 per cent. By the fourth quarter, the industry started rebounding to such an extent where many organised players saw numbers that were even higher than pre-COVID era. We expect the industry to grow from anywhere around 15 per cent to 17 per cent CAGR for the next five years and reach $1,453 million. The growing need for Indians to opt for medical assistance of infertility with high education and awareness levels, and acceptability of infertility, are some of the factors driving the growth of the industry.

What market opportunities did you see in the country before bringing ART Fertility here from the middle east, and what’s the market scenario there at present?

India has a large concentration of young adults, and the population has been observed to have a comparatively higher urge of parenthood. However, research states that nearly 22 to 33 million couples in the reproductive age are suffering from lifetime infertility. It is estimated that women account for 40 to 50 per cent of infertility among infertile couples, while men account for 30 to 40 per cent. To top it, various factors like changing lifestyle and a huge number of sub-fertile population contribute to the increased demand for infertility treatments.

Research states that ethnicity also has a major impact on fertility.  A study involving Spanish (n=229) and Indian women (n=236), in 2014, reported that:

• Indian women had lower Anti-Mullerian Hormone levels (AMH), higher Follicular Stimulating Hormone (FSH) levels, and a longer duration of infertility despite being significantly younger.
• Indian women had an earlier onset of decline in Antral Follicular Counts (AFC), nearly 6.3 years earlier than the Spanish cohort.
• Despite younger age and similar embryo quality, Indian-American women had a significantly lower live birth rate following IVF than white American women (24 per cent versus 41 per cent, respectively) suggesting poorer ovarian reserve.
• Lower IVF success rates, longer duration of infertility, lower AFC and AMH levels in Indian and South Asian women, occurring at a younger age compared to Caucasians, suggest poor ovarian reserve and an earlier onset of infertility.

These factors combined make India an infertility capital with a huge potential for reproductive medicine.

How does ART Fertility tend to make a difference as compared to other IVF players in the Indian market?

ART Fertility Clinics brings one-of-a-kind world-class centres in India starting with a centre in Gurugram. It is second to none in the country and can also be compared to clinics in the major cities of the world. We have the best infrastructure and facilities in the country, but we are not premium-charged clinics. Our aim is to provide world-class services at an affordable price.

We have a wide science and innovation programme through which our clinicians are undertaking research in a diverse field of topics related to human reproduction. We currently have 41 areas of active investigative research. At our clinics, we have designed the most efficient facility layouts to ensure patient safety and the best medical outcomes. We have invested in the latest and most technologically-advanced infrastructure, including AI-enabled incubators, microscopes, next-generation sequencers, four-dimensional ultrasound machines and the OR equipment and tools.

We adhere to a technology that is radio frequency identification (RFID)-barcoded to maintain the full transparency between the patients and the clinic. It enables us in eliminating the chances of human errors. We use sensor technology from the Netherlands to keep a check on humidity, temperature and PH levels for the best clinical outcomes and we have a one-priced cycle for our patients. There are no hidden costs attached to our treatment.

Some of our latest equipment are:

• RI witness system: ensures no mixing of embryos/sperms amongst patients
• Xiltrix alarm system: alarm system that is fitted with sensors to continuously monitor temperature, humidity and gases associated with key equipment and Volatile Organic Compunds (VOCs)
• ZAND-air PCOC: ensures healthy and filtered airflow throughout the IVF lab
• G 210 incubators: the most advanced and revolutionary incubators that combine optimal embryo growth conditions with advanced user control

Which are the cities where ART Fertility will open its eight clinics this year, and what all do you have in the pipeline for further expanding your business?

We plan to launch 18 clinics across the country by the end of 2022. Our aim for this year is to commence operation in eight clinics in India out of which three in Gurugram, New Delhi and Ahmedabad have already started, and the rest are planned in Hyderabad, Mumbai, Chennai, Bengaluru and Kolkata by August-September.