Despite this out-of-the-ordinary track record, Vinesh Gadhia is adamant that India would soon overtake the United States as the "fertility treatment capital of the world." The CEO of the third-largest reproductive clinic chain in the country, Gadhia, has been working in the field for 30 years and says, "Right now, India is No. 2 or 3 in the world, with 2,500+ fertility clinics."
More than 2.5 million fertility treatment cycles are performed annually in the country, and a new facility opens every week. Private equity investors are largely responsible for this rapid expansion; in April, investment holding company Verlinvest bought a majority share in Ferty9. Nova Medical Centre, which operates both IVF clinics and day surgery centers, received a $30 million investment from Goldman Sachs in 2011, making it the first private equity investment in the in-vitro fertilization (IVF) industry. Now Nova IVF is the second largest IVF clinic network in the United States.
Since then, the majority of industry leaders have sold sizable shares to private equity firms. Indira IVF, the largest fertility clinic chain in the country with 114 centers, is owned by private equity company TA Associates to the tune of roughly 47%. Asia Healthcare Holdings, a healthcare operating platform backed by private equity investors TPG Growth and GIC, is the owner of Nova IVF Fertility. It is a relatively untapped market. "The more money you put in, the more money you'll make," Gadhia remarked. The Indian in vitro fertilization market is projected to grow from an anticipated $793 million in 2020 to an anticipated $3,722 million in 2030, representing a CAGR of 16.5%.
According to a new report published by the World Health Organization (WHO) last month, around 17.5% of the world's adult population will experience infertility at some point in their lives. This is an enormous worldwide health problem, and the proportion is the same in high-, middle-, and low-income countries. According to a 2019 study by the All India Institute of Medical Sciences (AIIMS), between 12 and 18 million Indian couples receive a diagnosis of infertility each year. Failure to conceive after trying for at least 12 months during which you did not use birth control is what the World Health Organization (WHO) considers infertility.
Dr. Kamini Rao, a leader in the field of assisted reproduction in India, has observed, "Earlier, we used to talk about infertility due to people not conceiving irrespective of age, but now we see infertility due to late marriages as the egg pool comes down." She also notes that many people are seeking help now because of the abundance of available treatment alternatives. According to her, "there is more awareness and understanding of the protocols and procedures," and both availability and cost have gone up.
Since its implementation last year, the Assisted Reproduction Technology (ART) and Surrogacy Act has increased the interest of major corporations in the field of assisted reproduction. According to Dr. Nitiz Murdia, co-founder of Indira IVF and expert member of the National ART and Surrogacy Board, "the ART law is designed to ensure patient safety by accrediting the clinics and setting minimum equipment standards, provides an ethical framework for practising ART, lays down minimum qualifications of the specialists, brings in legal clarity and transparency and accountability."
Rao adds that consumers who are concerned about cost have more options now that the healthcare industry has become commoditized and clinics have sprung up all across the country."It is a great space to be in — for every stakeholder," said Dr. Somesh Mittal, CEO of ART Fertility Clinics. Since investments have increased, so has awareness.
The stigma is fading away. This is not seen as a problem exclusive to females. The introduction of new technologies. Medical professionals are eager to engage in this field independently. The success rate for fertility treatment, as measured by the number of kids born to the couples who undergo treatment, is only 30–35%, making ART treatment a costly endeavor despite the abundance of options and clinics. An average fertility treatment cycle (lasting about a month to 45 days) may set you back between Rs 1.5-2 lakh. However, the majority of group medical insurance policies do not cover the expense of this procedure. Although the number of infertility cases (among both men and women) and the cost of treatments are both on the rise, research by Plum, an employee health insurance platform, has discovered that less than 1% of corporates in India offer infertility coverage under Group Health Insurance.
To make infertility treatment more accessible, Mittal suggests expanding insurance coverage to include the cost. Another problem area for the market is the estimation of success rate. Multiple benchmarks, including chemical pregnancy, clinical pregnancy, fetal heart rate, and live birth rate, must be met for an IVF process to be considered a success. Industry participants frequently use the first two weeks of chemical or clinical pregnancy to demonstrate a high success rate of 60% or more for their IVF treatments. The number of live births achieved after IVF treatment is the gold standard for measuring success.
According to Gadhia, "the elephant in the room for the fertility industry is the nonstandardised success rate that does not factor the number of cycles undertaken before a baby was born." A good IVF facility can cost as much as Rs 3–4 crore to build. Mittal reveals, "However, there are players who have it set up for Rs 65-70 lakh." When resources aren't allocated adequately, success rates suffer. Murdia claims that the ART Act's planned National Registry will make clinics' total IVF cycles and success rates more transparent.
STEP AHEAD
Murdia predicts that the number of IVF cycles would double to 5.5 lakh cycles over the next five years, and that the sector will consolidate as a result. He stressed the importance of addressing the four A's of the fertility sector in India: awareness, accuracy, accessibility, and affordability.
Vinesh Gadhia has an optimistic outlook on the development of the market. The fertility market's true potential for expansion will become clear within the following decade. Egg freezing will emerge as the next growth driver in the market as a result of medical therapy for infertility.
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