Thirty two years after Harsha, the first test tube in India was successfully delivered under the care of Dr Indira Hinduja, India’s In Vitreo Fertilisation (IVF) industry has grown up to world standards in terms of quality and business growth. Despite being the second most populous nation, life style, pollution, stress, increased awareness has led to rising infertility among young couples.
With the proposed Aritificial Reproductive Techniques (ART) Bill addressing many of the ethical issues related to IVF treatment, donor programmes and in tandem with Surrogacy Bill, IVF business is showing rapid growth across the country.
Cocoon Fertility, a leading IVF Chain, launched its flag-ship centre in Thane in 2013. It now has centres in Dadar, Santacruz, Andheri, Versova and two centres in Pune.
The centre provides state-of-art facility for advanced treatment procedures in the field of IVF, Intracytoplasmic Sperm Injection (ICSI), Embryo Freezing (Vitrification) and Frozen Embryo Transfer (FET), PICSI (Physiological Intra Cytoplasmic Sperm Injection), Intra Uterine Insemination (IUI), and male procedures like PESA/ TESA, to name a few. The centre also has a dedicated unit for fertility diet and general weight loss management.
Ahead of launching their first IVF centre in South India in Kochi, Dr. Anagha Karkhanis, Senior Gynaecologist and Infertility Specialist and Director of Cocoon Fertility & Dr. Rajalaxmi Walavalkar, Senior Gynaecologist and IVF specialist at Cocoon Fertility share their thoughts on the industry and their business with Corporate Ethos.
#What are the reasons for rapid growth of Infertility (Assisted Reproductive Technology) Centers in India?
The IVF market in India is a very fast growing market and here are the major reasons-
a).Medical reasons â€“ late marriages, postponing child bearing due to career / professional needs and or financial reasons, lifestyle issues â€“ alcohol / smoking / obesity â€“ making it difficult to conceive. Incidence of infertility has gone up.
b)Medical advances â€“ more options available and access is getting better. Advanced treatments make it possible for more varieties of fertility problems to be tackled.
c).Social reasons â€“ infertility still remains a stigma hence need for a baby is very high. Patient awareness is increasing with celebrities accepting having done fertility treatments, hence social acceptance of the treatment is also increasing.
d).Infertility affects nearly 10-15% of married couples in India that is nearly 27.5 million couples (EY report). By 2020, more women will be in the 30-44 years age group, thus prevalence of infertility will increase increasing the number of people accessing treatment.
#How do you quantify the growth of IVF business in India and your expectations for near term growth?
Number of IVF cycles done per year in proportion will also increase as will the clinics offering treatments. The IVF market has grown at a CAGR of 18% in the last decade despite this the IVF market is highly under-penetrated with demand being 9 to 12 times higher than the current market, even in large metro cities. We face a serious challenge of high infertility rate and significantly low treatment rates. IVF market is expected to grow at a CAGR of ~20% thus estimating 260,000 cycles in the year 2020.India is also becoming the preferred destination for medical tourism. Indian IVF industry is seeing a surge in foreign investments e.g Goldman Sachs, Medicover etc.
#What is the checklist for a couple looking for a good IVF treatment facility?
Finding the right fertility clinic before one starts treatment is crucial. There are many fertility clinics and it can be hard to decide which one is best. Questions that need to be considered are. Does the clinic specialize in the particular aspect of care that one needs? Does the clinic offer tailored treatment option for each individual patient? Does the clinic accept patients with specific conditions? What is the rate of twin or multiple order pregnancies at the center you are considering? Multiple pregnancies are high risk pregnancies. What is the cost of treatment? What are the clinicâ€™s success rates and what is the success rate for you in particular? Also consider expertise and doctor’s experience. The more experienced your doctor is, the higher the chance that he has handled different types of cases and situations and will be better equipped to handle your case, too. Consider if the clinic has courteous and helpful staff that is willing to answer all your questions and offer all the unbiased advice you might need. Did you feel you were heard? Did they have empathy for you? Did they care? The answers to these questions will give you an idea of how your experience will be with the entire team because the employeeâ€™s behaviour is a reflection of the managementâ€™s philosophy.
Finally, it is not one single thing that should help you chose the clinic. Decision to have IVF treatment is a medical, emotional, psychological, physical and financial decision. Take it wisely. We wish you all the best in your search for the right clinic.
#IVF treatment costs have declined in recent years, has this enabled India to become a destination for fertility treatment for those seeking such services from abroad?
There is a shift that we see towards making IVF cost effective. IVF is more accessible to the common man than before. The WHO declared infertility as a disease and some insurance companies have started offering fertility insurance cover e.g. New India Assurance. Goa government recently declared the â€˜Matrutva Yojanaâ€™ for tribal women who had not been able to conceive despite 3 years of trying.India is the obvious destination for medical treatments. We have the best of medical facilities, most respected and experienced doctors and cost-effective medical care available in India. The industry has seen merging of various centres and also chain IVF clinics rise in the last few years. There has also been overseas funding into the IVF sector. IVF tourism has taken a drop since the proposed surrogacy regulation that does not allow any foreign national nor OCI / PIO card holders to have surrogacy in India.
#How do you assess the ART Bill and Surrogacy Bill? How helpful are they to take care of the ethical issues facing the industry?
The ART bill and Surrogacy bill aim to regulate the IVF industry providing for safe and ethical practices and disclosures on outcomes. The anonymity of the donor has to be maintained and therefore the child is not given a provision to know his biological father at any time in his life which is not the case in some European nations. Indian law therefore protects both the donor and the child. By fixing the mother’s upper age limit at 50 for participating in donor programs, it ensures that the child will have his mother around until it becomes an adult.
#Do you think the stigma attached to infertility and donor programs have lessened in India?
The World Health Organisation has classified infertility as a disease. More people are openingly talking about it and seeking IVF treatment. But in many regions, there is a need for increased awareness in the population, both about infertility and about the availability of treatments and a need to de-stigmatize infertility. This in addition to making affordable treatments available will increase the penetration of services in the market.