August 2014

Indias baby making business: The Growth Story

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Growth-StoryThe IVF industry in India is on a growth path. However, the industry is largely unregulated which can prove to be pernicious in the long run. ENNs Subash Deb charts the scenario

For almost all Indians, the family is the most important social unit. Till as recently as a couple of years ago, infertility was a glaring phenomenon that proved to be a shattering experience for many couples. In the Indian family milieu, mothers-inlaw and intrusive relatives would cast aspersions and make sly innuendoes on couples for not being able to have kids in the first few years of marriage. Irrespective of their socio-economic status and the caste or community they belong to, infertile couples are outcaste and discriminated against.
However, with the advancement of science and technology, a lot of things have changed for the better. Right from changing our old mindsets to motivating us to explore newer, more successful ways to live our life, technology has made things possible which werent so before.
The wonder of IVF is one such example which has come as a boon to millions of couples who face the scourge of infertility like a thorn in the flesh.

History of IVF – a tale of two cities

The concept of IVF came into being with the birth of Louise Joy Brown, the worlds first-ever, successful testtube baby, on July 25, 1978 in Great Britain. Two British doctors, who created history by performing this worlds first In-Vitro Fertilisation (IVF), were Robert Edwards and Patrick Steptoe. They eventually won the Nobel Prize in 2010 for the development of human IVF therapy.
Simultaneously, an Indian doctor, Dr Subhash Mukhopadhyay, brought glory to India for the same reason. Durga alias Kanupriya Agarwal, Indias first test-tube baby and the worlds second test-tube baby was born on October 3, 1978, just 67 days after the birth of Louise Brown. Unlike his British counterparts, Dr Mukhopadhyays work was barely recognised, yet his feat proves the countrys ability to deliver top-notch medical excellence.
The technology that made this fertilization possible is applauded and celebrated as an achievement for medical excellence. The In-Vitro Fertilization technology and its usefulness in the treatment of infertility have spurred immense interest among researchers and medical professionals. Consequently, numerous IVF clinics have sprung up all over the world.

The Growth Trajectory

Over the last two decades, there has been an exponential growth of infertility clinics around the world. The concept of IVF has gained popularity at a swift pace in India over the last decade. Currently, Indias fertility market is witnessing double-digit growth which is driven by proliferating infertility rates amongst married couples and availability of competitive treatment procedures.
IVF, Intrauterine Insemination (IUI) or artificial insemination by husband or donor sperm, egg freezing, Intra cytoplasmic sperm injection (ICSI), donor egg treatment, donor embryo treatment, endoscopic diagnosis as well as surrogacy are all practiced widely in India with new techniques being evolved and developed on a par with international standards. Sperm donation is a recent development in Indian fertility market. It requires a kind of a medical expertise that is being expanded and spread throughout.
Today, India stands at the forefront of reproductive medicine and is touted as a MECCA for all the IVF treatments.

Booming baby-making business in India

India is fast becoming the hub for IVF and surrogacy as the countrys market value is expected to touch INR 14.2 Billion and register a CAGR of 14 percent approximately over the next five years.
India has witnessed an unprecedented and unregulated growth of IVF/Infertility/Assisted Reproduction Technology (ART) clinics and hospitals. With the estimated number of around 700 clinics across the country and new clinics being added every day, India has occupied a place of prominence on the world IVF map.
The present boom, witnessed by the IVF segment, is a result of various factors. From increasing number of infertility cases in the country, to a relatively low-cost high-end treatments that attract a lot of foreign patients, to skilled doctors, to plentiful supply of surrogates, to increased awareness, to no regulations, all these factors have contributed well to the growth of the IVF sector in India. Also, easy availability of surrogate mother, gamete donors and low-cost infertility treatments have made India a favoured destination for reproductive medical tourism or better known as fertility tourism.
In India, IVF treatment is available at an affordable cost which is nearly one-quarter of the cost in developed nations. Fertility clinics in countries like UK, Israel, Australia, France, Spain, and Denmark are finding it more and more difficult to fulfill the demand for donor eggs and hence turning to India. Furthermore, India is also home to some of the finest international IVF centres and top-notch IVF doctors. Most of the major global IVF stakeholders have recognized the size of this opportunity, and some have already entered the market.
For instance, a renowned UK IVF operator, Bourn Hall has established its two clinics in Gurgaon and Kochi.
Despite this monumental growth and expansion, the IFV sector is not without a catch. There are glitches, pitfalls and dilemmas which can prove to be deleterious for its growth in the long run.

No rules in place

In India, the IVF market is largely monopolized by small niche players and sole-practitioners, as the loose regulatory environment is promoting constant mushrooming of such players. The IVF industry in India is completely unregulated. Anyone can open an infertility or Assisted Reproductive Technology (ART) clinic and start performing procedures the same day, as there is a lack of centralised regulatory body with complete visibility over the whole market.
Although the Indian Council of Medical Research (ICMR) reports 3,000 clinics around the country, certain market forecasters estimate that there could be as many as 15,000 solepractitioners who focus on surrogacy only.
Currently, the industry stick to guidelines set out by the ICMR that includes when, and by whom IVF can be performed. The guidelines do not lay down any rules for the setting up of ART clinics.

Need of the hour

On the whole, there is an urgent need of a binding law which will allow the Indian IVF industry to enter some form of consolidation. Small clinics that fail to meet regulatory standards will close. Barriers to entry will be higher which will make harder for small clinics to launch in the first place
The present situation is such that the Indian Council of Medical Research hardly cracks the whip on the IVF industry. Its guidelines are effectively optional as there is no legislative backing.
The Assisted Reproductive Technology (Regulation) Bill which is currently making its way through the parliamentary rounds has been significantly delayed. The Bill has been originally scheduled to become law in 2012. The original bill was drafted in 2008, and has been altered and reframed in 2010.
The ART Bill 2010 provides a national framework for married and unmarried couples as well as single parents seeking surrogacy in India. Its objective is to regulate and supervise the ART procedure happening throughout the country.
There is no doubt that new regulations will help formulate the Indian IVF industry. This will also be a positive step for potential investors and eventually provide an impetus for increased foreign investment.

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