My colleague Jeremy and I founded Fertilis with the goal of making IVF faster, better, cheaper, and more accessible. Our micro IVF device standardizes and automates the IVF process, reducing the average number of cycles it takes a woman to become pregnant from three to two.
While IVF clinics are places that help people fulfill their dreams of starting a family, they are also businesses. Alongside the clinicians and scientists who run the labs are the business leaders who crunch the numbers.
With current IVF practices, most women aged 37 or older will need at least three cycles of IVF to have a 50 percent or greater chance of becoming pregnant. While the cost varies from country to country, the price tag of an IVF cycle is usually between $3,000 to $25,000. The number of IVF cycles performed globally has been increasing each year, but it has not kept pace with the number of people seeking treatment.
IVF is a supply constrained market, and as it stands, current IVF infrastructure is not capable of scaling to meet present or future demand.
Using the most conservative numbers for infertility rates, Dr. David Sable has highlighted the gap between the number of IVF cycles performed globally per year and the number of people struggling with infertility.
Worldwide, clinics currently perform approximately 3 million IVF cycles per annum, yet Sable’s calculations put the number of couples struggling with infertility at around 10 million. Moreover, the number of cycles does not match the number of people receiving treatments: remember most women require more than one IVF cycle to become pregnant. Out of these 3 million cycles, approximately 600,000 live births occur.
If cycle volumes maintain their current trend of increasing by three to eight percent each year, IVF worldwide could result in the birth of 200 million children over the course of this century.
So what would it take to scale current IVF practices to meet this demand? First, and most importantly, IVF clinics would need access to a lot more highly skilled embryologists. That’s a problem because new embryologists aren’t entering the field at the rates needed to meet current demand, and a number of trained embryologists are leaving the field. For example, of the 206 students who graduated from Oxford University’s M.Sc. in Clinical Embryology between 2008 and 2016, only 32 percent still hold positions in embryology.
IVF clinics can be stressful environments where embryologists face intense workloads. However, Fertilis’s technology can help IVF clinics cope with the embryologist shortage in two ways. First, our device automates large parts of the IVF procedure, enhancing the embryologist’s job by reducing the stressful time frames and daily pressures associated with handling embryos.
Second, developing the skills required to perform complicated procedures such as ICSI requires years of training and good hand-eye coordination; however, with Fertilis’s device, embryologists can perform the procedure after only a few months of training because the device does a lot of the tricky parts for them.
To reduce supply constraints, IVF clinics must focus on decreasing embryologist burnout while increasing their bandwidth. For instance, some IVF clinics only collect eggs on Tuesdays and Thursdays because embryo growth has to follow a number of time-bound steps, and enough embryologists need to be available to perform those steps. These clinics are skillset constrained: clinicians can’t collect eggs every day because they don’t have the capacity to perform all the tasks required to collect at that frequency. With increased capacity, the clinic could collect eggs more frequently and see more patients.
While Fertilis’s technology decreases the number of cycles needed for a successful pregnancy, it provides clinics with the potential for increased revenues from seeing more patients. Evidence suggests that if IVF was more affordable for the individual, more people would seek treatment.
Consider the Canadian IVF market. One in six Canadian couples suffers from infertility; however, of the 3 million IVF cycles performed per year, a surprisingly low number– less than 25,000– take place in Canada. The national healthcare system doesn’t cover fertility treatments, making IVF an enormous investment for individuals accustomed to free medical care.
In Ontario, however, the provincial government provides funding for one IVF cycle per woman for up to 6,000 women under 43. After the government launched the program in 2015, the number of patients seeking IVF jumped significantly, and demand for the program continues to exceed the number of spots available. Waitlists can be up to three years long. (A challenge for women in their mid-to-late 30s who face decreased success rates if they wait until funding is available to start treatment).
The takeaway? When IVF becomes cheaper– even slightly– for the individual, a greater number of people opt to pursue the treatment. The number of new IVF patients increases because of people who would otherwise not attempt the treatment because of the cost.
It’s a similar story when it comes to patients who had successful IVF treatments. Most parents who have conceived one child via IVF would have liked to have another, but they say that they cannot because either because of the incurred cost of having the first child or the anticipated costs for the second.
Relieving the supply constraint in the IVF market will become increasingly important as demand for IVF treatment grows globally. More than a third of current IVF cycles take place in Europe and Japan, but the education of women in developing nations, population demographics in Africa and Asia, and the continuing impact of climate change and environmental factors on male infertility make it increasingly likely that demand for IVF will spike in new markets.
As demand rises and IVF clinics look to expand to new markets, they’ll need to be able to take on more patients and hire and train embryologists quickly. Fertilis can help these clinics prepare for the future wave of patients.
At the end of the day, commercial realities will kick in for IVF clinics. Customers will gravitate to IVF clinics that adopt Fertilis’s technology because these clinics will have higher success rates and greater availability of treatment. As in the past with other innovations such as specialist IVF time-lapse incubators, the clinics that don’t adopt the latest and best technology available will fall behind.
