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FLOW OF THE PRESENTATION

Assisted reproductive technologies (ART)
Success rate of ART Methods
IVF - InVitro Fertilization An Overview
IVF Treatment Plan
IVF Cost Aspects
Fertility treatments Cost Aspects
Fertility treatments Cost COMPARISON ACROSS GLOBE
Drugs usually prescribed in IVF Treatment
Top 10 Players in Indian IVF Segment Market & Emerging Players in IVF Market
INDIA IVF Market Overview ,Market Trends & Potential
Regulatory Aspects for IVF in India
THE ASSISTED REPRODUCTIVE TECHNOLOGIES (REGULATION) BILL – 2010
Regulatory Aspects for IVF across globe and comparison
The factors affecting IVF Market in India and across globe
Recommendations & Suggestions
ASSISTED REPRODUCTIVE TECHNOLOGIES (ART)


                                               Commonly used method in %
Assisted reproductive technologies
   (ART) refer to infertility treatments
   that involve the handling of eggs or
   embryos.
This includes IVF, GIFT, and ZIFT.
                                               ZIFT (Zygote Intra




                                           3
With GIFT (gamete intrafallopian               Fallopian Transfer)

    transfer), the egg and sperm, or
    gametes, are not fertilized outside
    the body. Instead, they are placed         GIFT (Gamete Intra                      Commonly used




                                           2
                                               Fallopian Transfer)                     method in %
    together into one of the woman's
    fallopian tubes
ZIFT: With ZIFT (zygote intrafallopian               IVF ( In Vitro

                                           1
                                                     Fertilization )
    transfer), the zygote is placed in
    one of the fallopian tubes. This is
    usually done via laparoscopic                                      0 20 40 60 80

    surgery.
SUCCESS RATE OF ART METHODS


                                                      Live birth rate of each IVF Cycle
   For women under age 35, the live birth rate                    Rate in %
        for each IVF cycle is 30% to 35%.
   For women ages 35 to 37, the rate is 25%.
                                                 35
   For women ages 38 to 40, the rate is 15% to
        20%,
                                                 30
   For women over age 40, the success rate is
        6% to 10%.
                                                 25
   ART is also sometimes performed with
        donor eggs and/or sperm.
   For women whose eggs are of lower             20
        quality, donor eggs may be the best
        option.                                                                    Live birth rate of
                                                 15                                each IVF Cycle Rate
   The live birth rate for egg donation is                                         in %
        between 40% to 45%, but less than
        10% of couples choose to use donor       10
        eggs or sperm.
                                                  5


                                                  0
                                                      <35   35-37   38-40   > 40

                                                       1     2       3       4
IVF - INVITRO FERTILIZATION AN OVERVIEW
What Is IVF?
IVF stands for in vitro fertilization, which
     literally means "in lab conception." With
     IVF treatment, the egg is fertilized with
     sperm in a petri dish. Typically, many eggs
     are retrieved from the biological mother
     (who may or may not be the intended
     parent), as not every egg will fertilize, and
     not every fertilized egg will become a
     viable embryo.


Indications:
   Bilateral blocked Fallopian tubes
    Severe endometriosis
    Pelvic inflammatory disease with severe
    adhesion
    Premature Menopause
    Failed reversal of Vasectomy/ Tubectomy
    Obstructive azoospermia
    Genetic diseases
    Menopause
    Surrogacy (Traditional/ Gestational)
CRYOPRESERVATION




A few days after fertilization, the best embryo or embryos are transferred to the
    mother or surrogate's uterus via a catheter through the cervix. Any extra
    embryos may be cryopreserved for future cycles.
IVF TREATMENT PLAN
IVF- Treatment Plan

• Day 1 . Inj Lupride, 0.2 ml sc. ( Downregulation starts)
Day 2 . Inj Lupride, 0.2 ml sc.
Day 3 . Inj Lupride, 0.2 ml sc.
• Vaginal ultrasound scan to confirm there is no ovarian cyst. If there is no cyst, we can commence superovulation.
• If there is a cyst, we aspirate/ puncture it under ultrasound guidance and continue with the treatment.
Day 4 Inj Lupride, 0.2 ml sc. Inj Menogon ( 75 IU), 4 amp IM. Superovulation starts.
Day 5 Inj Lupride, 0.2 ml sc. Inj Menogon ( 75 IU), 4 amp IM
Day 6 Inj Lupride, 0.2 ml sc. Inj Menogon ( 75 IU), 4 amp IM
Day 7 Inj Lupride, 0.2 ml sc. Inj Menogon ( 75 IU), 4 amp IM
Day 8 Inj Lupride, 0.2 ml sc. Inj Menogon ( 75 IU), 4 amp IM
Day 9 Inj Lupride, 0.2 ml sc. Inj Menogon ( 75 IU), 4 amp IM
Day 10 . Inj Lupride, 0.2 ml sc. Inj Menogon ( 75 IU), 4 amp IM.
Vaginal ultrasound scan to monitor follicular growth
The Lupride and Menogon injections will continue on a daily basis;
and scans will be performed every alternate day, until the follicles are mature.
This is usually Day 14- Day 16 for most patients. At this time, an HCG injection will be given, and eggs retrieved 36 hours after this.
Embryo transfer is performed 3 days later; and supernumerary embryos, if any, are cryopreserved.
After the transfer, luteal phase support is provided with daily Progynova ( estradiol valerate2 mg, 3 tab daily; and Uterogestan ( 200 mg), 6 vaginal
suppositories daily.
You can travel back 3 days after the embryo transfer.
14 days after the transfer, you need to do a blood test for beta HCG to confirm a pregnancy
IVF COST
What Does IVF Cost?
The average cost for IVF is $12,000, but this can vary depending,
on what technologies are being used. IVF with egg donation is the most costly, with
one cycle being anywhere from $25,000 to $30,000.
FERTILITY TREATMENTS COST ASPECTS

 Sr. No.   Activities for Infertility Treatment                                  INR               USD $
   1       Consultation                                                          5000-10000         20
   2       Semen Analysis                                                        200 - 500          10
   3       Hysterosalpingogram                                                   500 - 2000         40
   4       Hormonal blood assays (FSH, LH, prolactin, estrogen, progesterone)    200-400            10
   5       Testicular biopsy                                                     2000 - 10000      200
   6       Endometrial biopsy                                                    500 - 2000        400
   7       Diagnostic Laparoscopy                                                10000 -40000      1000
   8       Operative Laparoscopy                                                 25000 - 50000     1200
   9       Major surgery (microsurgery for tubal repair)                         40000 - 65000     1000
   10      IUI (insemination)                                                    3000 - 15000      500
   11      TID (Therapeutic insemination by donor), per cycle                    8000 - 20000      400
   12      HMG treatment cycle (for superovulation)                              8000 - 20000      400
   13      GIFT                                                  IN VITRO        50000 - 120000    3500
                                                            FERTILIZATION COST
   14      IVF                                                                   50000 - 120000    3000
   15      Embryo freezing                                                       40000 - 80000     3500
   16      Microinjection (ICSI)                                                 80000 - 150000    3500
   17      Preimplantation genetic diagnosis                                     150000 - 200000   5000
COST COMPARISON ACROSS GLOBE
                                                    Cost Comparison
                                                                                                  NDIA IS MOST
     The Comparative Costs between India and other developed countries like US, UK, and          FAVOURITE AND
                                                                                              Singapore -
                                                                                                    SELECTED
                                 Approximate Figures In US Dollars.

                                                                              UK       SINGAPO
                                                                      US                             INDIA
                                                                           (Private)      RE
                                                                   upto      upto                     upto
1              Bone Marrow Transplant                                                     -
                                                                 200,000   200,000
                                                                                                    25,000
2              Bypass Surgery                                     35,000   25,000         -          6,000
3              Breast Lump Removal                                    -     3,200       1,000         700
4              Haemorrhoidectomy                                      -     3,800       1,500        1000
5              Knee Joint Replacement                                 -    15,000       7,000        5,000
6              Lasik Surgery                                      4,000     2,800       1,600         700
7              No Stitch Cataract Surgery                         4,500     2,600         -           700
8              In-vitro fertilisation (IVF) cycle                 15,000       -          -          1,800
9              Hernia Correction                                  2,800     2,700       2,500        1,000
10             Dental Implants                                    3500      2800        1600          800

    * These rates are indicative of approximate costs. The actual rates will vary on case to case basis.
DRUGS USUALLY PRESCRIBED IN IVF TREATMENT
 Sr. No.   Generic Name                    Brand Name
    1      Follitropin Alfa
                                           Gonal - F
           (Recombinant FSH)
   2       Follitropin Beta
                                           Follistim / Puregon
           ( Recombinant FSH)
   3       FSH/Urofollitropin              Fostimon / Fertinex/ Bravelle
   4       HMG                             Repronex / Menopur / Merional
   5       HCG                             Pregnyl / Profasi / Novarel
   6       Lueproreline/Leuprolide
                                           Lupron / Enantone / Procrin
           (GnRH agonist)
   7       Naferelin Acetate Spray
                                           Synarel
           (GnRH agonist)
   8       Ganirelix
                                           Antagon / Orgalutran
           (GnRH agonist)
   9       Cetrorelix
                                           Cetrotide
           (GnRH agonist)
   10      Progesterone Suppositories      Prometrium / Cyclogest
   11      Progesterone Capsules           Prometrium / Utrogestan
   12      Progesterone 8% Gel             Crinone
   13      Progesterone injections         Gestone
   14      Clomiphene                      Clomid / Serophene
   15      Letrozole                       Letroz/ Femara
   16      Methylprednisolone
                                           Medrol / Medrone
           (steroid)
   17      Doxycycline Caps
                                           Doxycycline
           (antibiotic)
   18      Estradiol                       Vvelle / Estraderm / Estradot
   19      Estradiol Valerate              Progynova/ Estrace / Climaval
   20      Desogestrel
                                           Desogen / Marvellon
           (Low dose Birth control pill)
INDIA IVF MARKET OVERVIEW

India has a large population of 1.22 Billion people
and infertility in the country is rising at a rapid rate
(about 30 Million couples suffer from infertility).


Infertility or the inability to have children refers to a range of
   disorders some of which affect the male, and some the
   female, and contribute to childlessness in a couple.


There is also something called unexplained infertility, where
  doctors are unable to provide a medical explanation for the
  couple’s inability to conceive.
INDIA IVF MARKET POTENTIAL

In India, approximately 15% - 20% of married couple's in their fertile age group,
suffer from infertility and it is on the increase because of urbanization, pollution, chemical
exposure, stress, competitive work environment, fast-paced lifestyles, late settlement in life,
more women opting to work, increased incidence of diabetes, pelvic inflammatory
   diseases, etc.


Today, arrays of treatment options to treat infertility are readily available in India.
These include medications for ovulation induction; endoscopic surgery to correct anatomical
problems; and the assisted reproductive technologies, including IUI, IVF, and ICSI (intra
cytoplasmic sperm injection).


India has become one of the favored destinations for infertility treatments such as IVF due to
several factors including its medical expertise, state-of-the-art technology (which is at par with
the best in the world), and a cost-effective health care system.
MARKET SHARE THERAPEUTIC CATEGORY WISE INDIA IVF MARKET

               Market Share in %
  1 Gonadotropins FSH LH
  2 HMG ( Human Menopausal Gonadotropins, Menotropins)
  3 HCG
                                                         Sr. No.   Therapeutic Category                               Market Share in %
  4 Synthetic GnRH (Gonadotropins Releasing Hormones)
  5 GnRH Analogues
                                                            1      Gonadotropins FSH LH                                      10
  6 GnRH antagonists                                        2      HMG ( Human Menopausal Gonadotropins, Menotropins)        15
  7 Growth Hormones                                         3      HCG                                                        9
  8 Steroids
                                                            4      Synthetic GnRH (Gonadotropins Releasing Hormones)         16
  9 Antibiotics
  10 Estrogen Antagonists ( Aromatase inhibitors)           5      GnRH Analogues                                             7
                                                            6      GnRH antagonists                                           5
                                                            7      Growth Hormones                                           12
                     12%        10%                         8      Steroids                                                   6
           8%                                15%
      6%
                                                            9      Antibiotics                                                8
                                                    9%     10      Estrogen Antagonists ( Aromatase inhibitors)              12
     12%

               5%                      16%
                       7%
TOP 10 PLAYERS IN INDIAN IVF SEGMENT MARKET
   Sun Pharmaceutical Industries Ltd
   Lupin Pharma
   Zydus-Cadila Healthcare Ltd
   Intas Pharmaceuticals Ltd
   CIPLA
   Emecure House
   Bharat Serums and Vaccines Ltd
   Uni-Sankyo Limited
   Serum Institute of India
   Alembic Limited

Other Emerging Players are:
 Lifemedicare
 Svizera Laboratories Private Limited
 VHB Life Sciences Inc
 Plethico Pharmaceuticals Limited
 Ferring BV
SUN PHARMA IVF SEGMENT MARKET LEADER IN INDIA

Famous Brands of SUN Pharmaceutical LTD :
1.   leuprolide acetate :
     Brand Name : LUPRIDE
     Dosage Form : Injectable
     Strengths available : 1 mg/ 4 mg/ 11.2 mg/3.75 mg/22.5 mg
2. Gonadotropin chorionic
     Brand Name : FERTIGYN
     Dosage Form : Injectable
     Strengths available : 1000/2000/5000 IU in Ampoules
                            10000 IU in Vials
3.   Follitropin beta
     Brand Name : OVITROP-R
     Dosage Form : Injectable
     Strengths available : 1.20 ml/1.60 ml/0.40 ml
4.   Letrozole :
      Brand Name : LETOVAL / LETROZ
     Dosage Form : Tablets
     Strengths available : 2.5 mg
MONOPLOY OF PLAYERS IN SOME THERAPEUTIC CATEGORY IN INDIA IVF MARKET




1. For Cetrorelix acetate Injectable : only 1 Player in India Market
    CISCURE by EMECURE
2. For Choriogonadotropin alfa Molecule in India only 2 Players
    (OVITRELLE ) Merck KGaA & (PUBERGEN-HP ) UNI SANKYO
3. For Follitropin beta : only 3 Players
    ( OVITROP-R ) by Sun Pharma
    ( RECAGON ) by ORGANON
    ( PUREGON-R ) by ABOTT
4. For Letrozole, leuprolide acetate, urofollitropin, gonadotropin chorionic
   more than 25 players are     present in Domestic Market
REGULATORY ASPECTS INDIA
THE ASSISTED REPRODUCTIVE TECHNOLOGIES (REGULATION) BILL – 2010
MINISTRY OF HEALTH & FAMILY WELFARE , GOVT. OF INDIA, NEW DELHI
INDIAN COUNCIL OF MEDICAL RESEARCH , NEW DELHI
CHAPTER – II 5-11
CONSTITUTION OF AUTHORITIES TO REGULATE ASSISTED
REPRODUCTIVE TECHNOLOGIE
3. Establishment of National Advisory Board 5
4. Meetings of National Advisory Board 5-6
5. Functions of National Advisory Board 6
6. Establishment of State Boards 7
7. Meetings of State Boards 7
8. Powers and functions of State Boards 8
9. Term of office, conditions of service, etc., of Chairperson 8-9
and other members of State Boards
10. Procedure of State Boards 9-10
11 Constitution and functions of the Registration Authority 10
12. Proceedings before State Boards to be judicial proceedings 10-11
THE ASSISTED REPRODUCTIVE TECHNOLOGIES (REGULATION) BILL – 2010


 CHAPTER – III 12-14

 PROCEDURES FOR REGISTRATION AND COMPLAINTS
 13. Registration and accreditation of clinics 12

 14. Who may apply for registration 13

 15. Grant of registration 13

 16. Renewal, suspension or revocation of registration 14                CHAPTER – V 20-22
 17. Registration Authority to inspect premises 14                       SOURCING, STORAGE, HANDLING AND
 18. Applicability to ART banks and research organizations 14            RECORD KEEPING FOR
 19. Appeal to the State Board 14
                                                                         GAMETES, EMBRYOS AND SURROGATES
 CHAPTER – IV 15-19
                                                                         26. Sourcing of gametes 20-21
 DUTIES OF AN ASSISTED REPRODUCTIVE TECHNOLOGY CLINIC

 20. General duties of assisted reproductive technology clinics 15-17    27. Storage and handling of gametes
                                                                         and embryos 21
 21. Duty of the assisted reproductive technology clinic to 17

 obtain written consent                                                  28. Records to be maintained by the ART
 22. Duty of the assisted reproductive technology clinic to keep 17-18
                                                                         bank 22
 accurate records                                                        29. Restriction on sale of
 23. Duties of assisted reproductive technology clinics using 18         gametes, zygotes and embryos 22
 gametes and embryos

 24. Pre-implantation Genetic Diagnosis 19

 25. Sex selection 19
THE ASSISTED REPRODUCTIVE TECHNOLOGIES (REGULATION) BILL – 2010

                                                                   CHAPTER – VIII 30-32
CHAPTER – VI 23-24                                                 OFFENCES AND PENALTIES

REGULATION OF RESEARCH ON EMBRYOS, GAMETES OR                      37. Prohibition of advertisement relating to pre-natal determination 30
OTHER
                                                                   of sex and punishment for contravention
HUMAN REPRODUCTIVE MATERIAL
                                                                   38. Offences and penalties 30-31
30. Permission of the Department of Health Research for
                                                                   39. Presumption in the case of conduct of pre-natal diagnostic 31
research 23
                                                                   techniques
31. Regulation of research 23-24
                                                                   40. Penalty for contravention of the provisions of the Act or rules 31

                                                                   for which no specific punishment is provided

                                                                   41. Offences by companies 31-32

                                                                   42. Offence to be cognizable 32

CHAPTER – VII 25-29                                                CHAPTER – IX 33-35

RIGHTS AND DUTIES OF PATIENTS, DONORS, SURROGATES AND              MISCELLANEOUS

CHILDREN                                                           43. Maintenance of records 33

32. Rights and duties of patients 25                               44. Power to search and seize records etc. 33

33. Rights and duties of donors 25                                 45. Power to remove difficulties 33

34. Rights and duties in relation to surrogacy 26-28               46. Protection of action taken in good faith 34

35. Determination of status of the child 28-29                     47. Power to make regulations 34

36. Right of the child to information about donors or surrogates   48. Power of the Central Government to make rules 34-35
29
                                                                   49. Power of State Government to make rules 35

                                                                   50. Act to have effect in addition to other Acts 35
REGULATORY ASPECTS WORLD WIDE
REGULATORY ASPECTS WORLD WIDE
TEAM SELECTION AND FACTOR AFFECTING
•   TEAM SELECTION IS MOST IMPORTANT FACTOR FOR MARKETING STRATEGY
    FOR ANY PHARMACEUTICAL COMPANY,
•   For Product Management Team : its important to update the data about the
    clinics For infertility treatment and other diagnostics /blood testing procedures
    while Each IVF Cycles ,advances in technology for the same
•   Also understanding the IVF Procedure and the medication dosage regimen during
    entire process is another critical aspect.
•   Understanding Short term long term protocol for IVF Procedures ,
•   As on date there are more than 20,000 Infertility clinics in India and Majority are in
    Mumbai , at 2nd place Bangalore and at 3rd place Delhi is there in India .
•   There are more than 15,000 Doctors /Surgeons are included in this market
•   Apart from medical teams , in India some clinics provide total package for foreign
    visitors from the day of beginning to end of the treatment .
•   Team selection should be based on the factors mentioned in other slide
THE FACTORS AFFECTING TEAM SELECTION FOR IVF MARKET
1.   Competitive Landscape in same region/ state
2.   Understanding of Unorganized & Fragmented Market
3.   Understanding India Total Fertility Rate Profile
4.   Updates about merging In Vitro Fertilization (IVF) Market Trends
5.   Awareness about India Fertility Tourism
6.   Updating Technological Advances in Treatment Procedures
7.   Considering Changing Lifestyle Effecting Fertility Profile Among
     Youngsters
8.   Infertility Rate Among Indian Couples
9.   Awareness about Investment & Foreign Collaboration of Indian players
RECOMMENDATION & SUGGESTIONS
The most important economic issues in contemporary ART markets are:
1) Access to treatment
2) Treatment success, as measured through birth rates and multiple birth rates.
These issues of access and quality are also the central concerns for Indian health care markets in
general.
•   Across the medical sector of the economy and in IVF markets in particular,
it has been suggested that altering the competitive structure of markets or the extent of
insurance coverage can improve both access to care and quality.
•   In the market for infertility treatment, mandatory insurance coverage is predicted to bring
    new patients into the market and reduce the incentive to transfer a dangerously high number
    of embryos during treatment, thereby increasing the quality of care.
•   While price reducing competition is likely to improve access to IVF, there exist concerns that
competing clinics will attempt to win new patients by inflating birthrates using treatments that
also raise the risk of multiple births.
RECOMMENDATION & SUGGESTIONS
•   However, concerns about quality-reducing competition may be incorrect, and in fact additional
    competition can decrease multiple birth rates by reducing patients’ incentive to seek aggressive
    treatment for their fertility problems. With the present paper we evaluate the impacts of both
    mandated insurance coverage and an increase in competition on ART access and treatment
    success rates.


•   We expect the use of IVF to continue to grow, as treatment expenses fall with competition and
    technological progress, and more women account for the possibility of ART while making related
    life cycle choices regarding education, career, and marriage.


•   Indeed, the changing economic environment of the late 21st century is likely to have shifted
    substantially the demand for infertility treatment services.
•   As women’s labor force participation rates and real wages have increased, couples have deferred
    the decision to have children
RECENT UPDATES/ REASERCH IN WORLD IVF MARKET
• Cooper To Lead In Vitro Fertilization Market Following $189 Million Origio
  Acquisition ,Deal will boost Cooper’s share of the $220 million global IVF
  market from 7% to 39%.
• Discovery of a Molecule That Initiates Maturation of Mammalian
  Eggs Can Lead to More IVF Pregnancies
   researchers at the University of Gothenburg have identified a
  molecule called Cdk1 that has an important function for mammalian
  egg maturation. In the future this could lead to an increased rate of
  successful IVF.
This is the first functional evidence that Cdk1 is a key molecule in
   mammalian egg maturation. If the results can be translated into
   clinical settings, it could possibly improve the chances of successful
   IVF treatment for women who today are not becoming pregnant
   because their eggs do not mature" says Kui Liu, professor at the
   Department of Chemistry and Molecular Biology, the University of
   Gothenburg, Sweden.
RESEARCH IN WORLD IVF MARKET
•   A new technique successfully used in mice to identify embryos likely to result in a successful
    pregnancy could be used in humans, according to University scientists.
     The Cardiff scientists worked with a team in Oxford University to analyse the internal contents
    of the human egg or cytoplasm to observe distinct rhythmic patterns.
"Current IVF treatment involves fertilising eggs in the laboratory and then choosing those embryos
    considered to be the healthiest for implantation into the mother's womb, using selection
    criteria such as the number and appearance of cells produced during the division process,"
    according to Professor Karl Swann, School of Medicine, who led the research.
•   New Method for Picking the 'Right' Egg in IVF:
•   groundbreaking study,Yale School of Medicine researchers and colleagues at the
    University of Oxford have identified the chromosomal make-up of a human egg.
    This discovery may soon allow them to avoid using abnormal -- or aneuploid --
    eggs during infertility treatments, and instead to pick eggs that are healthy
    enough for a successful in vitro fertilization (IVF) cycle.
•   "This finding opens up the possibility of a safe, effective, and inexpensive way of
    identifying healthy eggs, potentially lowering the risks of miscarriage and Down
    syndrome," said Wells. "By conducting these tests before eggs are
    fertilized, ethical concerns about analysis of human embryos are avoided."
FUTURE OF INFERTILITY TRATMENT
The development of techniques to prolong the window of fertility for women has the ability
    to meet the needs of future populations and their delay in childbearing.
With current techniques of cryopreservation of embryos, oocytes, or ovarian
   tissue, prolongation of fertility with varying success is feasible.
In the future, rejuvenation of aging oocytes will offer the opportunity for the aging women
    to achieve pregnancy with their own genetic offspring.
Production of germ cells from embryonic stem cells is another alternative for patient with
   poor or depleted germ cells.
Better understanding of the cause of infertility can be achieved with new techniques to
    evaluate the oocytes, spermatozoa, and embryos on molecular and genetic levels.
With improved understanding of the etiology of infertility, treatment will be more effective.
With the advance of new drugs and surgical equipment, treatment of infertility will become
    more convenient and effective.
UPCOMING CONFERENCES - INDIA

Indian Society for the Study of Reproduction and Fertility (ISSRF)
The 23rd Annual Meeting of the ISSRF along with an International Conference on Repromics-
     Omics in Reproduction and Development will be held at the Rajiv Gandhi Centre for
     Biotechnology, Thiruvananthapuram during February 7-9, 2013.
    The relevant information will be up-loaded from time to time and will be circulated to all
    members of the Society.
    The contact person is:
    Dr. Pradeep Kumar G
    Scientist F
    Rajiv Gandhi Centre for Biotechnology
    Thycaud Post, Poojappura
    Thiruvananthapuram - 695014, Kerala, India
    Tel.: +91-471-2529459
    E-mail: kumarp@rgcb.res.in
UPCOMING CONFERENCES - INDIA

8th Annual National Conference of Indian Fertility Society on "INFERTILITY & ASSISTED
    REPRODUCTIVE TECHNOLOGIES" 8th & 9th December, 2012 ( 13 Dec, 2012 )
UPCOMING CONFERENCES - INDIA

Conference Name : Amasicon2006:

Date & Venue : March 31st April 1st & 2nd Kolkata, Hotel Hyatt Regency-Venue,

Contact Address : ILS MultispecialityClinic-Surgery, Jeewansatya, DD-6, Sector 1,

Salt Lake City, Kolkota, West Bengal Pin:700064

Office & Mobile Phone : Office: +91-33-23593700, Mobile: +91-9830400300, Telefax: +91-33-23214912

Email & Web : Email: secreteriat@amasicon2006.com Web: www.amasicon2006.com
UPCOMING INTERNATIONAL CONFERENCES - INTERNATIONAL

2012-06-13
International Society for Stem Cell Research 10th Annual Meeting
      Dates: June 13-16. 2012
      Location: Pacifico Yokohama, Yokohama, JAPAN
      For more information: http://www.isscr.org 2012-06-16
2012 AMA Annual Assembly Meeting
     Dates: June 16-20, 2012
     Location: Chicago, IL, USA
     For More Information:http://www.ama-assn.org
2012-06-20
Society of Obstetricians and Gynaecologists of Canada 68th Annual Clinical Meeting
     Dates: June 20-24, 2012
     Location: Ottawa, Ontario, CANADA
     For more information: http://www.sogc.org 2012-06-23
ENDO 2012
    Sponsor: The Endocrine Society
    Dates: June 23-26, 2012
    Location: Houston, Texas, USA
    For more information: http://www.endo-society.org 2012-06-27
8th International Congress on Minimally Invasive Gynecology
      Sponsors: American Association of Gynecologic Laparoscopists and the Romanian Society of Minimally Invasive Surgery in
      Gynecology
      Dates: June 27 - July 1, 2012
      Location: Bucharest, ROMANIA
      For more information: http://www.aagl.org 2012-07-01
ESHRE 2012
    Description: 28th Annual Meeting of the European Society of Human Reproduction and Embryology
    Dates: July 1-4, 2012
    Location: Istanbul, TURKEY
    For More Information:http://www.eshre.eu
UPCOMING INTERNATIONAL CONFERENCES - INTERNATIONAL

International Academy of Sex Research 38th Annual Meeting
     Dates: July 8-11, 2012
     Location: Lisbon, PORTUGAL
     For more information: http://www.iasr.org 2012-07-26
North American Council on Adoptable Children 38th Annual Conference
    Dates: July 26–28, 2012
    Location: Crystal City, Virginia, USA
    For more information: https://www.nacac.org/conference/conference.html 2012-08-02
12th Asia-Oceania Federation of Sexology (AOFS) Meeting
    Dates: August 2-5, 2012
    Location: Matsue, JAPAN
    For more information: http://www.12aocs.jp 2012-08-12
45th Annual Meeting of the Society for the Study of Reproduction
    Theme: “Applied Reproductive Biology: Making It Relevant”
    Dates: August 12–15, 2012
    Location: The College of Agricultural Sciences, The Pennsylvania State University, State
    College, Pennsylvania, USA
    For more information: http://www.ssr.org 2012-08-22
11th Asian Congress of Urology
    Sponsor: The Urological Association of Asia
    Dates: August 22-26, 2012
    Location: Pattaya, THAILAND
    For more information: http://11thacu2012.org 2012-08-26
UPCOMING INTERNATIONAL CONFERENCES - INTERNATIONAL

SMSNA/ISSM Joint Annual Meeting
   Sponsor: Sexual Medicine Society of North America
   Dates: August 26-30, 2012
   Location: Sheraton Chicago Hotel & Towers, Chicago, IL, USA
   For More Information: http://www.smsna.org
2012-09-05
21st SLS Annual Meeting and Endo Expo 2012
    Sponsor: Society of Laparoendoscopic Surgeons
    Dates: September 5-8, 2012
    Location: Westin Copley Place, Boston, MA, USA
    For More Information: www.sls.org
2012-09-06
CFAS 2012
    Sponsor: Canadian Fertility and Andrology Society
    Dates: September 6-9, 2012
    Location: Ottawa Westin, Ottawa, Ontario, CANADA
    For More Information: www.cfas.ca
2012-10-20
ASRM 2012
   Description: 68th Annual Meeting of the ASRM
   Dates: October 20-24, 2012
   Place: San Diego Convention Center, San Diego, California, USA
   For More Information: ASRM, Tel: 205-978-5000, Fax: 205-978-5018, Email: asrm@asrm.org
UPCOMING INTERNATIONAL CONFERENCES - INTERNATIONAL

2012-12-06 (ESSM)

15th Congress of the European Society for Sexual Medicine (ESSM)
       Dates: December 6-9, 2012
       Location: Amsterdam, THE NETHERLANDS
       For more information: http://www.essm.org 2013-03-07

The Best of ESHRE & ASRM
        Dates: March 7-9, 2013
        Location: Atlantis, Paradise Island, BAHAMAS
        For more information: http://www.asrm.org/Atlantis2013/ 2013-04-17

2013 Pacific Coast Reproductive Society Annual Meeting
       Dates: April 17-21, 2013
       Location: Renaissance Esmeralda, Indian Wells, CA, USA
       For More Information: http://www.pcrsonline.org

2013-05-04

2013 ACOG Annual Clinical Meeting
       Dates: May 4-8, 2013
       Location: New Orleans, LA, USA
       For More Information: http://www.acog.org/

2013-06-15

2013 AMA Annual Assembly Meeting
       Dates: June 15-19, 2013
       Location: Chicago, IL, USA
       For More Information: http://www.ama-assn.org

2013-10-12

Joint ASRM/IFFS Meeting
        Description: 69th Annual Meeting of the ASRM held conjointly with the Meeting of the International Federation of Fertility Societies
        Dates: October 12-17, 2013
        Place: Boston Convention and Exhibition Center, Boston, MA, USA
        For More Information: ASRM, Tel: 205-978-5000, Fax: 205-978-5018, Email: asrm@asrm.org: Website: http://www.asrm.org/IFFS-ASRM2013/

2014-04-23

2014 Pacific Coast Reproductive Society Annual Meeting
       Dates: April 23-27, 2014
       Location: Renaissance Esmeralda, Indian Wells, CA, USA
       For More Information: http://www.pcrsonline.org
UPCOMING INTERNATIONAL CONFERENCES - INTERNATIONAL

2014-06-07

2014 AMA Annual Assembly Meeting
      Dates: June 7-11, 2014
      Location: Chicago, IL, USA
      For More Information: http://www.ama-assn.org

2014-10-18

ASRM 2014
     Description: 70th Annual Meeting of the ASRM
     Dates: October 18-22, 2014
     Place: Hawaii Convention Center, Honolulu, HI, USA
     For More Information: ASRM, Tel: 205-978-5000, Fax: 205-978-5018, Email: asrm@asrm.org

2015-06-06
2015 AMA Annual Assembly Meeting
      Dates: June 6-10, 2015
      Location: Chicago, IL, USA
      For More Information: http://www.ama-assn.org

2015-10-17

ASRM 2015
     Description: 71st Annual Meeting of the ASRM
     Dates: October 17-21, 2015
     Place: Baltimore Convention Center, Baltimore, MD, USA
     For More Information: ASRM, Tel: 205-978-5000, Fax: 205-978-5018, Email: asrm@asrm.org
2016-06-11

2016 AMA Annual Assembly Meeting
      Dates: June 11-15, 2016
      Location: Chicago, IL, USA
      For More Information:http://www.ama-assn.org
THANK YOU

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Ivf market trends and an overview

  • 1.
  • 2. FLOW OF THE PRESENTATION Assisted reproductive technologies (ART) Success rate of ART Methods IVF - InVitro Fertilization An Overview IVF Treatment Plan IVF Cost Aspects Fertility treatments Cost Aspects Fertility treatments Cost COMPARISON ACROSS GLOBE Drugs usually prescribed in IVF Treatment Top 10 Players in Indian IVF Segment Market & Emerging Players in IVF Market INDIA IVF Market Overview ,Market Trends & Potential Regulatory Aspects for IVF in India THE ASSISTED REPRODUCTIVE TECHNOLOGIES (REGULATION) BILL – 2010 Regulatory Aspects for IVF across globe and comparison The factors affecting IVF Market in India and across globe Recommendations & Suggestions
  • 3. ASSISTED REPRODUCTIVE TECHNOLOGIES (ART) Commonly used method in % Assisted reproductive technologies (ART) refer to infertility treatments that involve the handling of eggs or embryos. This includes IVF, GIFT, and ZIFT. ZIFT (Zygote Intra 3 With GIFT (gamete intrafallopian Fallopian Transfer) transfer), the egg and sperm, or gametes, are not fertilized outside the body. Instead, they are placed GIFT (Gamete Intra Commonly used 2 Fallopian Transfer) method in % together into one of the woman's fallopian tubes ZIFT: With ZIFT (zygote intrafallopian IVF ( In Vitro 1 Fertilization ) transfer), the zygote is placed in one of the fallopian tubes. This is usually done via laparoscopic 0 20 40 60 80 surgery.
  • 4. SUCCESS RATE OF ART METHODS Live birth rate of each IVF Cycle For women under age 35, the live birth rate Rate in % for each IVF cycle is 30% to 35%. For women ages 35 to 37, the rate is 25%. 35 For women ages 38 to 40, the rate is 15% to 20%, 30 For women over age 40, the success rate is 6% to 10%. 25 ART is also sometimes performed with donor eggs and/or sperm. For women whose eggs are of lower 20 quality, donor eggs may be the best option. Live birth rate of 15 each IVF Cycle Rate The live birth rate for egg donation is in % between 40% to 45%, but less than 10% of couples choose to use donor 10 eggs or sperm. 5 0 <35 35-37 38-40 > 40 1 2 3 4
  • 5. IVF - INVITRO FERTILIZATION AN OVERVIEW What Is IVF? IVF stands for in vitro fertilization, which literally means "in lab conception." With IVF treatment, the egg is fertilized with sperm in a petri dish. Typically, many eggs are retrieved from the biological mother (who may or may not be the intended parent), as not every egg will fertilize, and not every fertilized egg will become a viable embryo. Indications:  Bilateral blocked Fallopian tubes Severe endometriosis Pelvic inflammatory disease with severe adhesion Premature Menopause Failed reversal of Vasectomy/ Tubectomy Obstructive azoospermia Genetic diseases Menopause Surrogacy (Traditional/ Gestational)
  • 6. CRYOPRESERVATION A few days after fertilization, the best embryo or embryos are transferred to the mother or surrogate's uterus via a catheter through the cervix. Any extra embryos may be cryopreserved for future cycles.
  • 7. IVF TREATMENT PLAN IVF- Treatment Plan • Day 1 . Inj Lupride, 0.2 ml sc. ( Downregulation starts) Day 2 . Inj Lupride, 0.2 ml sc. Day 3 . Inj Lupride, 0.2 ml sc. • Vaginal ultrasound scan to confirm there is no ovarian cyst. If there is no cyst, we can commence superovulation. • If there is a cyst, we aspirate/ puncture it under ultrasound guidance and continue with the treatment. Day 4 Inj Lupride, 0.2 ml sc. Inj Menogon ( 75 IU), 4 amp IM. Superovulation starts. Day 5 Inj Lupride, 0.2 ml sc. Inj Menogon ( 75 IU), 4 amp IM Day 6 Inj Lupride, 0.2 ml sc. Inj Menogon ( 75 IU), 4 amp IM Day 7 Inj Lupride, 0.2 ml sc. Inj Menogon ( 75 IU), 4 amp IM Day 8 Inj Lupride, 0.2 ml sc. Inj Menogon ( 75 IU), 4 amp IM Day 9 Inj Lupride, 0.2 ml sc. Inj Menogon ( 75 IU), 4 amp IM Day 10 . Inj Lupride, 0.2 ml sc. Inj Menogon ( 75 IU), 4 amp IM. Vaginal ultrasound scan to monitor follicular growth The Lupride and Menogon injections will continue on a daily basis; and scans will be performed every alternate day, until the follicles are mature. This is usually Day 14- Day 16 for most patients. At this time, an HCG injection will be given, and eggs retrieved 36 hours after this. Embryo transfer is performed 3 days later; and supernumerary embryos, if any, are cryopreserved. After the transfer, luteal phase support is provided with daily Progynova ( estradiol valerate2 mg, 3 tab daily; and Uterogestan ( 200 mg), 6 vaginal suppositories daily. You can travel back 3 days after the embryo transfer. 14 days after the transfer, you need to do a blood test for beta HCG to confirm a pregnancy
  • 8. IVF COST What Does IVF Cost? The average cost for IVF is $12,000, but this can vary depending, on what technologies are being used. IVF with egg donation is the most costly, with one cycle being anywhere from $25,000 to $30,000.
  • 9. FERTILITY TREATMENTS COST ASPECTS Sr. No. Activities for Infertility Treatment INR USD $ 1 Consultation 5000-10000 20 2 Semen Analysis 200 - 500 10 3 Hysterosalpingogram 500 - 2000 40 4 Hormonal blood assays (FSH, LH, prolactin, estrogen, progesterone) 200-400 10 5 Testicular biopsy 2000 - 10000 200 6 Endometrial biopsy 500 - 2000 400 7 Diagnostic Laparoscopy 10000 -40000 1000 8 Operative Laparoscopy 25000 - 50000 1200 9 Major surgery (microsurgery for tubal repair) 40000 - 65000 1000 10 IUI (insemination) 3000 - 15000 500 11 TID (Therapeutic insemination by donor), per cycle 8000 - 20000 400 12 HMG treatment cycle (for superovulation) 8000 - 20000 400 13 GIFT IN VITRO 50000 - 120000 3500 FERTILIZATION COST 14 IVF 50000 - 120000 3000 15 Embryo freezing 40000 - 80000 3500 16 Microinjection (ICSI) 80000 - 150000 3500 17 Preimplantation genetic diagnosis 150000 - 200000 5000
  • 10. COST COMPARISON ACROSS GLOBE Cost Comparison NDIA IS MOST The Comparative Costs between India and other developed countries like US, UK, and FAVOURITE AND Singapore - SELECTED Approximate Figures In US Dollars. UK SINGAPO US INDIA (Private) RE upto upto upto 1 Bone Marrow Transplant - 200,000 200,000 25,000 2 Bypass Surgery 35,000 25,000 - 6,000 3 Breast Lump Removal - 3,200 1,000 700 4 Haemorrhoidectomy - 3,800 1,500 1000 5 Knee Joint Replacement - 15,000 7,000 5,000 6 Lasik Surgery 4,000 2,800 1,600 700 7 No Stitch Cataract Surgery 4,500 2,600 - 700 8 In-vitro fertilisation (IVF) cycle 15,000 - - 1,800 9 Hernia Correction 2,800 2,700 2,500 1,000 10 Dental Implants 3500 2800 1600 800 * These rates are indicative of approximate costs. The actual rates will vary on case to case basis.
  • 11. DRUGS USUALLY PRESCRIBED IN IVF TREATMENT Sr. No. Generic Name Brand Name 1 Follitropin Alfa Gonal - F (Recombinant FSH) 2 Follitropin Beta Follistim / Puregon ( Recombinant FSH) 3 FSH/Urofollitropin Fostimon / Fertinex/ Bravelle 4 HMG Repronex / Menopur / Merional 5 HCG Pregnyl / Profasi / Novarel 6 Lueproreline/Leuprolide Lupron / Enantone / Procrin (GnRH agonist) 7 Naferelin Acetate Spray Synarel (GnRH agonist) 8 Ganirelix Antagon / Orgalutran (GnRH agonist) 9 Cetrorelix Cetrotide (GnRH agonist) 10 Progesterone Suppositories Prometrium / Cyclogest 11 Progesterone Capsules Prometrium / Utrogestan 12 Progesterone 8% Gel Crinone 13 Progesterone injections Gestone 14 Clomiphene Clomid / Serophene 15 Letrozole Letroz/ Femara 16 Methylprednisolone Medrol / Medrone (steroid) 17 Doxycycline Caps Doxycycline (antibiotic) 18 Estradiol Vvelle / Estraderm / Estradot 19 Estradiol Valerate Progynova/ Estrace / Climaval 20 Desogestrel Desogen / Marvellon (Low dose Birth control pill)
  • 12. INDIA IVF MARKET OVERVIEW India has a large population of 1.22 Billion people and infertility in the country is rising at a rapid rate (about 30 Million couples suffer from infertility). Infertility or the inability to have children refers to a range of disorders some of which affect the male, and some the female, and contribute to childlessness in a couple. There is also something called unexplained infertility, where doctors are unable to provide a medical explanation for the couple’s inability to conceive.
  • 13. INDIA IVF MARKET POTENTIAL In India, approximately 15% - 20% of married couple's in their fertile age group, suffer from infertility and it is on the increase because of urbanization, pollution, chemical exposure, stress, competitive work environment, fast-paced lifestyles, late settlement in life, more women opting to work, increased incidence of diabetes, pelvic inflammatory diseases, etc. Today, arrays of treatment options to treat infertility are readily available in India. These include medications for ovulation induction; endoscopic surgery to correct anatomical problems; and the assisted reproductive technologies, including IUI, IVF, and ICSI (intra cytoplasmic sperm injection). India has become one of the favored destinations for infertility treatments such as IVF due to several factors including its medical expertise, state-of-the-art technology (which is at par with the best in the world), and a cost-effective health care system.
  • 14. MARKET SHARE THERAPEUTIC CATEGORY WISE INDIA IVF MARKET Market Share in % 1 Gonadotropins FSH LH 2 HMG ( Human Menopausal Gonadotropins, Menotropins) 3 HCG Sr. No. Therapeutic Category Market Share in % 4 Synthetic GnRH (Gonadotropins Releasing Hormones) 5 GnRH Analogues 1 Gonadotropins FSH LH 10 6 GnRH antagonists 2 HMG ( Human Menopausal Gonadotropins, Menotropins) 15 7 Growth Hormones 3 HCG 9 8 Steroids 4 Synthetic GnRH (Gonadotropins Releasing Hormones) 16 9 Antibiotics 10 Estrogen Antagonists ( Aromatase inhibitors) 5 GnRH Analogues 7 6 GnRH antagonists 5 7 Growth Hormones 12 12% 10% 8 Steroids 6 8% 15% 6% 9 Antibiotics 8 9% 10 Estrogen Antagonists ( Aromatase inhibitors) 12 12% 5% 16% 7%
  • 15. TOP 10 PLAYERS IN INDIAN IVF SEGMENT MARKET  Sun Pharmaceutical Industries Ltd  Lupin Pharma  Zydus-Cadila Healthcare Ltd  Intas Pharmaceuticals Ltd  CIPLA  Emecure House  Bharat Serums and Vaccines Ltd  Uni-Sankyo Limited  Serum Institute of India  Alembic Limited Other Emerging Players are:  Lifemedicare  Svizera Laboratories Private Limited  VHB Life Sciences Inc  Plethico Pharmaceuticals Limited  Ferring BV
  • 16. SUN PHARMA IVF SEGMENT MARKET LEADER IN INDIA Famous Brands of SUN Pharmaceutical LTD : 1. leuprolide acetate : Brand Name : LUPRIDE Dosage Form : Injectable Strengths available : 1 mg/ 4 mg/ 11.2 mg/3.75 mg/22.5 mg 2. Gonadotropin chorionic Brand Name : FERTIGYN Dosage Form : Injectable Strengths available : 1000/2000/5000 IU in Ampoules 10000 IU in Vials 3. Follitropin beta Brand Name : OVITROP-R Dosage Form : Injectable Strengths available : 1.20 ml/1.60 ml/0.40 ml 4. Letrozole : Brand Name : LETOVAL / LETROZ Dosage Form : Tablets Strengths available : 2.5 mg
  • 17. MONOPLOY OF PLAYERS IN SOME THERAPEUTIC CATEGORY IN INDIA IVF MARKET 1. For Cetrorelix acetate Injectable : only 1 Player in India Market CISCURE by EMECURE 2. For Choriogonadotropin alfa Molecule in India only 2 Players (OVITRELLE ) Merck KGaA & (PUBERGEN-HP ) UNI SANKYO 3. For Follitropin beta : only 3 Players ( OVITROP-R ) by Sun Pharma ( RECAGON ) by ORGANON ( PUREGON-R ) by ABOTT 4. For Letrozole, leuprolide acetate, urofollitropin, gonadotropin chorionic more than 25 players are present in Domestic Market
  • 18. REGULATORY ASPECTS INDIA THE ASSISTED REPRODUCTIVE TECHNOLOGIES (REGULATION) BILL – 2010 MINISTRY OF HEALTH & FAMILY WELFARE , GOVT. OF INDIA, NEW DELHI INDIAN COUNCIL OF MEDICAL RESEARCH , NEW DELHI CHAPTER – II 5-11 CONSTITUTION OF AUTHORITIES TO REGULATE ASSISTED REPRODUCTIVE TECHNOLOGIE 3. Establishment of National Advisory Board 5 4. Meetings of National Advisory Board 5-6 5. Functions of National Advisory Board 6 6. Establishment of State Boards 7 7. Meetings of State Boards 7 8. Powers and functions of State Boards 8 9. Term of office, conditions of service, etc., of Chairperson 8-9 and other members of State Boards 10. Procedure of State Boards 9-10 11 Constitution and functions of the Registration Authority 10 12. Proceedings before State Boards to be judicial proceedings 10-11
  • 19. THE ASSISTED REPRODUCTIVE TECHNOLOGIES (REGULATION) BILL – 2010 CHAPTER – III 12-14 PROCEDURES FOR REGISTRATION AND COMPLAINTS 13. Registration and accreditation of clinics 12 14. Who may apply for registration 13 15. Grant of registration 13 16. Renewal, suspension or revocation of registration 14 CHAPTER – V 20-22 17. Registration Authority to inspect premises 14 SOURCING, STORAGE, HANDLING AND 18. Applicability to ART banks and research organizations 14 RECORD KEEPING FOR 19. Appeal to the State Board 14 GAMETES, EMBRYOS AND SURROGATES CHAPTER – IV 15-19 26. Sourcing of gametes 20-21 DUTIES OF AN ASSISTED REPRODUCTIVE TECHNOLOGY CLINIC 20. General duties of assisted reproductive technology clinics 15-17 27. Storage and handling of gametes and embryos 21 21. Duty of the assisted reproductive technology clinic to 17 obtain written consent 28. Records to be maintained by the ART 22. Duty of the assisted reproductive technology clinic to keep 17-18 bank 22 accurate records 29. Restriction on sale of 23. Duties of assisted reproductive technology clinics using 18 gametes, zygotes and embryos 22 gametes and embryos 24. Pre-implantation Genetic Diagnosis 19 25. Sex selection 19
  • 20. THE ASSISTED REPRODUCTIVE TECHNOLOGIES (REGULATION) BILL – 2010 CHAPTER – VIII 30-32 CHAPTER – VI 23-24 OFFENCES AND PENALTIES REGULATION OF RESEARCH ON EMBRYOS, GAMETES OR 37. Prohibition of advertisement relating to pre-natal determination 30 OTHER of sex and punishment for contravention HUMAN REPRODUCTIVE MATERIAL 38. Offences and penalties 30-31 30. Permission of the Department of Health Research for 39. Presumption in the case of conduct of pre-natal diagnostic 31 research 23 techniques 31. Regulation of research 23-24 40. Penalty for contravention of the provisions of the Act or rules 31 for which no specific punishment is provided 41. Offences by companies 31-32 42. Offence to be cognizable 32 CHAPTER – VII 25-29 CHAPTER – IX 33-35 RIGHTS AND DUTIES OF PATIENTS, DONORS, SURROGATES AND MISCELLANEOUS CHILDREN 43. Maintenance of records 33 32. Rights and duties of patients 25 44. Power to search and seize records etc. 33 33. Rights and duties of donors 25 45. Power to remove difficulties 33 34. Rights and duties in relation to surrogacy 26-28 46. Protection of action taken in good faith 34 35. Determination of status of the child 28-29 47. Power to make regulations 34 36. Right of the child to information about donors or surrogates 48. Power of the Central Government to make rules 34-35 29 49. Power of State Government to make rules 35 50. Act to have effect in addition to other Acts 35
  • 23. TEAM SELECTION AND FACTOR AFFECTING • TEAM SELECTION IS MOST IMPORTANT FACTOR FOR MARKETING STRATEGY FOR ANY PHARMACEUTICAL COMPANY, • For Product Management Team : its important to update the data about the clinics For infertility treatment and other diagnostics /blood testing procedures while Each IVF Cycles ,advances in technology for the same • Also understanding the IVF Procedure and the medication dosage regimen during entire process is another critical aspect. • Understanding Short term long term protocol for IVF Procedures , • As on date there are more than 20,000 Infertility clinics in India and Majority are in Mumbai , at 2nd place Bangalore and at 3rd place Delhi is there in India . • There are more than 15,000 Doctors /Surgeons are included in this market • Apart from medical teams , in India some clinics provide total package for foreign visitors from the day of beginning to end of the treatment . • Team selection should be based on the factors mentioned in other slide
  • 24. THE FACTORS AFFECTING TEAM SELECTION FOR IVF MARKET 1. Competitive Landscape in same region/ state 2. Understanding of Unorganized & Fragmented Market 3. Understanding India Total Fertility Rate Profile 4. Updates about merging In Vitro Fertilization (IVF) Market Trends 5. Awareness about India Fertility Tourism 6. Updating Technological Advances in Treatment Procedures 7. Considering Changing Lifestyle Effecting Fertility Profile Among Youngsters 8. Infertility Rate Among Indian Couples 9. Awareness about Investment & Foreign Collaboration of Indian players
  • 25. RECOMMENDATION & SUGGESTIONS The most important economic issues in contemporary ART markets are: 1) Access to treatment 2) Treatment success, as measured through birth rates and multiple birth rates. These issues of access and quality are also the central concerns for Indian health care markets in general. • Across the medical sector of the economy and in IVF markets in particular, it has been suggested that altering the competitive structure of markets or the extent of insurance coverage can improve both access to care and quality. • In the market for infertility treatment, mandatory insurance coverage is predicted to bring new patients into the market and reduce the incentive to transfer a dangerously high number of embryos during treatment, thereby increasing the quality of care. • While price reducing competition is likely to improve access to IVF, there exist concerns that competing clinics will attempt to win new patients by inflating birthrates using treatments that also raise the risk of multiple births.
  • 26. RECOMMENDATION & SUGGESTIONS • However, concerns about quality-reducing competition may be incorrect, and in fact additional competition can decrease multiple birth rates by reducing patients’ incentive to seek aggressive treatment for their fertility problems. With the present paper we evaluate the impacts of both mandated insurance coverage and an increase in competition on ART access and treatment success rates. • We expect the use of IVF to continue to grow, as treatment expenses fall with competition and technological progress, and more women account for the possibility of ART while making related life cycle choices regarding education, career, and marriage. • Indeed, the changing economic environment of the late 21st century is likely to have shifted substantially the demand for infertility treatment services. • As women’s labor force participation rates and real wages have increased, couples have deferred the decision to have children
  • 27. RECENT UPDATES/ REASERCH IN WORLD IVF MARKET • Cooper To Lead In Vitro Fertilization Market Following $189 Million Origio Acquisition ,Deal will boost Cooper’s share of the $220 million global IVF market from 7% to 39%. • Discovery of a Molecule That Initiates Maturation of Mammalian Eggs Can Lead to More IVF Pregnancies researchers at the University of Gothenburg have identified a molecule called Cdk1 that has an important function for mammalian egg maturation. In the future this could lead to an increased rate of successful IVF. This is the first functional evidence that Cdk1 is a key molecule in mammalian egg maturation. If the results can be translated into clinical settings, it could possibly improve the chances of successful IVF treatment for women who today are not becoming pregnant because their eggs do not mature" says Kui Liu, professor at the Department of Chemistry and Molecular Biology, the University of Gothenburg, Sweden.
  • 28. RESEARCH IN WORLD IVF MARKET • A new technique successfully used in mice to identify embryos likely to result in a successful pregnancy could be used in humans, according to University scientists. The Cardiff scientists worked with a team in Oxford University to analyse the internal contents of the human egg or cytoplasm to observe distinct rhythmic patterns. "Current IVF treatment involves fertilising eggs in the laboratory and then choosing those embryos considered to be the healthiest for implantation into the mother's womb, using selection criteria such as the number and appearance of cells produced during the division process," according to Professor Karl Swann, School of Medicine, who led the research. • New Method for Picking the 'Right' Egg in IVF: • groundbreaking study,Yale School of Medicine researchers and colleagues at the University of Oxford have identified the chromosomal make-up of a human egg. This discovery may soon allow them to avoid using abnormal -- or aneuploid -- eggs during infertility treatments, and instead to pick eggs that are healthy enough for a successful in vitro fertilization (IVF) cycle. • "This finding opens up the possibility of a safe, effective, and inexpensive way of identifying healthy eggs, potentially lowering the risks of miscarriage and Down syndrome," said Wells. "By conducting these tests before eggs are fertilized, ethical concerns about analysis of human embryos are avoided."
  • 29. FUTURE OF INFERTILITY TRATMENT The development of techniques to prolong the window of fertility for women has the ability to meet the needs of future populations and their delay in childbearing. With current techniques of cryopreservation of embryos, oocytes, or ovarian tissue, prolongation of fertility with varying success is feasible. In the future, rejuvenation of aging oocytes will offer the opportunity for the aging women to achieve pregnancy with their own genetic offspring. Production of germ cells from embryonic stem cells is another alternative for patient with poor or depleted germ cells. Better understanding of the cause of infertility can be achieved with new techniques to evaluate the oocytes, spermatozoa, and embryos on molecular and genetic levels. With improved understanding of the etiology of infertility, treatment will be more effective. With the advance of new drugs and surgical equipment, treatment of infertility will become more convenient and effective.
  • 30. UPCOMING CONFERENCES - INDIA Indian Society for the Study of Reproduction and Fertility (ISSRF) The 23rd Annual Meeting of the ISSRF along with an International Conference on Repromics- Omics in Reproduction and Development will be held at the Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram during February 7-9, 2013. The relevant information will be up-loaded from time to time and will be circulated to all members of the Society. The contact person is: Dr. Pradeep Kumar G Scientist F Rajiv Gandhi Centre for Biotechnology Thycaud Post, Poojappura Thiruvananthapuram - 695014, Kerala, India Tel.: +91-471-2529459 E-mail: kumarp@rgcb.res.in
  • 31. UPCOMING CONFERENCES - INDIA 8th Annual National Conference of Indian Fertility Society on "INFERTILITY & ASSISTED REPRODUCTIVE TECHNOLOGIES" 8th & 9th December, 2012 ( 13 Dec, 2012 )
  • 32. UPCOMING CONFERENCES - INDIA Conference Name : Amasicon2006: Date & Venue : March 31st April 1st & 2nd Kolkata, Hotel Hyatt Regency-Venue, Contact Address : ILS MultispecialityClinic-Surgery, Jeewansatya, DD-6, Sector 1, Salt Lake City, Kolkota, West Bengal Pin:700064 Office & Mobile Phone : Office: +91-33-23593700, Mobile: +91-9830400300, Telefax: +91-33-23214912 Email & Web : Email: secreteriat@amasicon2006.com Web: www.amasicon2006.com
  • 33. UPCOMING INTERNATIONAL CONFERENCES - INTERNATIONAL 2012-06-13 International Society for Stem Cell Research 10th Annual Meeting Dates: June 13-16. 2012 Location: Pacifico Yokohama, Yokohama, JAPAN For more information: http://www.isscr.org 2012-06-16 2012 AMA Annual Assembly Meeting Dates: June 16-20, 2012 Location: Chicago, IL, USA For More Information:http://www.ama-assn.org 2012-06-20 Society of Obstetricians and Gynaecologists of Canada 68th Annual Clinical Meeting Dates: June 20-24, 2012 Location: Ottawa, Ontario, CANADA For more information: http://www.sogc.org 2012-06-23 ENDO 2012 Sponsor: The Endocrine Society Dates: June 23-26, 2012 Location: Houston, Texas, USA For more information: http://www.endo-society.org 2012-06-27 8th International Congress on Minimally Invasive Gynecology Sponsors: American Association of Gynecologic Laparoscopists and the Romanian Society of Minimally Invasive Surgery in Gynecology Dates: June 27 - July 1, 2012 Location: Bucharest, ROMANIA For more information: http://www.aagl.org 2012-07-01 ESHRE 2012 Description: 28th Annual Meeting of the European Society of Human Reproduction and Embryology Dates: July 1-4, 2012 Location: Istanbul, TURKEY For More Information:http://www.eshre.eu
  • 34. UPCOMING INTERNATIONAL CONFERENCES - INTERNATIONAL International Academy of Sex Research 38th Annual Meeting Dates: July 8-11, 2012 Location: Lisbon, PORTUGAL For more information: http://www.iasr.org 2012-07-26 North American Council on Adoptable Children 38th Annual Conference Dates: July 26–28, 2012 Location: Crystal City, Virginia, USA For more information: https://www.nacac.org/conference/conference.html 2012-08-02 12th Asia-Oceania Federation of Sexology (AOFS) Meeting Dates: August 2-5, 2012 Location: Matsue, JAPAN For more information: http://www.12aocs.jp 2012-08-12 45th Annual Meeting of the Society for the Study of Reproduction Theme: “Applied Reproductive Biology: Making It Relevant” Dates: August 12–15, 2012 Location: The College of Agricultural Sciences, The Pennsylvania State University, State College, Pennsylvania, USA For more information: http://www.ssr.org 2012-08-22 11th Asian Congress of Urology Sponsor: The Urological Association of Asia Dates: August 22-26, 2012 Location: Pattaya, THAILAND For more information: http://11thacu2012.org 2012-08-26
  • 35. UPCOMING INTERNATIONAL CONFERENCES - INTERNATIONAL SMSNA/ISSM Joint Annual Meeting Sponsor: Sexual Medicine Society of North America Dates: August 26-30, 2012 Location: Sheraton Chicago Hotel & Towers, Chicago, IL, USA For More Information: http://www.smsna.org 2012-09-05 21st SLS Annual Meeting and Endo Expo 2012 Sponsor: Society of Laparoendoscopic Surgeons Dates: September 5-8, 2012 Location: Westin Copley Place, Boston, MA, USA For More Information: www.sls.org 2012-09-06 CFAS 2012 Sponsor: Canadian Fertility and Andrology Society Dates: September 6-9, 2012 Location: Ottawa Westin, Ottawa, Ontario, CANADA For More Information: www.cfas.ca 2012-10-20 ASRM 2012 Description: 68th Annual Meeting of the ASRM Dates: October 20-24, 2012 Place: San Diego Convention Center, San Diego, California, USA For More Information: ASRM, Tel: 205-978-5000, Fax: 205-978-5018, Email: asrm@asrm.org
  • 36. UPCOMING INTERNATIONAL CONFERENCES - INTERNATIONAL 2012-12-06 (ESSM) 15th Congress of the European Society for Sexual Medicine (ESSM) Dates: December 6-9, 2012 Location: Amsterdam, THE NETHERLANDS For more information: http://www.essm.org 2013-03-07 The Best of ESHRE & ASRM Dates: March 7-9, 2013 Location: Atlantis, Paradise Island, BAHAMAS For more information: http://www.asrm.org/Atlantis2013/ 2013-04-17 2013 Pacific Coast Reproductive Society Annual Meeting Dates: April 17-21, 2013 Location: Renaissance Esmeralda, Indian Wells, CA, USA For More Information: http://www.pcrsonline.org 2013-05-04 2013 ACOG Annual Clinical Meeting Dates: May 4-8, 2013 Location: New Orleans, LA, USA For More Information: http://www.acog.org/ 2013-06-15 2013 AMA Annual Assembly Meeting Dates: June 15-19, 2013 Location: Chicago, IL, USA For More Information: http://www.ama-assn.org 2013-10-12 Joint ASRM/IFFS Meeting Description: 69th Annual Meeting of the ASRM held conjointly with the Meeting of the International Federation of Fertility Societies Dates: October 12-17, 2013 Place: Boston Convention and Exhibition Center, Boston, MA, USA For More Information: ASRM, Tel: 205-978-5000, Fax: 205-978-5018, Email: asrm@asrm.org: Website: http://www.asrm.org/IFFS-ASRM2013/ 2014-04-23 2014 Pacific Coast Reproductive Society Annual Meeting Dates: April 23-27, 2014 Location: Renaissance Esmeralda, Indian Wells, CA, USA For More Information: http://www.pcrsonline.org
  • 37. UPCOMING INTERNATIONAL CONFERENCES - INTERNATIONAL 2014-06-07 2014 AMA Annual Assembly Meeting Dates: June 7-11, 2014 Location: Chicago, IL, USA For More Information: http://www.ama-assn.org 2014-10-18 ASRM 2014 Description: 70th Annual Meeting of the ASRM Dates: October 18-22, 2014 Place: Hawaii Convention Center, Honolulu, HI, USA For More Information: ASRM, Tel: 205-978-5000, Fax: 205-978-5018, Email: asrm@asrm.org 2015-06-06 2015 AMA Annual Assembly Meeting Dates: June 6-10, 2015 Location: Chicago, IL, USA For More Information: http://www.ama-assn.org 2015-10-17 ASRM 2015 Description: 71st Annual Meeting of the ASRM Dates: October 17-21, 2015 Place: Baltimore Convention Center, Baltimore, MD, USA For More Information: ASRM, Tel: 205-978-5000, Fax: 205-978-5018, Email: asrm@asrm.org 2016-06-11 2016 AMA Annual Assembly Meeting Dates: June 11-15, 2016 Location: Chicago, IL, USA For More Information:http://www.ama-assn.org