Technology will Democratize Infertility Treatments

Dr Sahil Gupta, Founder, Aveya Fertility And IVF CentreInfertility rates are rapidly increasing around the world and the current rates are approximately 15% in the reproductive age group. However, couples that receive successful infertility treatment are less than 1%. The major barriers to the broader use of Assisted Reproductive Technology (ART) are lack of access, high cost, complexity of treatment, and low success rates. Patients face challenges globally in accessing IVF due to financial reasons. Based on many reports, the total available market for IVF is 4x larger than the current market with cost being the only barrier.

In addition, Infertility is feared deeply in India because it affects status and security in society. Not only is there scarce counseling and information on the treatment options, but it also has both emotional and financial consequences. A typical IVF cycle in India costs around $2000 to $3,000. While this is significantly lower than in more developed countries like the United States and the United Kingdom, an average Indian family has a hard time sacrificing this amount considering the success rates are less than 50%. It is for this reason, therefore, that lowering the cost of in vitro fertilization can be a way to help more couples to conceive.

A person going through a cycle of in vitro fertilization goes through a multi-stage process to conceive a child. In the first stage, the woman is given fertility medications (hormones) to stimulate the follicles (eggs) in the ovary. The eggs are then surgically retrieved. In the laboratory, the eggs are mixed with a sample of sperm from either the partner or another donor to facilitate fertilization.
Fertility specialists can use Artificial Intelligence to predict the best ovarian stimulation protocol for couples based on data from the past and avoid ovarian hyperstimulation and stimulation failures. Other significant costs and variability reductions can be brought about by opportunities of Artificial intelligence. As a field, reproduction science has been slow to pursue opportunities in AI for reasons that are not at all clear. AI has remarkable potential to overcome the barriers of cost, access, and low success rates.

Consider the extremely manual and labor-intensive processes of ART as it is today. Success rates depend on numerous variables. While some variables are patient-specific and are uncontrollable, many others are rooted in the process, including sperm, oocyte, and embryo selection to fertilization to implantation. Lack of automation leads to excessive inter-user variability, who are not formally trained. Indeed, skilled embryologists can be quite successful after years of training and practice. However, the learning curve and inconsistency across providers are rate-limiting. These factors are also a source of considerable costs for the practice. Automating and streamlining the entire process should reduce overhead costs to fertility practices and increase access and reduce costs for patients.

It is useful to highlight some examples of how AI can be applied to the practice of ART. For instance, researchers have had promising successes in using AI to identify and characterize the most viable embryos. Indeed, as the dataset expands and additional ML continues, the AI can refine its accuracy & analytical capability and get better outcomes.

The automation of Intra Cytoplasmic Sperm Injection (ICSI) is a necessary step that can help the industry to circumvent the shortage of skilled embryologists and ensure consistent results among different technicians and clinics.

On the business side, the last decade has seen dramatic changes in trends that necessitated changes in the commercial approach of the industry. Most patients of IVF clinics are couples in their 30s and early 40s. The new digital customers prefer using data to make decisions. Over the past decade, online fertility platforms have grown by ~20x. Many patients use social media websites share information about their IVF journey. These websites have a lot of information and reviews about the procedure, success rates, and emotional as well as financial impact of the treatments.

In the next decade, new low-cost clinics will be launched with disruptive technologies to challenge the status quo and bring down the existing prices of infertility treatments and increase success rates.