Partnership & Recruitment

Red to Green: The UK's System for Rating IVF Add-Ons compared to US

Thirteen add-ons have been evaluated by a British public agency. In U.S., fertility patients and doctors are mostly on their own.

This News Digest Brought to You by
AIVF™

 
 

BY RON SHINKMAN

The United Kingdom is not only the birthplace of IVF, but of a distinctive ratings system of “add-on” services unique among developed countries.

In 2019, U.K.’s Human Fertilisation and Embryology Authority – an affiliate of its National Health Service – introduced a rating system on add-on services. First known as “Traffic Light,” the ratings initially followed a color-coded system of green, yellow and red. However, the ratings expanded earlier this year into five colors, according to an HFEA spokesperson.

A green rating means the add-on can improve the outcome; yellow means improvement is unclear. A black rating means the add-on has no impact on the treatment outcome. A red rating means the add-on could actually degrade the chance of a positive outcome, or even pose safety concerns for the patient. A gray rating means there is not enough clinical evidence to evaluate the add-on.

The ratings are based on research and analyses conducted by an HFEA subcommittee called the Scientific and Clinical Advances Committee. Currently, 13 add-ons have received grades. They include assisted hatching, endometrial scratching, PGT-A and time-lapse imaging and incubation. The ratings are for the procedures only, and do not apply to individual companies. However, “in line with the HFEA Code of Practice, clinics must give patients a clear idea of what any treatment add-on will involve, how likely it is to increase their chance of a successful pregnancy…how much it will cost, and link to the HFEA ratings system,” said HFEA CEO Peter Thompson said in a statement on the agency’s website.

No add-on has received a green rating. All-cycle elective freezing, endometrial scratching and a process known as “EmbryoGlue” have all received yellow ratings. IVIG, the use of glucocorticoids and endometrial receptivity testing have all received red ratings. IMSI, assisted hatching, immunological testing and treatments for fertility and intrauterine cultures all received gray ratings.

“I don’t think there is anything like this in any part of healthcare in the U.S.,” said Sean Tipton, chief advocacy and policy officer for the American Society for Reproductive Medicine. Tipton added that the fact the United Kingdom has a nationalized single-payer healthcare system means the government takes a much larger role compared to other countries in assessing and rating treatments.

Kate Devine, M.D., an OBGYN who works as medical director and chief research officer for Shady Grove Fertility, noted that patients and clinicians in the U.S. are largely on their own regarding the use of add-ons.

“Unfortunately, in the U.S. patients and their physicians must decide on a case by case basis whether there is enough evidence to warrant the additional cost, time, and/or discomfort entailed by IVF add-ons,” she said.

That’s further compounded by the fact that many fertility patients have done deep research on reproductive medicine and are highly driven to succeed. “They are often willing to try anything and everything, and sometimes beg for unvalidated add-ons,” Devine said.

As for Shady Grove, Devine said that it prefers to offer only add-ons that have a clear benefit, ideally proven through clinical trials. Devine said the practice conducted a randomized controlled trial on endometrial receptivity testing that was published in JAMA late last year.  Igenomix, the biotech company that created the add-on, collaborated, by providing free embryo genetic testing and endometrial receptivity testing to patients who participated in the study. The conclusion: Such testing doesn’t improve the chances of a pregnancy. “It should not be offered on a routine basis,” Devine said.

As for Shady Grove, Devine said that it prefers to offer only add-ons that have shown efficacious results in clinical studies. Devine said the practice sponsored and was the investigator for a study published in JAMA late last year on endometrial receptivity testing. The study was conducted with the cooperation of Igenomix, the biotech firm that created the add-on. The conclusion: Such testing doesn’t improve the chances of a pregnancy. “It’s not something that should probably be offered,” Devine said.

What guidance is offered to patients in the U.S. is more informational than advisory. For example, ASRM has materials on its website regarding add-ons and research about their outcomes, but none of the material is rated in any fashion.

“Our (medical) practice committees and other committees are in the business of trying to inform our members with the latest research so they can better inform their patients,” Tipton said.

However, translating such communications for the general public is complicated. Too high a level of detail overcomplicates the ability to make a decision about a specific add-on. But Tipton also believes that the Traffic Light system oversimplifies the issue.

“There is no way to control (for a specific patient),” he said. “Maybe it’s a green light for me, and maybe it’s a yellow light for somebody else, based on what the underlying conditions are.” Tipton noted that may be the “price to pay” to have a ratings system that is simple for everyone to understand.

Whether the U.S. ever gets an official rating system for add-ons remains in the air. But Devine noted that patients are going to keep coming in for treatment no matter what. 

“Until these things are proven, the better part of valor is to keep calm and transfer another embryo,” she said.

The themes reported in this publication are those of the news. They do not reflect the views of Inside Reproductive Health, nor of the Advertiser

Increase your Clinic’s Operational Capacity by 30% Without Adding Staff

Learn how EMA by AIVF™ enhances the accuracy and efficiency of IVF Clinics through: 

  • Objective decision-making. EMA is 30 times faster and as high as 38% more accurate than a human embryologist.

  • Empowering effectiveness by analyzing substantial data for real-time evaluation compared to traditional methods. 

  • Increasing IVF success rates nearing ~65% and reducing patient time to pregnancy by 21.5% on average. 

Cost Efficiency Calculator

See how EMA can unlock your business potential by providing a FREE analysis below.

 
 

This News Digest Brought to You by
AIVF™

 
 

All external links active as of 1/11/24.

External links are being provided as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by Fertility Bridge or Inside Reproductive Health of any of the products, services or opinions of the corporation or organization or individual. Neither Fertility Bridge nor Inside Reproductive Health bears responsibility for the accuracy, legality or content of the external site or for that of subsequent links. Contact the external site for answers to questions regarding its content.

Private Equity Backed Solutions to REI Shortage. ASRM, SREI Oppose Reducing Fellowship Length

Inside Reproductive Health follows up on fall Wall Street Journal article

This News Digest Brought to You by
The Prelude Network

 
 

BY: MALLIKA MITRA

Fertility clinics still face a shortage of specialists to meet the demand for their services. 

Proposed solutions include funding for REI fellowships from private equity-backed clinics — and shortening the length of Fellowship. Inside Reproductive Health followed up on the Wall Street Journal’s report of the debate, published in early October. 

Funding REI Fellowships 

There are just 49 reproductive endocrinology and infertility fellowship programs in the 2022-2023 academic year, according to the Accreditation Council for Graduate Medical Education (ACGME). In the past five years, there has not been an unfilled reproductive endocrinology position once matching algorithm was processed — every available REI position in the matching program was filled, data from the National Resident Matching Program shows. Data on obstetrics and gynecology fellowship matches for the 2024 appointment year show there is just one reproductive endocrinology fellowship unfilled. 

More recently, private-equity-backed private practices are showing an increased willingness to self-fund fellowship programs, said Rachel Weinerman, MD, of the University Hospitals Fertility Center. The challenge is that the goal of private equity may not align with that of academic practice, Weinerman said: The goal of private equity backed groups may be to increase profitability while the goal of an academic practice is to train a well-rounded fellow who is able to further scientific knowledge in the field.  

Dr. John Storment, an REI practicing in Louisiana, said there isn’t an issue with allowing private equity to help with the growing demand for REI fellowships as long as the fellowships and training remain pure and without any strings attached. 

“We have to maintain our integrity… and not let the industry dictate how we treat patients,” Storment said. Private-equity backed fellowships should not have different admission criteria, job benefits, salaries or opportunities than other fellowships, and they can’t be allowed to require a fellow to later join the private practice that’s providing the training, he added.  

Storment said he is not afraid that private equity funding is currently compromising integrity. But ensuring it stays that way should be a top priority, he added.   

Beth Zoneraich, CEO of Webster Equity Partners-backed Pinnacle Fertility, said multiple options need to be considered to meet demand. She is working on creating a program with key industry partners to train OBGYNs to assist REI physicians in practicing fertility treatment. She said that with appropriate training and REI supervision, OBGYNs could support REI physicians by performing initial fertility assessments, basic fertility workups and various REI procedures. They can also oversee routine follow-ups and monitor patient responses throughout the treatment process, guided by REI physicians, she adds. 

“When you look at needing to meet a supply-demand imbalance, certainly increasing the number of REIs — either through reducing the time of the fellowship or increasing the number of fellowships — are both options that should be considered. But also looking to OBGYNs to help is critically important,” Zoneraich said. 

Potential of Shortening the REI Fellowship

The REI fellowship was initially two years but was expanded to three years to account for an extra year of research. There is now talk in the industry of shortening the fellowship back to two years in an effort to increase the number of fellows. 

“The importance of training motivated, talented researchers in the field of REI should be maintained as a paramount goal,” said Kate Devine, M.D. and medical director and chief research officer at US Fertility, which is owned by Amulet Capital Partners. “That said, we can't turn people who are not researchers into researchers, and that is the rationale behind potentially shortening the fellowship to two years, rather than paying to support 18 months of research training for every REI in training.” 

Jay Rose, managing partner and co-founder at Amulet Capital Partners could not be reached for comment. 

Devine added that shortening the fellowship to two years could be a good solution if and only if two things were guaranteed: extra funds that would result from shortening the fellowship were used to train additional fellows, and that funds would be earmarked to provide the best possible training to those trainees who were motivated and talented in research. 

An ad hoc committee of the Society for Reproductive Endocrinology and Infertility (SREI) co-authored a white paper, which was endorsed by the American Society for Reproductive Medicine (ASRM), in September that recommended not shortening the fellowship to two years. 

“Our lens is that of what’s best for patients, what’s best for patient care and what’s best for our trainees so that they can go out and optimize patient care,” Erica Marsh, president of SREI and board member of ASRM, told Inside Reproductive Health. “That generally requires that they spend time learning about not only the physiology and pathophysiology of the diseases that we treat, but also understanding how to interpret research and apply research findings to clinical care independent of whether or not they ever conduct research.” 

OBGYN and Advanced Practice Provider (APP)’ roles 

TJ Farnsworth, CEO of Lee Equity Partners-backed Inception Fertility, said more practices have to better utilize APPs to the highest level of their licenses to try and improve the capacity of REIs. That would include more complex ultrasounds, IUIs, pre-consult workups and minor procedures. He added that there’s a move toward using generalist OBGYNs to provide fertility care, but his company has decided not to do that at this point. 

“Using generalists as part of fertility practices to me makes sense as long as you’re talking about them doing general care,” Farnsworth added. That may include hysteroscopies, HSGs, and surgical cases so that the REI can focus on fertility patients.

Zoneraich agreed that there are places where APPs can and should do tasks that they are able to do instead of having the physicians do them, such as monitoring ultrasounds, baseline testing, consultations for less complicated cases and intrauterine inseminations (IUI). That will give physicians the ability to do more new patient consults or follow-up consults, for example, she added.

The themes reported in this publication are those of the news. They do not reflect the views of Inside Reproductive Health, nor of the Advertiser

Shape the Future of Fertility with The Prelude Network

Embark on a transformative career with Prelude Fertility, where innovation in reproductive healthcare meets unparalleled professional growth. In our rapidly expanding network across North America, you'll harness advanced technology and collaborate with leading fertility experts, playing a key role in bringing joy to aspiring parents and redefining the future of fertility treatments.

Why join Prelude? Because here, you're part of something bigger. You're at the forefront of a network that’s constantly pushing the boundaries of fertility care. Together, we can shape a brighter future for families and set new standards in healthcare.

Discover how you can be a part of what's next in fertility. Visit rei.preludefertility.com and take the first step towards a career that's as fulfilling as it is trailblazing.

 
 

This News Digest Brought to You by
The Prelude Network

 
 

All external links active as of 1/4/24.

External links are being provided as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by Fertility Bridge or Inside Reproductive Health of any of the products, services or opinions of the corporation or organization or individual. Neither Fertility Bridge nor Inside Reproductive Health bears responsibility for the accuracy, legality or content of the external site or for that of subsequent links. Contact the external site for answers to questions regarding its content.

Simplified psychological evaluation for donors, gestational carriers, and intended parents revolutionizes third party IVF

Texas Fertility Center saves $100 per donor evaluation, Northstar Fertility portfolio company ensures compliance

This News Digest Is Paid Sponsored Content From
Mind360

 
 

BY: Rachel Leland

The lengthy, arduous process of conventional psychological evaluations often stalls fertility journeys for weeks or months, but a new telehealth platform is already speeding up the process while improving screening quality.  

You can send people to Labcorp to get a lab almost right away. You can get several screening tests done in a very short period of time, Mind360 executive director Julius Varzoni said. “[The psychological screening] was the only one that was taking weeks to get done…and we brought it down to a couple of days.”

Mind360 allows potential donors, gestational carriers, and intended parents to book a virtual psychological evaluation in 30 seconds with just a few clicks. Within two business days after the appointment, clients receive a comprehensive report of the assessment with all the ASRM criteria included.

As of November, roughly 167 million Americans live in an area with mental health provider shortages, with over 8,000 more providers needed to ensure adequate care. The average wait time to see a mental health professional is six weeks, according to the National Council for Mental Wellbeing.

Northstar Fertility portfolio company ensures compliance

Everie, the newest addition to Northstar Fertility’s portfolio, works with donors from across the country, which made finding qualified mental health professionals in every state a donor lived in cumbersome. 

“Before Mind360, we really had to make a lot of different relationships to ensure we were in compliance and then we had to nurture those relationships because we wanted to have reports that were similar even though we had been working with several businesses to get the job done,” Everie President Aisha Lewis said.

Furthermore, even available mental health professionals may be unfamiliar with the standards for third-party psychological evaluation set forth by the American Society for Reproductive Medicine. 

While Mind360 employs Ph.D. psychologists to conduct screenings, clinics often hire social workers, Varzoni said, adding that even then, thorough screenings are not guaranteed and some practitioners charge more for specialized services.

Silverberg: TFC saves $100 per mental health eval

Before partnering with Mind360, Texas Fertility Center would refer potential donors to local mental health professionals in Austin, but test results were not as specialized as desired, Dr. Kaylen Silverberg said. 

“It’s kind of like forcing a square peg into a round hole,” Silverberg said. “People don’t just do this, they do all kinds of therapy for different patients. We’ve allowed patients to use their own therapists and their own therapists who may not know anything about reproductive services or the questions we’re getting at. Here we see a lot more consistency.”

Silverberg estimated that Texas Fertility Center had saved up to $100 per evaluation since partnering with Mind360. 

In some areas of the country, the savings add up to 50% through utlizing Mind360’s services, Varazoni said.

Organic Growth

Since launching in August 2022, Mind360 has grown its business to 25 clients, including Cryos,  Fairfax EggBank, Nodal, and the recently launched Everie. By December, Mind360 will have conducted 2,500 psychological screenings in its first year, Varzoni said. 

Clients like Lewis said Mind360's most considerable value wasn't simply cost or time savings, but the personal attention its psychologists provide.

Often, when working with non-specialists in mental health, clinics or egg banks need to inform potential donors if they failed the screening, but Lewis prefers how Mind360 psychologists inform the donors directly. 

“I think, if the donor is not a good fit for the organization right now, that's a conversation that should be had at that level of the psychologist and donor, so they do that and I appreciate that. I really appreciate that,” Lewis said.

This News Digest Story is paid featured sponsor content, where the Advertiser has editorial control. They do not reflect the views of Inside Reproductive Health.

Wait time for third party IVF mental health screening reduced from six weeks to a few days

Mind360 shares their average psychological evaluation wait times and cost savings for intended donors, recipients, and gestational carriers.

Don’t let cost or limited availability delay your patient’s cycle. Download Mind360’s informational report to find out how quickly this process can be completed and compare it to your own services.

Mind360 provides:

  • Seamless online booking

  • Immediate availability

  • Telehealth appointments

  • ASRM trained psychologists

  • Compliance with ASRM and FDA recommendations 

Learn how your clinic’s process can be sped up and improved by clicking the button below.

 
 

This News Digest Is Paid Sponsored Content From
Mind360

 
 

All external links active as of 12/14/23.

External links are being provided as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by Fertility Bridge or Inside Reproductive Health of any of the products, services or opinions of the corporation or organization or individual. Neither Fertility Bridge nor Inside Reproductive Health bears responsibility for the accuracy, legality or content of the external site or for that of subsequent links. Contact the external site for answers to questions regarding its content.

IVI RMA’s Plans for Boston IVF’s Stern, TRIO’s Condon, brands, staff, after $535M Eugin Sale

The two chains are part of the assets the KKR-owned IVI RMA and GED Capital has just bought from the Eugin Group.

This News Digest Brought to You by
Family Inceptions

 
 

BY: RON SHINKMAN

IVI RMA has pursued one of the largest acquisitions of a reproductive medicine group in the United States, agreeing to acquire the North American assets of the Eugin Group – including Boston IVF and TRIO – as part of a larger deal to buy the entire company.

The transaction sheds a little light on how private equity firm KKR – which owns IVI RMA  – will consolidate and manage its recent dive into reproductive medicine. KKR finalized its acquisition of the Spanish-based IVI RMA earlier this year for $3.2 billion.

In conjunction with Spanish private equity firm GED Capital, IVI RMA is acquiring the Eugin Group assets for around $535 million from Fresenius Helios, the German-based hospital operator and dialysis giant. 

While IVI RMA will own and operate the Eugin clinics in the U.S. and Canada, GED Capital will own and operate the three-dozen clinics in Spain, Italy, Sweden, Denmark, Latvia and Portugal. It will also operate the Latin American properties in Brazil, Argentina and Colombia, GED spokesperson Alicia Hernández told Inside Reproductive Health.

A spokesperson for IVI RMA told Inside Reproductive Health that the acquisition of both Eugin’s North American and global operations are part of the same transaction. He declined to break out terms for the U.S. portion of Eugin’s assets. Hernandez also declined to break out terms for the GED portion of the purchase, but noted that the European and Latin American operations generate about $110 million in annual revenue.

Fresenius acquired Eugin less than three years ago for around $460 million from NMC Health. 

A KKR spokesperson has not responded to a request seeking comment.

IVI RMA’s acquisition includes two fertility clinic chains: Boston IVF and the Toronto-based TRIO. IVI RMA’s footprint in North America will expand from its current 29 clinics and 10 laboratories to 62 clinics and offices and 23 laboratories. Altogether, the combined enterprise will have more than 4,000 employees in North America.

There are no plans to rebrand Boston IVF and TRIO. The IVI RMA spokesperson said both will continue to operate under the same names.

“IVI RMA in other parts of the world have multiple brands in countries like Spain and Italy, so it’s not unusual for them to do that,” Boston IVF CEO David Stern told Inside Reproductive Health. He added that he will continue with the company in the same position.

The IVI RMA spokesperson also confirmed that TRIO CEO Nicole Condon will remain with the company. Condon could not be reached for comment. Both Stern and the company spokesperson said there are no layoffs planned after the acquisition closes.

Meanwhile, IVI RMA’s U.S. division recently named Lynn Mason as its president. The spokesperson said she will oversee all of the operations for IVI RMA, TRIO and Boston IVF.

“We’re actually continuing to expand and grow our network,” Stern said. He noted that Boston IVF recently opened a new clinic in Rochester, N.Y. Another expansion is planned for Springfield, Mass. before the end of the year. That new clinic will be based at the Baystate Medical Center in Springfield and be called Boston IVF at Baystate, Stern said. He suggested that expansion would continue in conjunction with IVI RMA.

“We’re really excited, because IVI RMA already has a strong brand in the United States and globally,” Stern said. He added that IVI RMA is also very strong in terms of research and training, and that Boston IVF’s ongoing fellowship programs with Harvard Medical School and Beth Israel Deaconess Medical Center in Boston will complement IVI RMA’s existing fellowship programs.

Stern said he expects the acquisition of the Eugin Group’s North American assets to close during the first quarter of 2024, in line with when IVI RMA said the entire Eugin acquisition will close.

The themes reported in this publication are those of the news. They do not reflect the views of Inside Reproductive Health, nor of the Advertiser

Compare Your Third Party IVF Cycle Pricing

Family Inceptions reveals cost averages for IVF cycles with Gestational Carriers.

See How Your Center Compares on

  • Surrogate and Partner Workup

  • Embryo Transfer with Gestational Carrier

See Price Averages for IVF Centers in all four quadrants of US

  • Northwest

  • Southwest

  • Northeast

  • Southeast

See how your Third Party IVF Program stacks up by clicking the button below

 
 

This News Digest Brought to You by
Family Inceptions

 
 

All external links active as of 11/16/23.

External links are being provided as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by Fertility Bridge or Inside Reproductive Health of any of the products, services or opinions of the corporation or organization or individual. Neither Fertility Bridge nor Inside Reproductive Health bears responsibility for the accuracy, legality or content of the external site or for that of subsequent links. Contact the external site for answers to questions regarding its content.

Meikle’s and Larkin’s New Roles at The Fertility Partners

Larkin one of two fertility CEOs to take top job at other network

This News Digest brought to you by
The World Egg & Sperm Bank

 
 

BY: Lisa Munger

The Fertility Partners (TFP) announced Derek Larkin as its new CEO on August 16, the same month that Cara Reyman took over as CEO of First Fertility, Larkin’s old post. Reyman was the CEO of a different fertility clinic network, Fertilitas, from July 2022 to July 2023.

Andrew Meikle, founder of TFP, served as the company’s first CEO from September 2019 to August 2023. Meikle will continue to serve as founder and executive chairman as the transition occurs to supporting partner relationships, corporate development and strategic decision-making. 

The Fertility Partners, founded in 2019, is a network of fertility practices with 36 clinic locations across North America, including 14 IVF centers. With more than 75 physicians and 1,000 employees, TFP operates in six provinces in Canada.

Larkin's experience extends beyond his time as CEO of First Fertility from May 2020 to July 2023. He held various leadership positions over a span of 12 years at Boston IVF, including CEO. In his roles at Boston IVF, Larkin demonstrated developed expertise in managing operations and guiding strategic direction, according to TFP. 

This background places him in an ideal position to lead TFP and further enhance its offerings to partner clinics, according to TFP. 

"My life's work has been in fertility, striving to improve the patient experience along their journey of family building," Larkin said in a statement. “I am excited to continue to lead this amazing organization with that purpose.” 

“This is a transformational time in our business, and we are very excited to have Derek guide the TFP team as we continue our growth across North America,” Meikle said in a statement.  “We have a tremendous alignment of vision and values, and his extensive operational expertise, sector knowledge and leadership will enhance our offering to partner clinics.”

Dr. Brijinder Minhas was a partner and COO at NewLIFE in Florida for 22 years before it was acquired by First Fertility in 2022. MidCap Advisors were investment bankers. After the sale, Minhas joined MidCap as vice president of healthcare.

“It is important that management companies truly understand the nuances of the practice they are dealing with,” Minhas said. 

“Having managers and C-suite folks with prior fertility experience, in my opinion, is essential and leads to a much more productive and profitable relationship … The reasons for the shake-up at First Fertility are not known. A good warning for other CEOs: ‘Hire the right team and keep both the practices and private equity bosses happy.’ Ultimately, clinicians want to provide the best patient care, and management partners want to maximize profitability. A good balancing act is required.”

Meikle and Larkin declined to comment on the transition for the purposes of this article.

The themes reported in this publication are those of the news. They do not reflect the views of Inside Reproductive Health, nor of the Advertiser

Amplification:
10/4/23, KKR Moves to Acquire Eugin Group for $525M, Fresenius declined to comment about the Eugin deal.

Protect Your IVF Program from Human Traffickers

Your practice and patients are vulnerable to using eggs from victims of human trafficking.

Without proper safeguards, fertility clinics like yours may unknowingly be selling the eggs of these trafficked victims, exposing your patients and your clinic to legal complications. 

There are precautions you can take to minimize your risk. The World Egg & Sperm Bank has created a free due diligence checklist that you can download now to ensure that your clinic only sells eggs from donors who have been safely and ethically protected.

This comprehensive checklist will help you determine the source, procurement process, and traceability of biological materials while also creating higher quality best practices for your patients in egg and sperm selection.

Protect your patients. Protect your practice. Protect the future of fertility by grabbing a copy of TWESB’s due diligence checklist today!

 
 

This News Digest Is Paid Sponsored Content From
The World Egg & Sperm Bank

 
 

All external links active as of 10/12/23.

External links are being provided as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by Fertility Bridge or Inside Reproductive Health of any of the products, services or opinions of the corporation or organization or individual. Neither Fertility Bridge nor Inside Reproductive Health bears responsibility for the accuracy, legality or content of the external site or for that of subsequent links. Contact the external site for answers to questions regarding its content.

KKR Moves to Acquire Eugin Group for $525M

The deal would make the investment banking firm one of the biggest global players in the fertility space.

This News Digest brought to you by
The World Egg & Sperm Bank

 
 

BY: RON SHINKMAN

Months of speculation as to which company would have the resources to purchase the massive fertility network the Eugin Group has narrowed down to a single candidate: Investment banking giant KKR. The deal could help it become one of the biggest global players in the fertility sector.

The Spanish media outlet CincoDías reported this week that KKR has entered into exclusive negotiations with Eugin’s parent company, Fresenius Helios, to make the purchase for an estimated $525 million. The investment banking firm Lazard is also involved in the transaction, according to CincoDías. Lazard helped Fresenius in consummating a $551 million biopharmaceutical acquisition last year.

KKR has been making significant inroads into the fertility space in the past couple of years. It acquired IVIRMA for about $3.2 billion earlier this year. It performed nearly 80,000 IVF cycles in 2021, primarily in Europe, but it also has clinics in the U.S. and Latin America. KKR also acquired the smaller GeneraLife Group last year, which performed some 25,000 cycles in 2021. It operates 30 clinics in Spain, Italy, the Czech Republic, Sweden and Portugal.

A KKR spokesperson declined to comment. Spokespersons for Fresenius and Lazard did not immediately respond to requests seeking comment.

Eugin operates 69 clinics in 11 countries on three continents, performing 45,000 cycles a year. And it is a big player in North America, owning and operating the Boston IVF network and TRIO, one of the biggest fertility practices in Canada. It also has a significant footprint in Latin America, with clinics in Colombia and Brazil. In Europe it has a large presence in Spain, along with clinics in Italy, Latvia and Sweden. 

Although Fresenius has only owned Eugin since late 2020, it is not a core business for the company, which is a leading dialysis provider in the U.S. and operates more than 80 hospitals in Europe. It has been under pressure to divest Eugin after Elliott Investment Management acquired a large stake in the company about a year ago and its management expressed dissatisfaction with Fresenius’ financial performance. The company’s stock has risen by about 33% since Elliott purchased the stake, although shares dropped about 7% since the news of a potential sale to KKR was made public.

Robert Goodman, vice president in charge of healthcare for New York City-based MidCap Advisors, said a sale to KKR makes sense. 

“It is a very large, very savvy firm that has made some big inroads into healthcare, and they are clearly a company with the capacity to do this,” Goodman said. He added that if KKR were to close the deal, it would likely use all its recent acquisitions to become the predominant player in the fertility space. 

“They will have a big footprint to get it started, and if they have their eyes on that prize, they have the capability,” Goodman said. “There’s no question about that.”

The themes reported in this publication are those of the news. They do not reflect the views of Inside Reproductive Health, nor of the Advertiser

Protect Your IVF Program from Human Traffickers

Your practice and patients are vulnerable to using eggs from victims of human trafficking.

Without proper safeguards, fertility clinics like yours may unknowingly be selling the eggs of these trafficked victims, exposing your patients and your clinic to legal complications. 

There are precautions you can take to minimize your risk. The World Egg & Sperm Bank has created a free due diligence checklist that you can download now to ensure that your clinic only sells eggs from donors who have been safely and ethically protected.

This comprehensive checklist will help you determine the source, procurement process, and traceability of biological materials while also creating higher quality best practices for your patients in egg and sperm selection.

Protect your patients. Protect your practice. Protect the future of fertility by grabbing a copy of TWESB’s due diligence checklist today!

 
 

This News Digest Is Paid Sponsored Content From
The World Egg & Sperm Bank

 
 

All external links active as of 10/5/23.

External links are being provided as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by Fertility Bridge or Inside Reproductive Health of any of the products, services or opinions of the corporation or organization or individual. Neither Fertility Bridge nor Inside Reproductive Health bears responsibility for the accuracy, legality or content of the external site or for that of subsequent links. Contact the external site for answers to questions regarding its content.

Why Amazon Chose Maven for Fertility Benefits in These 50 Countries, Sticks with Progyny in US, Canada

The partnership will provide free fertility and family building coverage to Amazon employees in 50 countries outside the U.S. and Canada.

This News Digest brought to you by
The World Egg & Sperm Bank

 
 

BY: ROSEMARY SCOTT

Amazon employees in 50 countries outside the U.S. and Canada will soon have access to free fertility and family-building services as part of a newly-formed partnership with Maven Clinic, the world’s largest virtual clinic for family and women’s health.

Amazon employees will have access to virtual appointments and referrals to local clinics and providers, including board-certified reproductive endocrinologists, obstetricians, gynecologists, nutritionists, mental health providers, adoption coaches and others. This coverage includes IVF, though neither Maven Clinic or Amazon could provide Inside Reproductive Health with specific information regarding how many IVF cycles are covered for each patient. 

Coverage will extend to full-time, part-time and hourly Amazon employees in the following countries:

  • Europe: Austria, Belgium, Croatia, Czech Republic, Denmark, Estonia, Finland, Greece, Iceland, Poland, Portugal, Norway, Republic of Serbia, Romania, Slovakia, Spain, Sweden, Switzerland, United Kingdom

  • Asia / Pacific: Australia, India, Indonesia, Japan, South Korea, Malaysia, New Zealand, Philippines, Singapore, Thailand, Vietnam

  • Latin America: Argentina, Brazil, Chile, Colombia, Costa Rica, Mexico, Peru

  • Middle East and Africa: Bahrain, Egypt, Israel, Jordan, Kenya, Kuwait, Mauritius, Morocco, Nigeria, Saudi Arabia, South Africa, Turkey, United Arab Emirates

Maven Clinic was the first female-focused health start-up valued at over $1 billion and currently manages the care of over 17 million patients through partnerships with hundreds of other companies, including Fortune 500s such as Snap Inc. and Buzzfeed. 

Still, as the world’s second-largest employer with over 1.5 million employees, this partnership with Amazon is a large undertaking for Maven. Amazon told Inside Reproductive Health that it chose Maven due to the company’s global presence and its flexible, digital-first approach that tailors coverage to each individual’s needs. 

Neel Shah, Chief Medical Officer at Maven Clinic, told Inside Reproductive Health that one of the primary challenges of offering fertility services on a global scale is accessibility. Maven is able to work around this challenge by offering a digital first approach, in which each patient is matched with a “Care Advocate” employed by Maven who can meet virtually with patients to offer advice and referrals to the best providers and IVF clinics in the patient’s area.

In some places, Shah said, this is easier than others. For example, he said that in the U.K., there is ample third-party data available in which Maven can determine the quality of each clinic and recommend the best option to their patients. In other countries, he said, that data isn’t available, so Maven has to perform its own vetting process. 

Ultimately, each patient’s care is up to them, and their needs will vary based on their physical locations and reproductive journeys. There are about 4,000 clinics in Maven’s global referral network, but if a patient wants to visit a clinic not recommended by their Care Advocate, “We don’t tell people that they can’t go somewhere,” Shah said. 

Since 2019, Amazon employees in the U.S. and Canada have had reproductive health coverage through Progyny, which has served more than 30,000 Amazon employees since the partnership began. 

Though Progyny was founded in 2008, its larger success began after a rebrand in 2016 and an IPO in 2019. Before Amazon’s partnership with Progyny in 2019, the company’s reproductive health benefits were bundled with its larger benefits package as confirmed by Brad Senstra, CEO of ReproTech and former executive director of Seattle Reproductive Medicine. 

Senstra told Inside Reproductive Health that before 2016, it was much less common for employers in the U.S. to offer fertility benefits, and those that did provide coverage put a cap on how much employees could spend on their treatment, ultimately resulting in lower success rates for patients and higher costs for employers. 

Senstra said that Amazon’s decision to partner with Progyny for its reproductive health coverage in 2019 was likely due to Progyny’s unique benefit structure that did not put a cap on coverage.

Only time will tell if Maven Clinic’s partnership with Amazon will have a similar butterfly effect outside the U.S. In the meantime, Shah said, Maven’s goal is simple: “to provide the best possible care to as many Amazonians as possible.”

The themes reported in this publication are those of the news. They do not reflect the views of Inside Reproductive Health, nor of the Advertiser

Protect Your IVF Program from Human Traffickers

Your practice and patients are vulnerable to using eggs from victims of human trafficking.

Without proper safeguards, fertility clinics like yours may unknowingly be selling the eggs of these trafficked victims, exposing your patients and your clinic to legal complications. 

There are precautions you can take to minimize your risk. The World Egg & Sperm Bank has created a free due diligence checklist that you can download now to ensure that your clinic only sells eggs from donors who have been safely and ethically protected.

This comprehensive checklist will help you determine the source, procurement process, and traceability of biological materials while also creating higher quality best practices for your patients in egg and sperm selection.

Protect your patients. Protect your practice. Protect the future of fertility by grabbing a copy of TWESB’s due diligence checklist today!

 
 

This News Digest Is Paid Sponsored Content From
The World Egg & Sperm Bank

 
 

All external links active as of 9/28/23.

External links are being provided as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by Fertility Bridge or Inside Reproductive Health of any of the products, services or opinions of the corporation or organization or individual. Neither Fertility Bridge nor Inside Reproductive Health bears responsibility for the accuracy, legality or content of the external site or for that of subsequent links. Contact the external site for answers to questions regarding its content.

,

SREI Weighs Options to Deal with Fellowship Scarcity in REI

,

Taking fellowship training from three years to two, corporate-academic partnerships considered primary options

 

BY: LISA MUNGER

There are 49 accredited fellowship programs, as of the Accreditation Council for Graduate Medical Education's most recent data from the 2021-2022 academic year. ACGME assumed accreditation responsibilities for the first year in 2016 from the American Board of Obstetrics and Gynecology; 41 REI fellowships existed. 

As first reported by Inside Reproductive Health, the University of Miami/Jackson Health System Program and the University of Washington Program received ACGME approval in fall 2022, making them the latest programs to receive approval. 

Academic Years and New Programs Accredited By ACGME

2021-2022 University of Rochester

2020-2021 None

2019-2020 SUNY Downstate Health Sciences

2018-2019 None

Before the 2018-2019 academic year, all previously ABOG-accredited programs had to apply for accreditation with ACGME. Thus, in 2016-2018 all existing were re-approved.

What’s more, the National Resident Matching Program matched 49 out of 49 open fellowship positions in 2022. There were 78 individual applicants for REI fellowship program positions for the 2021-2022 academic year in the most recent available data.

The Pipeline for New Programs

ACGME cannot estimate new programs coming in the pipeline. 

“It depends on receiving and approving new program applications,” said Susan Holub, director of communications at ACGME. 

Currently, 49 fellowship programs exist, with 175 fellows, according to ACGME. 

How to Increase REI Fellowships: Challenges

One hurdle in establishing new REI Fellowships is finding qualified faculty. REI is a specialized field; a limited number of qualified physicians can teach in fellowship programs. Another barrier is finding a suitable location for the program. REI programs require access to a large number of patients, as well as state-of-the-art facilities—all costly prospects.

Ruben Alvero, M.D., past president of SREI, professor of Obstetrics and Gynecology at Stanford Medical School and division director of Reproductive Endocrinology and Infertility at the Lucille Packard Children’s Hospital told Inside Reproductive Health there are several impediments to establishing programs and in adding fellows. 

“It's onerous to establish new programs or fellows,” he said. The biggest stumbling blocks that exist are securing financing and in terms of the paperwork and the actual application itself.” 

Alvero said the cost of adding fellows is highly variable, as is the prospect of beginning a new fellowship program. Costs vary based on the geographic area, cost of living, demographics, facilities in place, availability of private partnerships and faculty recruitment needs; thus, no amalgamate data exist as these factors are unique to each case. 

Securing Accreditation: The Process

The process of starting an REI fellowship program is complex and requires a significant investment of time and resources. The first step is to obtain accreditation from the ACGME. A five-step journey is outlined on their website. 

This process involves submitting a detailed application with information about the program's curriculum, faculty and facilities. Once accreditation is granted, the program can begin recruiting fellows.

Step 1—Locate and Read Program Requirements and FAQs

Step 2—Locate and Save Review Committee Staff Contact Information

Step 3—Gather Information Needed to Prepare the Application

  • Complete the specialty-specific application, which can be found on the Program Requirements and FAQs and Applications page of the REI specialty section of the ACGME website. 

  • Provide a block diagram for each year of education in the program

  • All Program Letters of Agreement for participating sites with required rotations

  • Policies and procedures for resident/fellow clinical and educational work hours, including policies on moonlighting

  • Policy for supervision of residents and fellows

  • Establish competency-based goals and objectives for one educational experience at each educational level.

  • Evaluation forms for residents/fellows, faculty, program assessors

  • Semi-annual, summative and final evaluation forms

  • Policy for resident/fellow and faculty member well-being 

Step 4—Initiate Application to ACGME’s Accreditation Data System

Step 5—Submit the Application

  • A Letter of Notification (LoN) will be sent through ADS after the Review Committee reviews the application. 

  • The LoN will detail the accreditation decision and any citations or areas for Improvement issued during the review.

  • It can take four to 12 months following the submission of an application to undergo a review and receive an accreditation decision from the Review Committee. 

Viable Options for Expanding Fellows

Alvero said one option under discussion is possibly shortening the fellowship term from three years to two. However, given the rigor the programs require, this may not be an appealing choice. 

Alvero’s colleague and current president of the American Society for Reproductive Medicine, Michael A. Thomas, MD, told Inside Reproductive Health that though ASRM will look to SREI for guidance, as an REI specialist himself, moving from three years to two may be untenable. 

“In a short amount of time, it’s not just learning how to get the eggs and put the embryos back, but also learned understanding the physiology, understanding and contributing to the research,” said Thomas, professor and department chair of Obstetrics and Gynecology at the University of Cincinnati College of Medicine. “From what we know from a clinical standpoint, it takes longer than six months to contribute the research necessary to advance the field.” 

Alvero said that a second option is to secure public/private investments to support academic programs financially. 

One example is private funding from Shady Grove Fertility with publicly-held Walter Reed National Military Medical Center, intended to benefit military families. 

“The program at Shady Grove has fellows from Walter Reed from the National with support through NIH [fellowship program] so that there's a collaboration there,” he said. 

Alvero said he expects more of these collaborations to develop. 

In the interim, Thomas said he hopes more fellows will mean REI specialty services will be available to a broader audience and, promisingly, with insurance coverage to increase access to more marginalized populations. 

“The problem is you can’t just expand a program; they must be good programs. You want to make sure that you have fellows that are being trained rigorously and make sure that those fellows have the opportunity to go wherever they want [rather than limited by geography near major population centers.].”

The themes reported in this publication are those of the news. They do not reflect the views of Inside Reproductive Health.

 
 

All external links active as of 6/8/23.

External links are being provided as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by Fertility Bridge or Inside Reproductive Health of any of the products, services or opinions of the corporation or organization or individual. Neither Fertility Bridge nor Inside Reproductive Health bears responsibility for the accuracy, legality or content of the external site or for that of subsequent links. Contact the external site for answers to questions regarding its content.

,

Number of REI Fellowship programs since ACGME’s takeover from ABOG

,
 

BY: LISA MUNGER

If REI fellowships and physicians with this expertise are limited, there are several consequences, some of which can be seen in evaluating patient care today. Without enough fellowship programs, qualified REI specialists may be unable to care for patients with infertility and other reproductive health issues. Without enough fellowship programs, there may be reduced research on infertility and other reproductive health issues, limiting progress in the field, according to the NIH.

Escalating Need

Rachel Weinerman, M.D. and REI specialist, credited as a nationally-recognized educator in the field, said REI fellowships and specialists are needed now more than ever. REI services demand has experienced a precipitous uptick in recent years, even as the number of fellowships haven’t increased properly to meet the demand. 

Increased coverage for IVF among employer-sponsored insurance and more states requiring coverage accounts for part of the equation. 

The International Foundation of Employee Benefit Plans has tracked fertility benefits over the past since 2016. According to their most recent survey in 2022, 40% of overall U.S. employers  currently offer fertility benefits (an increase from 30% in 2020).

  • 28% cover fertility medications (8% covered in 2016, 14% in 2018, 24% in 2020)

  • 30% cover in vitro fertilization (IVF) treatments (13% in 2016, 17% in 2018, 24% in 2020)

  • 16% cover genetic testing to determine infertility issues (11% in 2018, 12% in 2020)

  • 17% cover non-IVF fertility treatments (6% in 2016, 11% in 2018, 11% in 2020)

“People are accessing IVF services for fertility and fertility preservation, " Weinerman said. “There is a much wider population of people accessing services, including members of the LGBTQ community, who are increasingly seeking IVF services.”

REI Fellowships

There are 49 accredited fellowship programs, as of the Accreditation Council for Graduate Medical Education most recent data from the full 2021-2022 academic year. The National Resident Matching Program’s (NRMP)’s April 2023 The Match report says that there were 41 REI Fellowship programs in 2022. ReportingWhen ACGME assumed accreditation responsibilities for the first year in 2016 from the American Board of Obstetrics and Gynecology; 41 REI fellowships existed.

The University of Miami/Jackson Health System Program and the University of Washington Program received ACGME approval in September 2022, making them the latest programs to receive approval. 

The University of Miami/Jackson Health System Program and the University of Washington Program received ACGME accreditation in September 2022, making them the latest programs to get the nod. 

ACGME cannot estimate new programs coming in the pipeline. 

“It depends on receiving and approving new program applications,” said Susan Holub, director of communications at ACGME. 

The National Resident Matching Program matched 49 out of 49 open fellowship positions in 2022.There were 78 individual applicants for REI fellowship program positions for the 2021-2022 academic year in the most recent available data.

Creating an REI Fellowship: Obstacles

Potential programs must meet the ACGME requirements for the REI specialty and the Common Program Requirements to be accredited. 

The organization is solely responsible for accrediting new programs, said Susan Holub, vice president of communications for ACGME. 

Obstacles are inherent in beginning an REI program, as doing so requires significant resources, expertise and infrastructure. 

Securing funding to developing and sustaining a fellowship program can be difficult, Weinerman said. 

Besides the dollars required to pay staff, upstart also needs to include the resources for educational resources and materials, equipment and technology, according to the American Society for Reproductive Medicine. 

Programs must undergo accreditation by ACGME, which is sometimes a time-consuming and complex process. Further, new programs require many resources, including access to clinical facilities (reproductive surgery spaces, labs for testing and access to assisted reproductive technologies like IVF and IUI. 

Since ACGME took over accreditation from the American Board of Obstetrics and Gynecology in 2016, guidelines for establishing a new fellowship are more stringent and often more complex, which often translates into cost in actual dollars and time. 

“There are very specific guidelines and an intense application process. There's the review, so establishing a new program can take up to a year,” she said.

A Field, Underserved

While training obstetricians and gynecologists in a private setting can provide valuable experience in diagnosing and managing REI issues, it’s not necessarily a sufficient substitute for an REI fellowship, said Ruth Lathi, M.D., program director of the REI Fellowship at Stanford Health Care. 

“This requires access to complex patients and advanced specialists, which are rarely encountered in private clinics,” she said. “While many providers do not care for all aspects of reproductive life, this knowledge is used in managing complex patients with infertility.” 

Nonetheless, she said REI fellowships are needed to further the industry. 

“Without sufficient REI fellowships, there may not be a sufficient pipeline of providers and research to serve the future men, women and people who require reproductive care.”

Weinerman concurred. 

“We have a lot more use of advanced practice providers like NPs, PAs and general OBGYNs to fill those roles because of demands, she said. “There are a lot of practices that have very long waitlist practices because it’s hard to hire REIs … That may change overall the field provides patient care.”

The themes reported in this publication are those of the news. They do not reflect the views of Inside Reproductive Health, nor of the Advertiser

 
 

All external links active as of 4/13/23.

External links are being provided as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by Fertility Bridge or Inside Reproductive Health of any of the products, services or opinions of the corporation or organization or individual. Neither Fertility Bridge nor Inside Reproductive Health bears responsibility for the accuracy, legality or content of the external site or for that of subsequent links. Contact the external site for answers to questions regarding its content.