Friday, January 25, 2013

Nano IVF

Flickr - DFID - A female doctor with the Inter...
With the mushrooming of IVF clinics all across the country, I hope that the quality of care for IVF patients in India will improve. Unfortunately, the tragedy seems to be that most IVF clinics are just copying each other. They are  competing for the same set of patients and doing exactly the same thing. They aggressively super ovulate their patients with high doses of injections ; and use agonists and antagonists for down regulation . They copy the protocols which are laid down in western textbooks and western journals  , without taking into account the fact that these have been optimized for Western patients - not Indian patients. Sadly , none of them are innovating or trying to address the special needs of Indians !

While it's true that reproductive biological systems are the same for women all over the world, it’s also true that Indian women marry much younger ; and that their ability to be able to pay is much more limited. This is actually a huge opportunity for a clever IVF clinic which wants to differentiate itself and create a mark in the world by addressing the needs of infertile couples at “ the bottom of the pyramid” ! Rather than follow standard aggressive IVF super ovulation protocols , Indian doctors need to develop protocols for indigent patients. Typically these would be low-cost protocols , which would involve either letrozole or clomiphene citrate for super ovulation , so that these patients would grow maybe 2-3 follicles ; and the doctor would transfer 1-2 embryos without having to make the patient spend a lot of money .

Indians have a great reputation for innovation and frugality and Indian doctors need to capitalize on this. This actually is a great opportunity to develop new techniques and innovations which can actually help put the IVF doctor who's willing to do this on the world map and become a global leader . He will be able to treat a much larger number of patients , as compared to the other IVF clinics , which charge so much more. This could happen in medical colleges ; or in private clinics set up in smaller towns , which have a captive patient population base of a large number of infertile women who cannot afford standard high-cost IVF, which is what most IVF clinics in the cities offer . This doctor would then be able to tailor his protocol for patients who are likely to be patient ; and are willing to do multiple cycles , because the cycle costs much less
money , and they cannot go anywhere else !

Is a smart Indian IVF entrepreneur doctor listening ?

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1 comment:

  1. Here are my few opinions upon your article. Firstly, clinics copying from each other; as long as they are following the medical regulations properly, and for the benefit of patients, i believe it is ok.
    Secondly, yes I agree to what you say about treating patients, giving high injections. It doesn't mean if one treatment works for them(westerns), it will work well with us.
    Proper care is needed before implementing any action, it's a sensitive subject.
    Thanks for sharing good thoughts.


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