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EF: Antonio, as a founding member of IVI RMA, could you elaborate on the company's trajectory as it grows globally and opens branches in different parts of the world?
AP: Transitioning from full-time positions at the university to part-time roles enabled us to venture into private medicine, marking the inception of IVI in 1990. We initially focused on Valencia, and after our success, we expanded to Madrid as most patients were coming from there. This pattern repeated across Spain and Latin America, establishing clinics in Mexico, Panama, Argentina, Chile, and Brazil.
Our expansion strategy involved a fellowship training program, where individuals trained by us assumed roles as clinical directors in newly established clinics. This model facilitated organic growth across Spain and Latin America.
Despite opportunities to establish clinics in India and the Emirates, we opted for royalty agreements due to geographical and cultural disparities. However, our commitment to expansion remained steadfast, culminating in our entry into the United States in 2017. Recognizing the importance of research and clinical excellence, we merged with RMA New Jersey, leveraging their expertise to establish clinics in key cities like San Francisco, Philadelphia, Houston, and Seattle.
Our growth trajectory in the United States is bolstered by dedicated teams and strategic investments, enabling us to rapidly expand and assemble specialized talent within our ranks.
Our company is one of the world's biggest and best-organized IVF companies. We continue to maintain the pillars on which we started the company: clinical excellence, research, and education.
EF: Javier, what attracted you to this industry, and what was your mission when you were appointed to this current role?
JP: The first thing that attracted me to the healthcare industry was its purpose. It allowed me to work in the IVF field alongside Anthony Pellicer, one of the company's co-founders. Our company has a 34-year history and has developed alongside the IVF industry. Infertility issues have been declared a disease that affects no less than 17.5 percent of the population. This declaration was made by the World Health Organization (WHO). I moved into this healthcare career as it was an opportunity to be part of the development and shaping of this industry.
EF: What are your current priorities and expectations for the company in 2024?
JP: One of our priorities is to continue to be the best in clinical outcomes and provide excellent patient care through our doctors and physicians. We will also continue investing in scientific knowledge.
On the business side, our priority will be to continue bringing together a great team to continue growing. We see the opportunity for more growth. It is a privilege to work with IVI RMA as it has the best clinical results. We are the best option for IVF interventions, as we treat the most complicated cases. Being able to spread our services all over the world is a privilege. We have the opportunity, will, and financial support to achieve this goal.
We have the ambition to be better and improve clinical outcomes. We are investing a lot in scientific knowledge. We have a global research alliance that works worldwide, and we have more than 650 papers to be published in the next few years. This is also the engine that fuels the company and its growth.
AP: All indicators suggest that the United States has more room for growth than the rest of Europe. Therefore, we will look for good partners in the United States who can maintain our good reputation. We are looking not only for the ability to grow the business but also to maintain quality and share our philosophy.
EF: What is the value of having long-term investments in innovation and research?
AP: We recognize the inherent risk involved in our research endeavors; typically, only 1 out of 10 patents or ideas will succeed. Our primary focus remains on patient care, with publication being a by-product of our efforts. We strive to enhance quality and support couples facing infertility issues, particularly emphasizing the rejuvenation of ovarian function as a key area of interest.
The pressing clinical challenge we encounter is the arrival of women seeking assistance after their eggs have already incurred damage. Our investment in rejuvenation projects holds immense significance, as success in this area would address numerous clinical obstacles.
Our Genetics and Genomics department has stood at the forefront of medical evolution over the past three decades. Leveraging this expertise places us in a unique position to delve deeper into infertility complexities. Integrating genomic analysis with clinical and embryological data will yield a comprehensive database, empowering us with valuable insights and algorithms to enhance treatment efficacy and patient satisfaction. We aim to elevate pregnancy rates and introduce innovative products.
While the current implantation rate for an embryo stands at 65 percent in optimal conditions, we are committed to improving this figure. Despite notable progress over the past 35 years, there's ample room for enhancement, particularly in refining embryo selection methods and gaining a deeper understanding of uterine dynamics. These objectives drive our focus for the coming years.
EF: What do you think about the upcoming innovations?
JP: We're continuously innovating to elevate the quality of care for our patients, particularly in embracing digital solutions to meet their evolving preferences. Our focus is on the patient journey through digital enhancements tailored to individual needs, ensuring a seamless experience.
Our primary objective remains to deliver optimal clinical outcomes and care quality. By prioritizing patient-centric approaches, we anticipate sustainable financial outcomes. To achieve this, we must consistently place our patients at the forefront of our initiatives, investing in solutions that optimize clinical results and care quality.
Addressing the significant gap between infertility prevalence and treatment uptake presents both a challenge and an opportunity. Beyond business considerations, it aligns with our core mission. Raising awareness about infertility is paramount, given its societal implications. Proactive steps are essential to prevent future demographic challenges.
We're witnessing a shift in societal discourse around fertility issues, indicating progress in awareness. However, further efforts are needed to ensure a broader understanding and accessibility to treatment options, and we must act decisively to safeguard the well-being of future generations.
AP: Beyond awareness, addressing affordability is important. Government support is crucial for ensuring access to fertility treatments for all infertile couples. It's not solely about reducing costs on our end; it's about recognizing the expense involved in advanced techniques like genetic and embryo analysis, which are essential for optimal outcomes. If patients lack the financial means, the government must step in. Unfortunately, there's still a lack of understanding among policymakers regarding the necessity of robust support for infertile couples, indicating a significant gap in overall support that requires urgent attention.
EF: What is the importance of increasing education about infertility?
AP: People usually realize that they have an infertility problem when it is too late. It is important to increase infertility education. We started the fertility preservation program in 2007. The growth of this program is exponential. The numbers for the 2021–2022 period show growth of over 30 percent. This growth has been seen in the United States, Spain, and Italy. Women now know this is the only efficient way to stop the biological clock. They are now freezing their eggs for the future. Research has shown that people can be ignorant in that they believe that because specialized infertility clinics exist, they can go to them and get pregnant immediately. Unfortunately, this is not correct, and more education is needed.
EF: What is your current footprint in Spain, and what is the strategic importance of that market?
AP: Spain's legislation on assisted reproduction has been notably progressive since its inception in 1988, with the subsequent revision in 2006. This legal framework has fostered scientific advancements, particularly in embryo research, positioning Spain ahead of its European counterparts.
Moreover, Spain's organ and tissue donation record showcases a culture of generosity and support. This willingness extends to women who donate eggs for research, contributing to refining techniques and methodologies in assisted reproduction.
As a result, Spain consistently ranks among the top countries in Europe for assisted reproduction. This reputation for excellence often prompts inquiries from couples, even internationally, contemplating treatment abroad.
JP: Initially, I found the rankings somewhat surprising as a newcomer, but upon reflection, they align with Spain's substantial investments in research and development, coupled with favorable regulations. Spanish clinics attract many international patients due to our doctors' reputation as pioneers in cutting-edge techniques.
Additionally, Spain boasts a top-two position in IVF penetration globally, underscoring its prominence in the field. The legacy of IVI's origins in Valencia further solidifies Spain's standing as a premier destination for reproductive treatments.
EF: IVI RMA is celebrating its 35th anniversary next year. What would you like to celebrate with your team and everyone involved in making IVI RMA grow?
JP: Firstly, it's important to recognize and celebrate the hard work of our team. As CEOs, it's crucial not to overshadow the dedication and commitment of our staff, who tirelessly provide quality care to our patients. They truly deserve our appreciation for their outstanding efforts.
Secondly, achieving excellence is no small feat. Drawing from my experience in the airline industry, I understand the challenges of striving for the top spot, such as becoming the world's most punctual airline.
Our leadership in clinical outcomes is a direct result of our team's unwavering dedication and investment of time. We've maintained our position for 35 years through extensive research and hard work. Looking ahead, I'm excited to celebrate our growth and our commitment to making our treatments more accessible and affordable in the coming year.
AP: Our journey began with a single clinic and a small team of two doctors, two nurses, and two secretaries. Our network has expanded to over 190 clinics, with projections to reach approximately 200 within the next year. Reflecting on our growth, it's remarkable to note that our initial goal for IVI wasn't about clinic numbers but delivering the best clinical and infertility treatments. Now, with a global presence, we continue to uphold our commitment to excellence in healthcare.
