In Conversation with Dr. Gauri Agarwal, Fertility Specialist, Founder & Director, Seeds of Innocence and Genestrings Diagnostic

• How and when was Seeds of Innocence conceptualized and established in Delhi?

Dr. Gauri Agarwal (MD, DNB, and MBBS), is the Founder of Seeds of Innocence IVF & Fertility Center chain and Genestrings Laboratory. A pivotal decisive factor for studying IVF and medicine was her sister’s unfortunate failure to conceive. Inspired with an idea of bettering lives of a million mothers, it was her vision coloured with passion that led her way to become a leading IVF Specialist in India.

After successful completion of her academics, Dr. Gauri got married in a family of devout doctors, and the founders of the Yashoda Group of Hospitals where she was endowed with a choice of joining her husband, in the Ghaziabad Centre of Yashoda Hospitals. However, with her determination to pave her own path, she began initiating small health and awareness camps in rural areas like Dadri, Hapol and Loni, where she would encourage education and right medical knowledge to patients, and welcomed the ones who wanted to proceed with IVF to visit her hospital in Ghaziabad. With continuous efforts in these initiatives, Dr Gauri soon managed to run 50 IVF cycles per month, and attained high success rates where the majority of healthy conceptions were achieved in the very first IVF cycle. Soon, her gradual progression in the market began with a word of mouth about better treatment through Dr. Gauri Agarwal, which acquired her local fame and eventually led to the establishment of Seeds of Innocence, a bootstrapped IVF chain that started with one center in 2015 in Delhi's Malviya Nagar and is currently running 14+ centers across North India. She is also the Founder of Genestrings, a state-of-the-art Genetic Diagnostic Laboratory.

The centers are the brainchild of visionary Dr. Gauri Agrawal. Seeds of Innocence owns and operates 14 IVF & Surrogacy centers across 8 Indian states and was also the first IVF center in the country to have an in-house genetic testing lab, back in 2017

• How many dreams of parents have Seeds of Innocence fulfilled so far?

Seeds of Innocence is a one of its kind comprehensive Fertility Clinic with state-of-the-art treatment & diagnostic facilities encompassing not just IVF but also niche departments like Medical Genetics and Fetal Medicine. These departments not only improve overall success rates but are also a blessing for couples suffering from any hereditary diseases such as thalassemia and sickle cell anemia.

With international standard medical infrastructure, we provide specialized services in Assisted Reproductive Technologies, treatment of infertility, management of high-risk pregnancies and genetic diagnostics.

Currently, Seeds of Innocence has 14+ centers across the country with over 250+ dedicated employees and approximately 12,000 successful cases of IVF

• Seeds of Innocence offers Pre-Implant Genetic Screening to couples, how does that help in IVF treatment?

As an intended parent you can screen your viable embryos before the embryo transfer procedure through a modern non-invasive technique called Pre-Implantation Genetic Screening (PGS), also called Pre-Implantation Genetic Testing for Aneuploidies (PGT-A). An estimated 48.5 million couples suffer from infertility worldwide that has unprecedentedly increased the usage of Assisted Reproductive Technologies around the globe. As a result,

Preimplantation Genetic Testing (PGT) has attracted scientists and institutes to bring forth advanced developments in In Vitro Fertilization (IVF) procedures. These innovative IVF solutions deliver rapid results from precious samples, avoiding the complexities that traditionally come with conventional genetic analysis tools. PGS is used for detection of Aneuploidies, or Numerical Chromosomal Abnormalities, across all 24 chromosomes (22 autosomes and the X and Y chromosomes), like Trisomy 21 (Down syndrome) and Monosomy X (Turner syndrome), other Trisomies (having an extra chromosome), Sex Chromosomal Abnormalities, Monosomies (missing a chromosome) and Single Gene Disorders such as Cystic Fibrosis, Sickle Cell Disease and many more.

How does Pre-Implant Genetic Screening help the couple?

● Minimizing the chances of miscarriage - In order to determine the right treatment for a couple’s pregnancy loss, it’s important to conduct relevant tests. Opting for PGS helps to pinpoint the reason for the pregnancy loss, and give fertility specialists a good understanding of how to properly address and deal with the issue, this consequently decreases the time it takes to become pregnant.

● Cost effective- While PGS is an additional cost, it can often decrease the price of your IVF journey in the long run by decreasing the number of transfers necessary to conceive.

● Successful IVF- PGS gives your fertility doctors an insight into which embryos will be most likely to implant and develop healthily. To optimize your IVF process, avoid unsuccessful embryo transfers by knowing which embryos will help you achieve a full-term pregnancy. Ensures that you’re not spending months transferring embryos that won’t lead to a successful pregnancy and birth.

● Quicker time to pregnancy - Ensure you’re not spending months transferring embryos that won’t lead to a successful pregnancy and birth. Using PGS/PGT-A, your fertility clinic can avoid futile embryo transfers by transferring the healthiest embryos first.

● No Doubt, No Stress- Less Uncertainty - A significant benefit of PGS/PGT-A is the reduced level of uncertainty that patients may experience before and after an embryo transfer. The Procedure provides you with an ensured healthy embryo, a lower risk of pregnancy loss, and less emotional stress, especially for patients who’ve experienced the saddening loss of miscarriage before.

● Minimal risk to the embryo- These tests are conducted under the supervision of expert doctors, Trophectoderm embryo biopsy involves only the outer layer of the embryo and therefore minimizes risks to the fetus

● Genetically Healthy Baby- These tests assure a transfer of a healthy embryo hence conclusively assuring the couple of having a genetically normal and healthy baby.

• In India, the IVF industry is growing at a steady pace, what is your take on it?

The Assisted Reproductive Technology Bill, 2021 is a quantum leap by the Union Government to promote the Indian IVF industry. However, it is pertinent to focus that the nodal concern still remains to be the general people of the country and their struggles with access to Assisted Reproductive Technologies, popularly, IVF. The problem is complemented by a failure by leading insurance companies to cover infertility, which makes it highly difficult for general people to avail these services.

Assisted Reproductive Technologies (ART) is a dynamic approach to science of reproduction and is not only limited to conceiving, rather it also is engaged in spreading an overall awareness about the right contraceptive measures and appropriate sanitation procedures. Consequently, it is an essential discipline concerning the overall health and well-being of people.

Recent research in this field has constantly warned us about the expected increase in the infertility rates of the country. Hence, it becomes significant to undertake preventive measures against this. Accordingly, increasing accessibility to ARTs in rural areas and providing more incentives to people to avail these services will come as a boon to the Indian IVF industry which is expected to become a $12 Billion Global Market in the coming Financial Year.

• What improvements are required for IVF in the country as compared to countries that are leading the IVF industry presently?

The global In vitro fertilization services are anticipated to exhibit significant growth in the upcoming years, owing to the rise in infertility rate, increase in trend of delayed pregnancies, surge in IVF success rate, and a rise in disposable income worldwide.

The Asia-Pacific region accounts for the largest market share in 2018, and is expected to retain its dominance in the years to follow. This is attributed to the presence of a high population base in countries such as India & China and a significant rise in infertility among people.

However, high cost & complications associated with IVF treatment in India and low awareness in the underdeveloped regions hinder the overall growth of the IVF services market. Given the population and the infertility rate, it’s more about how healthcare providers can reach out to the masses and make IVF treatments accessible and affordable while generating awareness about reproductive health for all. The tailor-made pricing and cost to be paid in easy interest free installment could encourage couples to consider wholesome benefits of IVF treatment.

Increased success rate by opting PGS is also one of the leading factors to encourage infertile couples to go for IVF treatment.

Seed of Innocence has 14 Centers across India and our reason to grow more is to increase our accessibility and touch more lives.

• While consulting patients, what are some of the major challenges that you have come across?

It is evident that good IVF centers are not easily accessible for people in India. Most often we have observed that couples traveled to metro cities for their treatment and genetic testing was not easily available for people especially in the Northern Part of the country. Seeds of Innocence aims to provide solutions by making world-class IVF facilities accessible all across India.

Even during the pandemic at peak, we ensured continuity of treatment for existing patients undergoing treatment, since they would have not just suffered financial loss due to restarting of treatment but also emotional trauma and hopelessness.

One of the most daunting challenges is the lack of awareness about fertility and limited understanding of infertility treatments. The field of medical science is still considered a taboo and the major belief is that women are the only cause for not having a child after marriage. While, male Infertility is an important part of the infertility segment in India and having access to the diagnostic facilities such as semen analysis and testicular biopsy helps us to have a better understanding of the issues being faced by a couple.

• In the foreseeable future, what potential does IVF hold and how can we accelerate that?

The global In vitro fertilization services market size generated $12,506 million in 2018, and is projected to reach $25,563 million by 2026, growing at a CAGR of 9.3% from 2019 to 2026. Fertility segment in India alone has grown by 20% in the last five years.

The Assisted Reproductive Technology Bill, 2021 is a quantum leap by the Union Government to promote the Indian IVF industry. However, it is pertinent to focus that the nodal concern still remains to be the general people of the country and their struggles with access to Assisted Reproductive Technologies, popularly, IVF. The problem is complemented by a failure of leading insurance companies to cover infertility as a disease, which makes it highly difficult for general people to avail services like IVF. A steady start in recognising infertility in health insurance and covering it in the policy, can motivate people to get proper consultations and subsequent medical treatment.

Also, considering the growing Infertility rates around the globe and declining fertility in both the genders with rise in their age, has created a demand for fertility preservation, i.e., preserving eggs and sperms by freezing them for later use. The industry thus beholds a golden potential with increasing access to the above mentioned services, an inclusion of infertility and IVF in health insurance policies, and a general realization among the people that fertility preservation and IVF is a way to overcome issues of infertility and have a healthy pregnancy.