How did the pandemic affect the company's operations?
RAFAEL FRAILE Our first challenge was that we did not know how this disease could affect our processes. Therefore, we stopped all our activity and started some investigations. We were the first to prove scientifically that women infected with COVID-19 did not transmit the virus to their eggs; however, during the shutdown of our activity, many fertilization cycles were cancelled, which affected birth rates. In fact, birth rates fell approximately 20% in the last few months of the year, which presents a long-term problem for society as a whole. As a result of COVID-19, we took all possible actions to prevent infections. National patients have a more standardized process, as they have freer mobility, and the vaccination process is making solid progress. We adapted our methods to keep in touch with international patients and offer them medical support via telematic means. Thus, there have been patients that were able to continue the process and finish their fertilization cycle. In addition, we have facilitated the process by providing certificates that allowed our patients to cross borders by presenting a PCR test. Nevertheless, everything is gradually returning to normal.
ANTONIO PELLICER About 14,000 assisted reproduction cycles were halted in Spain due to the pandemic, which means around 4,000 fewer births. IVIRMA had to postpone 4,000 treatments and, as a result, lost at least EUR3 million. In Spain and Italy, in 2020 we were obliged to close by the Ministry of Health, just when we were about to celebrate IVI's 30th anniversary. As a consequence of the closure, we had to furlough some of our employees, though only for two months. At the end of the year, work had fully recovered, excluding some international patients who comprise about 20% of our clients. In the US, many companies, including university programs, shut down. However, we continued to operate without significant impact from the crisis. From a business point of view, the sector has proven to be resistant to all crises. The research element has been affected in clinical trials, as some had to stop in order to use healthcare resources for COVID-19 research. In addition, we are promoting the IVI Contigo (IVI with You) plan, offering 12-month finance to ensure our clients have access to greater flexibility.
What factors make Spain such an advanced country in terms of assisted reproduction?
RF First, Spain has an advanced level of medicine. Reproductive medicine is a form of hyper-specialization in medicine. Great progress has been made in this area, and Spain is ahead of other countries in this regard. Moreover, Spanish legislation is clearly defined, which facilitates the whole process. Another factor is that in Spain, gametes, sperm, and oocytes donation are regarded as another form of donation, and we are committed to donation as a country.
AP In Spain, 33,000 babies are born every year through assisted reproduction, or one in every 10 births. Spain was fortunate to have two progressive governments, with presidents Felipe González and Zapatero, boasting the most advanced law in Europe in 1988. IVIRMA has been able to carry out research with embryos and embryo biopsies in order to select embryos, which is impossible in countries like Germany and France.
What are the company's expansion plans?
RF We are always working at an international level while evaluating other growth options. We usually go with inorganic growth when entering foreign markets because it makes more sense to start our activity by creating a partnership with a company that is already established there, so that we have a better idea of how that country works. Besides, we always look for partners that share our views of this business.
AP IVIRMA has 65 clinics and is present in 11 countries such as Spain, the UK, Portugal, Panama, Chile, Argentina, and United States, among others. Recently, we established a strong presence in Italy, starting with Rome, Milan, and Bari. Today, the company has turned its attention to the US. In 2017, IVI Clinics merged with an American group, the Reproductive Medicine Associates (RMA) New Jersey, becoming what we know today as IVIRMA Global. There are two reasons we went to the US: research collaborations there with universities were much greater than in Europe, and the US is a market that has yet to be fully explored and is the best.