Monash Ivf Group Ltd · ASX:MVF
Monash Ivf — Investor Day (April 2015)
49 slides from Monash Ivf's investor day presentation, Apr 30, 2015
Slide 1: Investor Day & Site Tour
For personal use only INVESTOR DAY & SITE TOUR 30 APRIL 2015
Slide 2: Disclaimer
DISCLAIMER For personal use only The presentation has been prepared by Monash IVF Group Limited (ACN 169 302 309) (“MVF”) (including its subsidiaries, affiliates and associated companies) and provides general background information about MVF’s activities as at the date of this presentation. The info
Slide 3: Overview of Monash IVF Group
OVERVIEW OF MONASH IVF GROUP For personal use only Monash IVF Group (MVF) is a market leader in the fields of fertility care, womens imaging & diagnostics Core Assisted Reproductive Services Diagnostic and ancillary services Ultrasound Range of treatments and techniques to assist Diagnostic and
Slide 4: Strategy and Outlook
STRATEGY AND OUTLOOK For personal use only Science, • Continue to develop industry leading science and technology technology & • Deliver patients with clinically superior services and increase market penetration patient success • Promote Monash Group’s scientific and clinical excellence with potenti
Slide 5: H1 FY2015 Highlights
H1 FY2015 HIGHLIGHTS For personal use only Underlying Revenue, NPAT and volume growth in 1H FY2015 Revenues increased $2.7M (4.7%) to $60.3M vs pcp including • International revenues up 24% vs pcp • Monash Ultrasound for Women revenues up 11% vs pcp NPAT increased $3.4M (45%) to $11.0M vs pcp
Slide 6: Australian Market Movement
AUSTRALIAN MARKET MOVEMENT For personal use only Assisted Reproductive Services Patient Treatment growth in Australian Key Markets1 contracted -0.6% Prospectus forecast assumed market growth in Patient Treatments of 4.1% based on historical growth trend Prospectus highlighted market growth rat
Slide 7: Pricing and Treatment Mix
PRICING AND TREATMENT MIX For personal use only Frozen Embryo Transfers (FETs) increased to 39.2% of Patient Treatments for the period Patient Treatment shift to FETs reflects ongoing change in clinical practice and improvements in FET pregnancy rates Preimplantation Genetic Screening/Diagnosi
Slide 8: Expanding Domestic Footprint
EXPANDING DOMESTIC FOOTPRINT For personal use only Acquisitions & New Locations Next Generation Fertility (Western Sydney, NSW) performed to plan for period, delivering 5% of Group Patient Treatments Fertility East acquired in December 2014 and accordingly made minimal contribution to H1 FY2015
Slide 9: Sydney Ultrasound for Women
SYDNEY ULTRASOUND FOR WOMEN For personal use only Leading provider of specialist womens imaging in NSW operating 10 practices in the Sydney metropolitan area The acquisition will complement the existing Monash Ultrasound for Women business in Victoria and Monash IVF Group’s focus on womens health
Slide 10: Summary
SUMMARY For personal use only Solid performance in H1 FY2015 in slightly weaker overall ARS market in Australia Established NSW clinic footprint through start up and acquisitions • SUFW will provide significant lift in scale in Sydney H1 results impacted by lower than expected Patient Treatmen
Slide 11: Questions
For personal use only 11 QUESTIONS
Slide 12: Investor Day April 2015
For personal use only INVESTOR DAY 30 APRIL 2015
Slide 13: Disclaimer
DISCLAIMER For personal use only The presentation has been prepared by Monash IVF Group Limited (ACN 169 302 309) (“MVF”) (including its subsidiaries, affiliates and associated companies) and provides general background information about MVF’s activities as at the date of this presentation. The info
Slide 14: IVF Treatment
IVF TREATMENT For personal use only INFERTILITY NOW AFFECTS ONE IN SIX COUPLES Ovarian Stimulation and monitoring Egg collection procedures In vitro fertilisation (IVF) Intracytoplasmic Sperm Injection (ICSI) Embryo Culture Embryo Freezing (Vitrification) Embryo Transfer 3
Slide 15: IVF: The Process
IVF: THE PROCESS For personal use only STIMULATION TO PRODUCE EGGS Injections of Follicle Stimulating Hormone (FSH) to increase egg production from 1 egg to around 8-10 eggs TAKES APPROXIMATELY 2 WEEKS FOR THE EGGS TO GROW AND DEVELOP THEIR SIZE WILL BE MONITORED BY ULTRASOUND SCANNING AND BLOODS 4
Slide 16: Oocyte Retrieval
OOCYTE RETRIEVAL For personal use only Once the follicles have developed to around 17mm patients are given a trigger injection of hCG to release the eggs. After you are given sedation the eggs are retrieved from the follicles using a needle and the embryologist will transfer them to the laboratory 5
Slide 17: Sperm Preparation
SPERM PREPARATION For personal use only Swim-up (sperm are placed into a tube with media on top and the highly motile sperm swim to the surface) Density gradient (sperm is added to a test-tube that contains a special media which filters out sperm that have poor motility) Spin (sperm count is very po
Slide 18: Insemination
INSEMINATION For personal use only Once the sperm has been prepared and the eggs have been collected, insemination is performed: IVF standard insemination ICSI IVF: Place sperm and eggs together overnight ICSI: Direct injection of sperm into the egg, incubated overnight and hopefully fertilisation w
Slide 19: ICSI Video
For personal use only ICSI VIDEO 8
Slide 20: Fertilisation
FERTILISATION For personal use only The following morning the embryology team check each egg for signs of fertilisation Each fertilised egg is now called an embryo and is then cultured on in the laboratory before transfer back into the uterus 9
Slide 21: Embryo Culture
EMBRYO CULTURE For personal use only Embryos are grown in the lab until the morula/blastocyst stage and assessed for transfer - fresh transfer -genetic screening CLEAVAGE STAGE EXTENDED CULTURE 10
Slide 22: In the Laboratory
IN THE LABORATORY For personal use only Embryos are extremely sensitive to their environment They are grown in specialised media designed to mimic its natural in vivo environment. The embryos are kept in specialised incubators that can tightly control temperature, gas and light. 11
Slide 23: Embryo Transfer
EMBRYO TRANSFER For personal use only •On the day of your embryo transfer the scientists will assess your embryos and pick the most advanced one for transfer •The embryo is loaded into a very thin catheter by the embryologist and placed back into the uterus by a Doctor 12
Slide 24: Embryo Freezing
EMBRYO FREEZING For personal use only •When patients have more embryos than they are having transferred the option of embryo freezing becomes available •After transfer the remaining embryos are assessed and those of suitable quality are chosen for cryopreservation (vitrification) •Embryos are placed
Slide 25: Luteal Support
LUTEAL SUPPORT For personal use only •Following your embryo transfer you will be given a drug regime to help maintain your body in the optimum stage for implantation •Drug used for support •Crinone (progesterone) •Estrogen Patches •Pregnyl
Slide 26: Pregnancy Test
PREGNANCY TEST For personal use only •After your embryo transfer, you will need to wait for nearly two weeks till your pregnancy test. •The pregnancy test is scheduled approx 19 days from the day of your egg collection. •We need to wait this long as if you are pregnant; it takes this long for your h
Slide 27: IVF is not IVF
IVF IS NOT IVF - For personal use only 2012 Track record in taking units into the first percentile
Slide 28: Quality Control
QUALITY CONTROL For personal use only •The laboratory is constantly audited both internally and externally to maintain the highest level of quality •Internal: •Internal auditing of staff to ensure consistent skill levels •Internal auditing of all equipment and consumables to maintain highest embryo
Slide 29: Quality and Risk Management
QUALITY AND RISK MANAGEMENT For personal use only • Culture of risk management • double witnessing (at all steps) • constant monitoring of equipment • Back up power • Security and monitoring 18
Slide 30: Questions
For personal use only 19 QUESTIONS
Slide 31: Investor Day April 2015
For personal use only INVESTOR DAY 30 APRIL 2015
Slide 32: Disclaimer
DISCLAIMER For personal use only The presentation has been prepared by Monash IVF Group Limited (ACN 169 302 309) (“MVF”) (including its subsidiaries, affiliates and associated companies) and provides general background information about MVF’s activities as at the date of this presentation. The info
Slide 33: Cornerstones of Technology
CORNERSTONES OF TECHNOLOGY For personal use only Blastocyst Vitrification Technology Technology
Slide 34: Changes in Lab Practices
For personal use only 0 5 10 15 20 25 30 35 40 1980 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1992 1992 1993 1994 CHANGES IN LAB PRACTICES 1995 1996 Implantation Rates 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Slide 35: Embryo Development
For personal use only 5 EMBRYO DEVELOPMENT
Slide 36: Vitrification
VITRIFICATION For personal use only – Embryos are vitrified in microdrops to induce cooling rates of greater than 20,000oC/min. – No ice formation – Pregnancy rates from frozen embryo transfer cycles are now essentially equivocal with fresh transfer pregnancy rates.
Slide 37: For personal use only
For personal use only
Slide 38: Vitrification
For personal use only VITRIFICATION
Slide 39: For personal use only
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Slide 40: Why We Do PGS
For personal use only WHY WE DO PGS
Slide 41: Aneuploidy
For personal use only ANEUPLOIDY
Slide 42: Genetic Services
GENETIC SERVICES For personal use only PGS- PREIMPLANTATION GENETIC SCREENING Aneupolidy eg: trisomy 21 Down’s syndrome translocations PGD- PREIMPLANTATION GENETIC DIAGNOSIS Single gene disorders eg: cystic fibrosis
Slide 43: What Is It
WHAT IS IT For personal use only • BLASTOCYST • BIOPSY • VITRIFICATION • AMPLIFICATION • NGS
Slide 44: Biopsy
For personal use only BIOPSY
Slide 45: NGS Profiles
NGS PROFILES For personal use only Trisomy 21
Slide 46: NGS Profiles
NGS PROFILES For personal use only Duplication: Deletion of Ch10
Slide 47: Next Generation Sequencing
NEXT GENERATION SEQUENCING For personal use only •Screen all 23 chromosome pairs •Uses sequencing of DNA aligned with human genome •Millions of fragmented DNA sequences Practical benefits of NGS vs Array for Embryo Applications •increased precision •increased reliability or capacity to confirm a res
Slide 48: Short-Term Update of Platform
SHORT- TERM- UPDATE OF PLATFORM For personal use only PGS - Launched updated diagnostic platform of next generation sequencing (January 2015) PGD Update the diagnostic platform to karyomapping or sequencing based technology
Slide 49: Questions
For personal use only 19 QUESTIONS