Egg Donation Horizon&

Impact of Egg Banks

Saghar KasiriDirector of European Operations

Cryos International1st November 2019

Overview

• Global donor egg market

• Fertility tourism and egg donation

• Fresh versus frozen donor eggs

• Impact of egg banks

Global Egg Donation Market

Global Egg Donation Market Projection

• The Global Egg Donation market was valued at US$ 2,172.6 Mn in 2018

• Estimated to grow at a CAGR of 7.5% over the forecast period (2018–2028) to reach US$ 4,474.0 Mn by 2028

• Europe region is the largest market with a revenue share of 50.1% in 2018

Source: Market report prepared for Cryos International by Future Market Insights - 2019

Global Egg Donation Market - 2018

Global Egg Donation Market Revenue Share by Cycle Type, 2018E Global Egg Donation Market Revenue Share by End User, 2018E

Source: Market report prepared for Cryos International by Future Market Insights - 2019

Reasons for Egg Donation Market Growth

• Increasing prevalence of infertility worldwide• Delayed motherhood • Social risk factors• Social acceptance of single parents – double donation• Countries legalizing same-sex marriages• Government & social support toward gamete donation & donor offspring • Patient awareness of pregnancy rates > 40 years• > 70% of women over 45 years use egg donation• Technological advancements in Egg Vitrification• Egg banks - cost less & greater range of choice

Fertility Tourism and Egg Donation

Fertility Tourism Drivers – Egg Donation

• Costs

• Lack of available donors in homeland

• Limited donor characteristic choices

• National regulations and limitations

➢ Banned donation

➢ Donor anonymity

➢ Egg recipient age limit

➢ Marital & social status

➢ Parental rights

• Egg donation success rates

• Better patient journey

Source: Photo curtesy of Egg Donation Friends website

Global Egg Donation Treatment – Success Rates“Spain and South Africa have the highest pregnancy success rates for egg donation”

Source: inviTRA, 2019 (Magazine specialized in assisted reproduction and pregnancy)

Egg Donation Abroad

Source: Egg Donation Friends website, updated Sept 2018

Fresh vs Frozen Donor Eggs

Fresh Egg Donation Process

Fresh vs Frozen Donor Eggs Egg Donation Advantages Disadvantages

Fresh

• High Number Eggs

• More Embryos

• High Number Cryopreserved?

• Low Cost Consecutive Cycle – Thaw

• Success Rate

• Time

• Synchronization

• Cancellation Risk

• Donor Liability

➢ Medication

➢ Empty Follicles

➢ OHSS

• Regulatory Compliance

• Initial Cost

Frozen

• Time

• Convenience

• No Synchronization

• No Cancellation Risk

• No Donor Liability

• Large Selection of Donors

• Success Rate

• Cost First Attempt

• 6-8 eggs

• Less Number Cryopreserved

• Technique

• Cost Consecutive Attempts

Impact of Egg Banks

Survival Clinical Pregnancy% With Surplus

Embryos

Ongoing and Live

Birth per Transfer

Cryos

International92% 75% 61% 62%

Source: Results compiled by Cryos International, 2018

Banking Statistics

Cryos, TWEB, FF, and DEB - cumulative clinical pregnancy rate of 54% and live birth rate of 44% (48.9%)

Live Birth Rates

Source: Clinical experience with vitrified-warmed (V-W) donor eggs versus fresh donor eggs at a busy IVF programMcCaffrey, C. et al., Fertility and Sterility , Volume 102 , Issue 3 , e314 2014

Live Birth & Miscarriage Rates

Source: There is no difference in clinical miscarriage rates between vitrified blastocysts developed from fresh donor oocytes vs. vitrified banked donor oocytesLamb, Julie D. et al., Fertility and Sterility , Volume 109 , Issue 3 , e34 , 2017

Fresh Donor Eggs

Source: SART National Data Summary Report 2017 Pooled Data

Frozen Donor Egg

Source: SART National Data Summary Report 2017 Pooled Data

Success rates using frozen donor eggs are dependent on several factors:

• The quality of the donor eggs

• The ability to perform effective freezing and thawing of the eggs

• The number of eggs thawed, and embryos produced

• The expertise and quality of the IVF program

• Embryo development & egg guarantee programme

Success Rate Factors

Impact of Egg Banks - B2B & B2C

• No need to recruit, screen or approve donors

• No donor payment

• No Regulatory concerns

• Syncing donor/recipient cycles are a thing of the past

• Ease lab pressure and workload

• Guaranteed blastocyst transfer

• Provide a greater selection to patients

• Immediately available

• Results are improving & treatment cycles are increasing

Making Your Life Simpler, One Task at a Time

Take Away

• Globally the egg donation market is growing

• Currently egg donor shortages remedied through fertility tourism – keep them home!

• Trends show increase in use of frozen donor eggs – vitrification technology advancement

• Egg banks experts in vitrification of eggs – matching success rates & less surplus eggs/embryos

Questions & Answer Session