KKR-backed IVI to buy ART Fertility Clinics for $450 million

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KKR-backed IVI RMA Global, a US-based leader in infertility treatment, is set to acquire ART Fertility Clinics for $400-450 million, according to people familiar with the matter. The acquisition marks a significant step in IVI RMA's global expansion, adding India to its presence in over 15 countries and more than 190 clinical offices across the US, Europe and Latin America.Both parties are in the final stages of documentation for a shareholders' agreement and are hoping to wrap up the transaction by June end.As with private hospitals, the IVF industry in India too is witnessing consolidation as several private equity funds have been aggressive with acquisitions. In 2023, Swedish fund EQT Partners acquired a significant majority stake in Indira IVF, the largest provider of fertility services in India and top five globally in terms of annual IVF cycles, at a $1.1 billion ('9,000 crore) valuation.ART Fertility Clinics began in 2015 as IVI Middle East, an international arm of IVI RMA Global. In 2020, IVI RMA divested the business to Gulf Capital, which rebranded it as ART Fertility Clinics. Since then, the brand has rapidly grown, expanding across West Asia and India.With clinics in Abu Dhabi, Dubai and Al Ain in the UAE as well as 11 centres across India, ART Fertility has established itself as a high-performance network in reproductive medicine. The Indian expansion began in 2021, backed by a $30 million investment from Gulf Capital.ART Fertility operates in big Indian cities including Mumbai, Noida, Ahmedabad, Chennai, Hyderabad, Gurgaon and Faridabad.Led by Suresh Soni, former co-founder and CEO of Nova IVF Fertility, ART Fertility reports a pregnancy success rate of 70% and has recorded over 5,000 successful pregnancies in under nine years.According to sources, ART Fertility posted revenue of $100-120 million in FY25, with an estimated Ebitda of $35 million."For an Indian healthcare player, a $25-35 million ebitda which is borderline ebitda positive coming from the Middle East would add no value," said a fund manager at a Mumbai-based private equity firm that operates a pan-India IVF chain. "However, IVI being a US player where multiples are low, adding a Middle East business works well."IVI RMA trumped a rival bid by Temasek-backed Cloudnine Hospitals.A KKR spokesperson declined to comment. IVI RMA and ART Fertility did not respond to queries.Moelis is the advisor in the transaction.India is rapidly emerging as one of the world's fastest-growing markets for Assisted Reproductive Technology (ART). However, the sector has scope for expansion at 210 IVF cycles per million people, compared with 1,200 in the US and over 2,000 in Europe.Infertility affects approximately 15% of Indian couples, a figure expected to rise due to lifestyle factors such as poor diet, stress, late marriages, and pollution.According to EY, India's IVF market is expected to grow from $793 million in 2020 to $1.45 billion by 2027, at a projected CAGR of 15-20%.India sees around 300,000 IVF cycles annually, with projections suggesting this could grow to 500,000-600,000 cycles by 2030. About 30% of the market is controlled by 10-15 organised players, while the remaining is fragmented among smaller, unorganised clinics. Key players in India's fertility sector include Indira IVF, Nova IVF, Oasis IVF, Bloom Fertility Centre, Bengaluru-based Milann, Morpheus IVF, Ridge IVF, Akanksha IVF and Bourn Hall Clinic.Nova IVF, the second largest player in India, is owned by Asia Healthcare Holdings (AHH), the single specialty hospitals platform backed by GIC and TPG.Similarly, homegrown PE fund Kedaara Capital owns a minority stake in Oasis Fertility, while Brussels-based fund Verlinvest owns a controlling stake in Ferty9 F, a premier chain of fertility clinics in the AP/Telangana region.

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