Vitrolife Ab · OMXSTO:VITR
Vitrolife Ab — Investor Day (2023)
178 slides from Vitrolife Ab's investor day presentation, 2023
Slide 1: Vitrolife Group 2023 Capital Markets Day
Vitrolife Group 2023 Capital Markets Day Enable people to fulfill the dream of having a healthy baby
Slide 2: Disclaimer
DISCLAIMER This presentation contains estimates and forward-looking statements, which reflect the Management’s current views with respect to the market, certain future events and financial performance. Although the statements are based upon estimates the Management believes to be reasonable, there i
Slide 3: Participating KOL experts
Participating KOL experts David K. Gardner Carlos Simón Keiichi Kato Eduardo Gonzalez Mitchell P. Rosen Ph.D., AM, FAA, Scientific M.D., Ph.D. Professor of Managing Director, Group CEO, Reproductive Director of Melbourne IVF Obstetrics and Gynecology Kato Ladies Clinic Eugin Group endocrinologist, U
Slide 4: Vitrolife Group speakers
Vitrolife Group speakers Bronwyn Brophy Patrik Tolf Mark Larman Claus Bisgaard Ricardo Capella CEO CFO VP Vitrolife Group Academy SVP Technologies SVP Genetic Services Jørgen Berntsen Carmen Rubio Rickard Ericsson Sabrina Ritossa Fernandez Janne Östlund Team Lead, AI Group, VP R&D SVP Global Group S
Slide 5: Agenda
Agenda 10:05 Introducing the new Vitrolife Group strategy The history and future of IVF 11:10 Coffee break 11:20 Own the platform connecting products and services Innovate to expand leadership Accelerate growth in key markets 12:30 Lunch (including product demos at ‘Vitrolife Group Marketplace’) 13:
Slide 6: Introducing the Vitrolife Group strategy
Introducing the Vitrolife Group strategy Bronwyn Brophy, CEO Vitrolife Group 6
Slide 7: Introduction to Bronwyn Brophy
Introduction to Bronwyn Brophy • Appointed CEO of Vitrolife AB on 1st August 2023 • 26 years working in the Medtech and Life Sciences industries • Former Vice Chair of Medtech Europe serving on the Operations Management Committee • Passionate about innovation and improved access in healthcare 7
Slide 8: Mission, global presence and sales
Integrity Mission Be the leading global partner in reproductive health, Quality striving for better treatment outcomes for patients Global presence in Employees Sales in 2022 Innovation 125 markets ~ 1,100 3,234MSEK Collaboration 8
Slide 9: Well balanced global company with strong market presence
Well balanced global company with strong market presence Net sales of 2,607 MSEK (Jan-Sep 2023) Consumables APAC Americas Genetic 45% 31% 33% Services Present in 38% Revenue by Revenue by countries representing geography business area 94% of global IVF treatments ~90% of sales from EMEA Technologies
Slide 10: Vision: Enable people to fulfill the dream of having a healthy baby
Vision: Enable people to fulfill the dream of having a healthy baby Portfolio covering every step of the IVF journey combined with best-in-class quality, service and training IVF process Prenatal & Postnatal Pretreatment 10
Slide 11: Uniquely positioned to serve different standards of care
The Vitrolife Group is uniquely positioned to serve different standards of care Two methods for embryo evaluation m PGT- PGT-A Embrace M 1 Time-lapse technology-based assessment 2 Genetic assessment EmbryoScope® uses AI-based algorithms to analyse full course Analysis of embryo DNA to determine exis
Slide 12: New products and tests brought to market
As innovation leaders we continue to bring new products and tests to the market iDAScore EMMA & ALICE Gx Media NiPOC VitroTemp Infertility Panels Smart PGT-A Plus KaryoMap v2 12
Slide 13: Significant market opportunity in reproductive health
Significant market opportunity in reproductive health Successful treatment outcomes ~33% *** 1 in 6 134 M Access and affordability 5-7% people globally is babies born annually** estimated cycle affected by infertility* < 1% via IVF growth 13 *Source: World Health Organization **Source: United Nation
Slide 14: Improvement in treatment outcomes is needed
Improvement in treatment outcomes is needed Less than half of all embryos transferred today, result in pregnancy IVF birth rates have risen for patients under 43 in the last 30 years Birth rates per embryo transferred using patient eggs by age band, 1991-2018, 2019 data 35% Under 35 30% 25% 35-37 Bi
Slide 15: Global access and affordability to IVF treatment is improving
Global access and affordability to IVF treatment is improving Country 2022 IVF treatments % of total China 1,045 25% Japan 511 12% USA 387 9% India 176 4% Russia 149 4% Spain 143 3% Other countries 1,746 42% Global 4,157 100% State fertility Insurance Coverage Laws; Twenty-one states have fertility
Slide 16: Key IVF market dynamics
Key IVF market dynamics – How can we bring value to the ecosystem Growth in demand Increase IVF capacity and accessibility Clinics labour and skills shortage Automation and digitalisation Consolidation of clinics Standardisation and scalability Diverse portfolio to address differences in Regionalisa
Slide 17: Five strategic priorities
Vitrolife Group committed to deliver sustainable profitable growth Focus on five strategic priorities 1. 2. 3. 4. 5. Own the Innovate to Accelerate Optimise go- Drive platform expand growth in key to-market operational connecting leadership markets model excellence products and services • Drive embr
Slide 18: The history and the future of IVF
The history and the future of IVF David K. Gardner Ph.D., AM, FAA, Scientific Director of Melbourne IVF Carlos Simón M.D., Ph.D. Professor of Obstetrics and Gynecology 18
Slide 19: The history and future of IVF: David K. Gardner
The history and future of IVF David K. Gardner Ph.D., AM, FAA, Scientific Director of Melbourne IVF 19
Slide 20: Growing viable embryos
The history and future of IVF: Growing viable embryos David K. Gardner, AM, FAA Fellow of the Australian Academy of Science Distinguished Professorial Fellow, School of BioSciences, University of Melbourne Scientific Director, Melbourne IVF Director of ART, Science, Innovation and Research, VirtusHe
Slide 21: Disclosure
DISCLOSURE Research funded by grants from: Vitrolife AB Scientific Advisor to: Fertilis NeoGenix 21
Slide 22: 40 years in embryology and IVF
40 years in embryology and IVF Trained at the University of York (UK), Harvard Medical School and at Monash Medical Center. Scientific Director of the Colorado Center for Reproductive Medicine (1997-2007) Distinguished Professor University of Melbourne (2007 - present) Scientific Director
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23
Slide 24: Photograph: Central Press/Getty Images
Photograph: Central Press/Getty Images 24
Slide 25: Photograph: Central Press/Getty Images
Photograph: Central Press/Getty Images 25
Slide 26: Louise Brown born July 25, 1978
Louise Brown was born July 25, 1978 at the Oldham General Hospital, Oldham, England 26
Slide 27: Scandinavian IVF Science AB
27 Scandinavian IVF Science AB BOX 14105 MOLNDALSVAGEN 26 S-400 20 GOTEBORG SWEDEN ORDER TEL: 46-31-40 50 84 ORDER FAX. 46-31-40 54.74 ICSI-100 Viscous solution ready-to-use hadwesal medical organization "20 jor asiam 230! lawprona 02)427427 ail aaaseah ‘elon Hit haase te 21 TEBE noqn mewrta nn, sup
Slide 28: Development of Embryo Culture Media
Development of Embryo Culture Media Early human embryo culture media were simple salt solutions Only supported the embryo for 2 to 3 days Multiple embryos were transferred-still implantation and pregnancy rates were low A decade of research in the Gardner lab led to the development of sequen
Slide 29: Randomized trial of blastocyst culture and transfer
29 Human Reproduction vol.13 no.12 pp.3434-3440, 1998 A prospective randomized trial of blastocyst culture and transfer in in-vitro fertilization TH David K.Gardner!, William B.Schoolcraft, ) 5 Lyla Wagley, Terry Schlenker, John Stevens and y John Hesla 3 2s w 4 * A C= G+" pLus G-2" PLUS SUPPLEMENTE
Slide 30: Quality Control: The Mouse Embryo Assay (MEA)
Quality Control: The Mouse Embryo Assay (MEA) 30
Slide 31: 149 74
149 74 31
Slide 32: Industry leading 1-cell MEA
32 Industry leading 1-cell MEA We utilise the MEA to screen all materials used in the manufacturing process as well as for testing finished products. The release criteria for the MEA exceed the standards provided by regulatory agencies and meet the standards expected by our customers. Our MEA is des
Slide 33: Embryo scoring
33 Embryo scoring |
Slide 34: Gardner Blastocyst Grading System
Gardner Blastocyst Grading System 1) 2) 3) 4) 5) 6) Gardner and Schoolcraft (1999) In-vitro culture of human blastocysts. In Towards Reproductive Certainty: Fertility and Genetics Beyond 1999. 34 Eds. R Jansen and D Mortimer. Parthenon Press, Carnforth, pp 378-388.
Slide 35: Inner cell mass and trophectoderm grading
For blastocysts graded as 3 to 6 (i.e., full blastocysts onwards), it is possible to score the inner cell mass (ICM) and trophectoderm. ICM Grading A. Tightly packed, many cells B. Loosely grouped, many cells C. Very few cells Trophectoderm Grading A. Many cells forming a cohesive epithelium B. Few
Slide 36: DAScore
DAScore’ 36
Slide 37: Embryo Transfer Medium
Embryo Transfer Medium Levels of the glycosaminoglycan Hyaluronan increases dramatically in both the mouse and the human uterus at the time of implantation Inclusion of Hyaluronan improved embryo development in culture, and at 0.5mg/ml in the embryo transfer medium had a significant beneficial e
Slide 38: Hyaluronan concentration and implantation rate
38 Monday, October 14, 2002 2:30 P.M. O-11 Increased hyaluronan concentration in the embryo transfer medium results in a significant increase in human embryo implantation rate. William Schoolcraft, Michelle Lane, John Stevens, David K. Gardner. Colorado Ctr for Reproductive Medicine, Englewood, CO.
Slide 39: Cochrane Database of Systematic Reviews
39 Cochrane Database of Systematic Reviews Heymann et al 2020 (26 studies)
Slide 40: New media development
New media development 40
Slide 41: Stress!
The artificial nature of a laboratory leads directly to Stress! 41
Slide 42: Oxidative metabolism and oxygen exposure
Atmospheric oxygen exposure - Gamete collection, preparation and ICSI - Fertilisation check, grading and biopsy - Embryo culture (20% oxygen commonly used for culture) - Cryopreservation Oxidative metabolism (independent of oxygen concentration) 42
Slide 43: α-Lipoic Acid
α-Lipoic Acid Acetyl-L-Carnitine N-Acetyl-L-Cysteine 43
Slide 44: Gx-Mops Plus
a | a { Gx-Mops™ p.us: ee , 44
Slide 45: Antioxidants in culture media improve ICSI fertilisation rate
Antioxidants in culture media improve ICSI fertilisation rate: Results from a randomised controlled trial Rebecca L. Kelley, Lisa Y.S. Lee, Franca Agresta, Alice Huang, Joseph Sgroi, Genia Rozen, Alex Polyakov, Lyndon Hale, Raelia Lew, Catharyn Stern, Manuela Toledo, Fleur Cattrall, David K. Gardner
Slide 46: e rT
e rT SUPPLEMENTED WITH HSA ‘ae 10128, 30 mu. "Medium or cite of omy fom the ronucleate stage 10 day 2 0 day 3. Ready to use ator aquabration at +37 °C and'6 % COn Contaning human serum albumin aod gentamicin |) a Pant ce’ 3 46
Slide 47: Future IVF lab developments
Future IVF lab developments Fertil Steril 120:457 (2023) 47
Slide 48: ≠
≠ 48
Slide 49: Mammalian embryo culture in the absence of serum
From: Gardner DK (1994) Mammalian embryo culture in the absence of serum or somatic cell support. Cell Biol. International 18: 1163-1179. 49
Slide 50: Nano-liter perfusion microfluidic device
scientific reports (2023) D) check for updates OPEN Nano-liter perfusion microfluidic device made entirely by two-photon polymerization for dynamic cell culture with easy cell recovery Hanna J. McLennan®™, Adam J. Blanch®?, Samuel J. Wallace®, Lesley J. Ritter®2, Shauna L. Heinrich®®, David K. Gardn
Slide 51: 3D micron-lithography to create an Embryo Perfusion System
3D micron-lithography to create an Embryo Perfusion System cradle garage embryo Embryo in cradle, 200µm 1mm in garage Two-photon polymerisation 3D-printing technology – micron size, optically clear 3D-printing with sub-micron features resolution No residual toxicity as assessed by MEA and furthe
Slide 52: Summary
Summary Pioneered the movement to single blastocyst transfer Continued media development for 3 decades Move to faster and more objective embryo evaluation Future is increased automation 52
Slide 53: The history and future of IVF: Carlos Simón
The history and future of IVF Carlos Simón M.D., Ph.D. Professor of Obstetrics and Gynecology 53
Slide 54: Increasing clinical outcomes
The history and future of IVF: Increasing clinical outcomes Carlos Simon MD. PhD. Professor Ob/Gyn, University of Valencia, Spain Senior Lecturer PT, Ob/Gyn Department BIDMC, Harvard University, USA Adjunct Clinical Professor Ob/Gyn Department. Baylor College,USA President, Carlos Simon Foundation,
Slide 55: Disclosure
Disclosure FOUNDER & PRESIDENT FOUNDER ASSOCIATE EDITOR FOR PRECONCEPTIONAL CARE EXTERNAL SCIENTIFIC ADVISOR 55 55
Slide 56: 39 years as Reproductive Endocrinologist and Scientist
• 39 years as Reproductive Endocrinologist and Scientist • Trained at Valencia University (Spain) and Stanford University • Scientific Director of IVI (1994-2016) • Founder and Scientific Director of Igenomix (2011-2021) • Professor of Ob/Gyn, University of Valencia & Senior Lecturer PT at BIDMC Har
Slide 57: ART remains inefficient and safety is not better than nature
ART remains inefficient and safety is not better than nature Globally, live birth rates in ART range between 25%-35% per initiated cycle Genetic disorders caused by recessive or X-linked genetic mutations affect 1% of live births causing 20% of pediatric hospitalizations and 20% of infant mortal
Slide 58: 68% of IVF cycles failed
68 % of IVF cycles failed= failed implantation Total 19,898 started cycles 120 100 87% 77% 80 60 45% 40 32% 23% 20 0 Started Cycles Oocyte Pick-up Embryo Transfer Pregnancy Ongoing Pregnancy 58 IVF results, The Netherlands, 202058
Slide 59: Day
Day 48- 7 Days 6 5 59
Slide 60: The periconceptional space
The periconceptional space Life Checkpoints Materno-embryonic crosstalk Endometrial Microbiota Vilella et al., Development Endometrial 2015 receptivity Decidualization Balaguer et al., MHR 2018 Balaguer et al., AJOG 2019 Garrido-Gomez et al., JCEM 2011 Diaz-Gimeno et al., F&S 2011 Moreno et al., AJO
Slide 61: Our genome can be…
Our genome can be… Read Written Hacked 61
Slide 62: Personalized/Precision medicine
Personalized/Precision medicine Generalized Medicine based on population averages towards Precision Medicine based on each person´s individual biology The use of molecular diagnostic tests to determine which medical treatments will work best for your patient 62
Slide 63: Preconception genome medicine
Preconception genome medicine Genomic medicine is the use of genomic information for determining the risk and predisposition to a specific disease, its diagnosis and prognosis, and the most effective therapeutic approach to be employed (Doble et al., 2017). 63
Slide 64: Reproductive genetic risk
Reproductive genetic risk Couple Periconceptional Space Future Capalbo, Poli, Riera-Escamilla, Shukla, Høffding, Krausz, Hoffmann, Carlos Simon. Hum Reprod Update 2021 64
Slide 65: Reproductive genetic risk
Reproductive genetic risk Couple’s at risk for recessive diseases Women’s risk for Down Syndrome screening is aneuploidies offered to all pregnant women! Capalbo et al., HR 2021 65 Female age
Slide 66: The burden of recessive gene disorders
The burden of recessive gene disorders Couples at risk of having a child affected with a 5% recessive genetic condition. Paediatric hospitalizations and mortality 40% (developed countries) Of children born with a genetic disease have 88% no family history for the conditions Expanded carrier screenin
Slide 67: The Human Embryo
The Human Embryo
Slide 68: From PGT-A to niPGT-A
From PGT-A to niPGT-A NGS (Illumina) aCGH (Illumina) NGS (Life-Thermo) 1995 PGT-A 2.0 Blastocyst biopsies PGT-A 3.0 niPGT-A Blastocyst biopsies Cell-free DNA Fluorescence Frozen-thawed cycles Culture medium In Situ Hybridization (FISH) 2008 2010 2012 2013-2017 2018-2019 2020-2022 PGT-A 1.0 Array Com
Slide 69: How to perform embryo aneuploidy testing
How to perform embryo aneuploidy testing Conventional Preimplantation Genetic Non-invasive for PGT-A Testing for Aneuploidies (PGT-A) (niPGT-A) Blastocyst biopsy Cell free DNA (cfDNA) 5-8 trophectoderm cells Embryos cultured Day 5-day 6 released to the media from day 4 -day 6 NGS NGS NGS trophectode
Slide 70: Human embryo live imaging reveals nuclear DNA shedding
© CelPress Human embryo live imaging reveals nuclear DNA shedding during blastocyst expansion and biopsy ‘Ana Domingo-Muelas,'*"° Robin M. Skory,'®"° Adam A. Movertey, Goli Ardestani,° Oz Pomp," Carmen Rubio, Piotr Tetlak,' Blake Hernandez,’ Eric A. Rhon-Calderon,' Luis Navarro-Sanchez,° Carmen M. G
Slide 71: The periconceptional space
The periconceptional space Life Checkpoints Materno-embryonic crosstalk Endometrial Microbiota Vilella et al., Development Endometrial 2015 receptivity Decidualization Balaguer et al., MHR 2018 Balaguer et al., AJOG 2019 Garrido-Gomez et al., JCEM 2011 Diaz-Gimeno et al., F&S 2011 Moreno et al., AJO
Slide 72: The endometrial microbiota
The endometrial microbiota 74
Slide 73: Evidence about the existence of the Endometrial Microbiota
Evidence about the existence of the Endometrial Microbiota 75
Slide 74: In a nutshell
In a nutshell Reproductive success Reproductive failure Live Birth Biochemical Pregnancy + Clinical Miscarriage + No Pregnancy 76 Moreno et al., Microbiome 2022
Slide 75: First independent interventional study
First independent interventional study 77
Slide 76: Personalized treatment cured endometrial dysbiosis in 75%
Personalized treatment “cured” endometrial dysbiosis in 75% of patients ABNORMAL MICROBIOTA ≥10% pathogens 1st biopsy (n=30, 100%) Personalized Antibiotic treatment “CURED” <10% pathogens ABNORMAL 2nd biopsy (n=23, 75%) (n=7, 25%) 78 Iwami et al., JARG 2023
Slide 77: Clinical results in RIF patients
Clinical results in RIF patients PREGNANCY OUTCOMES Intervention AFTER 1ST FROZEN ET 79 Iwami et al., JARG 2023
Slide 78: Endometrial receptivity
Endometrial receptivity Anatomical medicine Molecular medicine Plasma membrane transformation 80
Slide 79: Human endometrial transcriptome
Molecular medicine: human endometrial transcriptome Riesewijk et al., 2003 (HG-U133 2.0) WOI Ponnapalam et al., 2004 (Home-made array) menstrual cycle Talbi et al., 2005 (HG-U133 2.0) menstrual cycle WOI 81 Díaz-Gimeno et al., Fertil Steril 2011
Slide 80: Single cell RNA analysis of the human endometrium
Single cell RNA analysis of the human endometrium 500 bp Single cell separation Stromal Epithelial cells cells Single-cell isolation Wash cells with DMEM medium Data: 71,032 cells from 29 healthy ovum donors throughout their natural menstrual cycle 82 Wang et al., Nat Med 2020
Slide 81: Temporal transcriptome dynamics
Temporal transcriptome dynamics WOI menstrual early-pro late-pro early-sec mid-sec late-sec Unciliated epithelia log2 (rpm+1) fibroblasts Stromal menstrual early-pro late-pro early-sec mid-sec late-sec 83 Wang et al., Nat Med 2020 Decidualization
Slide 82: Personalized embryo transfer (pET)
Personalized embryo transfer (pET) as a treatment for RIF of endometrial origin pET ET P+3 P+5 P+7 LH+5 LH+7 LH+9
Slide 83: How many lines of evidence lead to the truth
How many lines of evidence lead to the truth Essential protection against flawed ideas is triangulation Each approach has its own unrelated assumptions, strengths and weaknesses 86 Munafo & Davey Nature 553, 399-401 (2018)
Slide 84: The pyramid of evidence-based medicine
The pyramid of evidence-based medicine Meta-Analysis Randomized Controlled Trial Prospective Cohort Studies Case-Control Studies Case Series, Case Reports Editorial, Expert Opinion 87
Slide 85: Meta-analysis of personalized embryo transfer guided by ERA
88 fe. Carlos Simon oeetbe roundation SYSTEMATIC REVIEW article Front. Physiol, 27 April 2022 | https://doi.org/10.3389/fphys.2022.841437 The Clinical Efficacy of Personalized Embryo Transfer Guided by the Endometrial Receptivity Array/Analysis on IVF/ICSI Outcomes: A Systematic Review and Meta- Ana
Slide 86: PRISMA
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 89 Liu et al., Front Physiol 2022
Slide 87: RIF patients: ≥3 prior failed attempts
RIF patients: ≥ 3 prior failed attempts Conclusion: pET guided by ERA significantly increases the chances of pregnancy for non-receptive patients with RIF of endometrial origin 90 Liu et al., Front Physiol 2022
Slide 88: Good-prognosis patients: 0-2 prior failed attempts
Good-prognosis patients: 0-2 prior failed attempts Sample size 770 268 OPR/LBR 39.5% 53.7% 91 Liu et al., Front Physiol 2022
Slide 89: Systematic review with meta-analysis
92 fp. Carlos Simon Ls ‘© Foundation Human Reproduction, 2023, 38(7), 1305-1317 human | https://doi.org/10.1093/humrep/dead098 rep roduction Advance Access Publication Date: May 18, 2023 OXFORD Meta-Analysis eye Infertility Personalized embryo transfer guided by endometrial receptivity analysis: a s
Slide 90: Selection of studies
Selection of studies 93 Glujovsky et al., Hum Reprod 2023
Slide 91: RIF patients: ≥3 prior failed attempts
RIF patients: ≥ 3 prior failed attempts Conclusion: In women with RIF, low CoE suggests that pET might improve the CPR (OR 2.50, 95% CI 1.42–4.40). 94 Glujovsky et al., Hum Reprod 2023
Slide 92: Good-prognosis patients: 0-2 prior failed attempts
Good-prognosis patients: 0-2 prior failed attempts Sample size 290 280 OPR/LBR 53.7% 52.9% 95 Glujovsky et al., Hum Reprod 2023
Slide 93: Conclusions
Conclusions ERA is a molecular test based on the transcriptomic signature of endometrial receptivity and its surrogate treatment is personalized embryo transfer (pET). Endometrial transcriptomic signature reveals 30% of displaced WOI that should be corrected for proper embryo-endometrial synchro
Slide 94: Scientific Innovation Phases for PGT-A
Scientific Innovation Phases for PGT-A Panacea Paradise Progress Reality Conclusions: Preimplantation genetic screening did not increase but instead significantly Start reduced the rates of ongoing Harmfull Hell pregnancies and live births after IVF in women of advanced maternal age. Time 97
Slide 95: Scientific Innovation Phases for ERA
Scientific Innovation Phases for ERA Panacea Paradise Progress Reality Conclusion: pET guided by ERA significantly increases the chances of pregnancy for non- Start receptive patients with RIF of endometrial origin Harmfull Hell Time 98
Slide 96: Our view: live birth rates
Our view 65 LIVE BIRTH RATES % 60 Endometrial 15% 55 50 Factor 45 40 Chromosomal 15% 35 Embryo Factor 30 25 20 15 10 IVF 1.0 IVF 2.0 5 1978 2010 99
Slide 97: Carlos Simon Foundation
We work to make a world in which pathologies affecting the UTERUS will no longer be an impossible barrier Co-Presidents Ph.D. Students Clinical Trial Collaborators: Carlos Simon, M.D., Ph.D. Alba Machado Carla Gómez Hugo Vankelecom, David Jimenez Bruno Toson Alba Vives University of Leuven, Belgium
Slide 98: Five strategic priorities
Vitrolife Group committed to deliver sustainable profitable growth Focus on five strategic priorities 1. 2. 3. 4. 5. Own the Innovate to Accelerate Optimise go- Drive platform expand growth in key to-market operational connecting leadership markets model excellence products and services 101 Ensure s
Slide 99: Own the platform connecting products and services
Own the platform connecting products and services Mark Larman Ph.D., VP Vitrolife Group Academy 102
Slide 100: IVF is currently a highly segmented and manual process
IVF is currently a highly segmented and manual process Egg retrieval Sperm processing Insemination and ICSI Embryo culture and evaluation Transfer/Cryopreservation Automate Standardise 103
Slide 101: IVF will become more automated and integrated
IVF will become more automated and integrated Egg retrieval Sperm processing Insemination and ICSI Embryo culture and evaluation Transfer/Cryopreservation 104
Slide 102: IVF will become more automated and integrated
IVF will become more automated and integrated Egg retrieval Sperm processing Insemination and ICSI Embryo culture and evaluation Transfer/Cryopreservation Consumables tracking Equipment Quality Control Sample and procedure tracking Data 105
Slide 103: Our platform approach
IVF will become more automated and integrated – our platform approach Egg retrieval Sperm processing Insemination and ICSI Embryo culture and evaluation Transfer/Cryopreservation Consumables tracking Equipment Quality Control Sample and procedure tracking Data 106
Slide 104: Uniquely positioned to own the platform
Uniquely positioned to own the platform by connecting products and services Approx. 1 million cycles* 107 *Capacity of installed base with around 4.2 million IVF cycles performed globally
Slide 105: Building the platform through innovation and M&A
Actively working on building the platform through innovation and M&A Growth in demand Increase IVF capacity and accessibility Clinics labour and skills shortage Automation and digitalisation Consolidation of clinics Standardisation and scalability Diverse portfolio to address differences in Regional
Slide 106: Clinical experience using EmbryoScope
Clinical experience using EmbryoScope Dr. Mitchell Rosen Reproductive Endocrinologist, Lab Director, University of California San Francisco (UCSF) 109
Slide 107: UCSF clinic profile
UCSF One-site Employees: 160 Number of ART cycles: 3,000 Success rates: 50-70% - depending on embryo and patient diagnosis Percentage of PGT-A: 50% 110
Slide 108: Time saving equivalent to one full time employee
Time-lapse decreased daily time spent evaluating Embryologist time manual Embryologist time time-lapse Time saved with EmbryoScope Daily Procedure (hours) (hours) (hours) Fertilisation check 2.5 0.5 2.0 Embryo evaluations 20.5 15.3 4.2 TOTAL TIME 22.5 15.8 6.2 Time saving equivalent to one full time
Slide 109: Disturbance and risk with manual evaluations
Disturbance and risk with manual evaluations 114
Slide 110: Time-lapse imaging decreases disturbance and risk
Time-lapse imaging decreases disturbance and risk 115
Slide 111: Old laboratory
Old laboratory 116
Slide 112: 100 percent EmbryoScope
100 percent EmbryoScope 117
Slide 113: Time-lapse imaging increased clinical efficiency
Time-lapse Imaging Increased Clinical Efficiency • Fertilization checks • Embryo evaluation 118
Slide 114: Time-lapse imaging increased clinical efficiency
Time-lapse Imaging Increased Clinical Efficiency Fertilization checks Embryo evaluation Egg retrievals 119
Slide 115: Time-lapse imaging increased clinical efficiency
Time-lapse imaging increased clinical efficiency • Fertilization checks • Embryo evaluation • Egg retrievals • Embryo Transfers 120
Slide 116: EmbryoScope time-lapse imaging increased clinical efficiency
EmbryoScope Time-lapse imaging increased clinical efficiency Evaluation is less time dependent 121
Slide 117: Time-lapse imaging increased clinical efficiency
Time-lapse imaging increased clinical efficiency • Embryo Transfers • Egg retrievals • Fertilization checks • Embryo evaluation 122
Slide 118: Time-lapse imaging increased clinical efficiency
Time-lapse Imaging Increased Clinical Efficiency Embryo Transfers More transfers/day Patient satisfier Staff satisfier Egg retrievals Fertilization checks Embryo evaluation 123
Slide 119: Tool for Standardization, Communication, and Research
Tool for Standardization, Communication, and Research • Training new embryologists • Standardises embryo evaluation • Facilitates communication between doctors, embryologists and patients • Research 124
Slide 120: Future of evaluation
Future of evaluation • Integration of AI for embryo evaluation o Increased efficiencies • Standardization • Integration of AI for improved pregnancy rates/transfer • AI and PGT-A for combined score 125
Slide 121: Five strategic priorities
Vitrolife Group committed to deliver sustainable profitable growth Focus on five strategic priorities 1. 2. 3. 4. 5. Own the Innovate to Accelerate Optimise go- Drive platform expand growth in key to-market operational connecting leadership markets model excellence products and services 126 Ensure s
Slide 122: Innovate to expand leadership
Innovate to expand leadership Jørgen Berntsen, Team Lead, AI Group, Technologies/ Carmen Rubio, VP R&D, Genetic Services 127
Slide 123: Innovate to expand leadership – Artificial intelligence
Innovate to expand leadership – Artificial intelligence Jørgen Berntsen Team Lead, AI Group, Technologies
Slide 124: Our history as a pioneer in time-lapse and AI
Our history as a pioneer in the development of time-lapse and AI First time-lapse First baby KIDScore D3 EmbryoScope+ KIDScore D5 EmbryoScope Guided EmbryoScope 8 iDAScore system released born using Flex Annotation for clinical use EmbryoScope® 129
Slide 125: It is all about data
It is all about data 5,000,000 embryo images/day 130
Slide 126: Guided Annotation – an AI for embryo evaluation
Guided Annotation – an AI for embryo evaluation Inner Cell Mass • Timings of embryo development • Blastocyst morphology Trophectoderm • User validated predictions 131
Slide 127: iDAScore – fully automated embryo evaluation
iDAScore – our fully automated embryo evaluation Live birth vs iDAScore Trained on more than 50 30,000 45 transferred embryos 40 Live birth rate (%) 35 30 25 20 15 10 5 0 Poor Medium Good Excellent 132 Adapted Ueno et al., JARG (2022)
Slide 128: Transparent AI development improving workflow efficiency
Transparent AI development improving workflow efficiency Human performance 0,7 Ranking (AUC) 0,6 Science: 0,5 15+ peer-reviewed articles Manual iDAScore v1 Continuous improvements 0,75 Ranking (AUC) 0,70 0,65 0,60 iDAScore v1 iDAScore v2 133 Adapted from Berntsen et al., Plos One (2022) and Ueno et
Slide 129: How AI is set to transform the IVF industry
How AI is set to transform the IVF industry Automation, Time to live birth Patient consultation, Workflow planning, Data integration, KPI, Intelligent QC, Predictive maintenance AI enabled devices 136
Slide 130: Genetic testing to improve clinical outcomes
Innovate to expand leadership: Genetic testing to improve clinical outcomes Carmen Rubio, VP R&D Genetic Services
Slide 131: Advancing our genetics portfolio to improve IVF outcomes
Continuing to advance our genetics portfolio to improve IVF outcomes IVF cycle pathway Stage of reproductive journey R&D priorities THE THE PA TIENTS ENDOM ETRIUM THE EM BRYO THE PREGNA NCY • WES • Future PGT-A R&D • New ERA • EMBRACE 2.0 • NIPT • WGS programmes • Ni Microbiota • niPOC analysis • In
Slide 132: Main drivers of innovation in reproductive genetics
Main drivers of innovation in reproductive genetics 139
Slide 133: From chromosome testing to whole genome sequencing
From chromosome testing to whole genome sequencing The patients The embryo Healthy baby 140
Slide 134: Patients at the heart of everything we do
THE PATIENTS Patients at the heart of everything we do 131 related genes 122 related genes 141
Slide 135: The endometrium is a key player for implantation
The endometrium is a key player for successful implantation THE ENDOMETRIUM 142
Slide 136: Non-selection study in patients with implantation failure
Non-selection study in patients with implantation failure THE ENDOMETRIUM AIMS To increase ERA Additional scientific biomarkers for Non-invasive evidence after immune and EMMA in transfer of metabolic endometrial fluid normal embryos alterations >700 Patients Endometrial Biopsies Embryo Transfer Ong
Slide 137: Non-invasive analysis of cell-free DNA
Non-invasive analysis of cell-free DNA in the culture medium THE EMBRYO American Journal Obstetrics & Gynaecology, 2020 144
Slide 138: Holistic embryo evaluation
Holistic embryo evaluation THE EMBRYO Non-invasive approaches: imaging and multi-omics Bioinformatic analysis cfDNA: cell-free DNA in the culture medium 145
Slide 139: Holistic embryo evaluation
Holistic embryo evaluation THE EMBRYO Comprehensive embryo evaluation combining EmbryoScope® and EMBRACE Prospective clinical study >200 patients >800 embryos 8 clinics 146
Slide 140: Five strategic priorities
Vitrolife Group committed to deliver sustainable profitable growth Focus on five strategic priorities 1. 2. 3. 4. 5. Own the Innovate to Accelerate Optimise go- Drive platform expand growth in key to-market operational connecting leadership markets model excellence products and services 147 Ensure s
Slide 141: Accelerate growth in key markets
Accelerate growth in key markets Rickard Ericsson, SVP, Global Sales & Marketing 148
Slide 142: Well positioned in a growing market
Vitrolife Group is well positioned in a growing market Americas EMEA APAC Total IVF treatments 0.6 M 1.4 M 2.2 M 4.2 M Largest markets Share of total sales 33% 36% 31% 149
Slide 143: Market dynamics in the US, Europe and Japan
Current and future market dynamics in the US, Europe and Japan Dr. Mitchell Rosen Director of UCSF Fertility Preservation Center Mr. Eduardo Gonzalez CEO Eugin Group Dr. Keiichi Kato M.D. at Kato Ladies Clinic 150
Slide 144: The IVF market in the US
The IVF market in the US What major trends and factors are currently shaping the growth and evolution of the IVF market in the US? How do you envisage the IVF market in the US looking in 5-10 years’ time? Which are the key success factors for clinics and networks to focus on to be the preferre
Slide 145: Key IVF market dynamics – How will we bring value
Key IVF market dynamics – How will we bring value Growth in demand Increase IVF capacity and accessibility Clinics labour and skills shortage Automation and digitalisation Consolidation of clinics Standardisation and scalability Diverse portfolio to address differences in Regionalisation of standard
Slide 146: Welcome to explore Vitrolife Group Marketplace
Welcome to explore Vitrolife Group Marketplace 153
Slide 147: Five strategic priorities
Vitrolife Group committed to deliver sustainable profitable growth Focus on five strategic priorities 1. 2. 3. 4. 5. Own the Innovate to Accelerate Optimise go- Drive platform expand growth in key to-market operational connecting leadership markets model excellence products and services 154 Ensure s
Slide 148: Optimise go-to-market model
Optimise go-to-market model Rickard Ericsson, SVP, Global Sales & Marketing 155
Slide 149: What we do to optimise our go-to-market model
What we do to optimise our go-to-market model • Leverage breadth of Vitrolife Group portfolio • Differentiate with value-adding services • Improve customer experience through digital solutions 156
Slide 150: Leverage breadth of portfolio and footprint strengths
Leverage breadth of Vitrolife Group portfolio and footprint strengths 1. Wide portfolio of high-quality products and services with unique spearheads 2. Further strengthening of our direct presence to improve customer access and experience 3. Portfolio of high relevance for all stakeholders within th
Slide 151: Differentiation with value-adding services
Differentiation with value-adding services, support and collaboration initiatives Technical support and procedure optimisation High quality products and services with unique spearheads Education and training Order management and service levels Collaborative research and development initiatives 158
Slide 152: Digital solutions to improve customer experience
Digital solutions to improve customer experience Registered users for Vitrolife Academy Online courses: 3,000 Vitrolife Academy Online courses started: 7,000 Orders through digital channels last 12 months: 40,000 Views of ESHRE/ASRM Online Studio content: 10,000 Vitrolife Webshop Igenomix Clinic Por
Slide 153: Five strategic priorities
Vitrolife Group committed to deliver sustainable profitable growth Focus on five strategic priorities 1. 2. 3. 4. 5. Own the Innovate to Accelerate Optimise go- Drive platform expand growth in key to-market operational connecting leadership markets model excellence products and services 160 Ensure s
Slide 154: Drive operational excellence
Drive operational excellence Patrik Tolf, Janne Östlund, Claus Bisgaard and Ricardo Capella, Vitrolife Group 161
Slide 155: Driving operational excellence
Driving operational excellence Our values Why? Integrity How? What? Quality Sustainable profitable growth Innovation Fund innovation Collaboration 162
Slide 156: Consumables – investments in automisation
Consumables – investments in automisation Doubled and Investments in automated needle media production (2024-26) production capacity Double the capacity (2022) Lower costs and higher flexibility Bulk infeed HSL Cartridge Filling and closing of cartridges DT Depyrogenation tunnel RWM Rotary washing m
Slide 157: Technologies – optimising aftersales service
Technologies – optimising Saved onsite aftersales service service 2024 >500 EmbryoScope® >1,650 instruments in operation Saved onsite service 2027 >1,000 • From preventive towards predictive maintenance o Improved quality and extended service interval o Digitalisation and localisation • Enabling ext
Slide 158: Genetic Services – invest and harmonise to increase scalability
Genetic Services – invest and harmonise to increase scalability • Investment in latest technologies Valencia • Harmonise lab processes to reduce complexity Los Angeles Tokyo • High volume/site to optimise protocol Miami Dubai São Paulo Brazil • Enable new product development 1 Tier 1 • Increase scal
Slide 159: Five strategic priorities
Vitrolife Group committed to deliver sustainable profitable growth Focus on five strategic priorities 1. 2. 3. 4. 5. Own the Innovate to Accelerate Optimise go- Drive platform expand growth in key to-market operational connecting leadership markets model excellence products and services 166 Ensure s
Slide 160: Ensure sustainability in everything we do
Ensure sustainability in everything we do Sabrina Ritossa Fernandez, Group Sustainability Business Partner 167
Slide 161: Sustainability strategy
Sustainability strategy: grounded in our values, driven by our mission Sustainability strategy Purpose-driven growth Mission Be the leading global Ethical profitability partner in reproductive health, striving for better Planet accountability treatment outcomes for patients Inclusive engagement Inte
Slide 162: Purpose-driven growth
Purpose-driven growth 2030 ambition Continue meeting customers and patients' needs by innovating towards successful treatment outcomes, improved accessibility and always ensuring excellent product quality and customer service Prioritised 2030 target Net Promoter Score > 60 2023 progress Survey about
Slide 163: Ethical profitability
Ethical profitability 2030 ambition Alignment of all suppliers, business partners Together for our purpose and distributors with the Vitrolife Group Principles for Responsible Business Conduct (PRBC) Together for ethical conduct Prioritised 2030 target 100% PRBC alignment throughout the value chain
Slide 164: Planet accountability
Planet accountability 2030 ambition Align the Group’s carbon emissions with a 1.5°C emission reduction pathway Prioritised 2030 target Scope 1-3 emissions reduction pathway in line with Paris agreement 2023 progress Committed to set near-term emissions reduction targets in line with climate science
Slide 165: Inclusive engagement
Inclusive engagement 2030 ambition Foster a diverse, inclusive and engaging workplace over the long-term Prioritised 2030 targets People engagement index > benchmark Diversity and Inclusion index > 80 • Diversity performance • People's voice on inclusion 2023 progress • People engagement index: 74 v
Slide 166: Our sustainability strategy
Our sustainability strategy Purpose-driven growth Ethical profitability Planet accountability Inclusive engagement 173 Committed to sustainability for future generations
Slide 167: Financial Overview
Financial Overview Patrik Tolf, CFO Vitrolife Group 174
Slide 168: Consistent profitable growth
Consistent profitable growth - SEK millions + 21% 3,234 2,817 2,607 Gross margin, % 55-56 + 11% SEK 1,780 + 10% local currencies + 5% local currencies 1,569 EBITDA, % 1,463 32-33 1,050 906 842 2021 2022 2023 2021 2022 2023 2021 2022 2023 Pro forma Full Year Q1-Q3 Pro forma Full Year Q1-Q3 Pro forma
Slide 169: Sales and growth per geographic segment
Sales and growth per geographic segment Americas EMEA APAC Total Organic growth* 2022 vs 2021 + 8% + 3% + 40% + 10% 2023 Q3 YTD - 3% + 6% + 15% + 5% vs 2022 Q3 YTD Sales Q3 YTD (MSEK) 869 943 796 2,607 Gross income (MSEK) 418 540 505 1,463 Gross margin % 48% 57% 64% 56% Selling expenses (MSEK) - 189
Slide 170: Sales and growth across business areas
Sales and growth across business areas - SEK millions + 23% + 21% 1,343 1,339 1,252 1,170 1,090 + 18% in SEK 1,004 + 12% in local currencies + 7% in local currencies + 4% in SEK - 1% in local currencies + 16% 553 + 12% in local currencies 475 434 + 9% in SEK + 4% in local currencies + 10% in local c
Slide 171: Well capitalised to pursue future M&A opportunities
Well capitalised to pursue future M&A opportunities Strong operating cash flow… 636 586 ...decrease net debt/EBITDA 384 3 2 1 Operating cash flow, MSEK 2023 Net debt/EBITDA 2023 Q1-Q3 rolling 12 months Q1-Q3 178
Slide 172: Investing for long-term sustainable growth
Investing for long-term sustainable growth CAPEX, MSEK 100 Going forward 90 • Ramping up Consumables and Genetic 80 70 Services capacity 60 • Focused on applied product development 50 and innovation 40 30 • Capex will be doubled over the coming years 20 10 0 2021 2022 2023 Q3 YTD Intangible Tangible
Slide 173: Updated long-term financial objectives
Updated long-term financial objectives Long-term objectives* Annual organic revenue growth in local currency > 10% EBITDA margin > 33% Net Debt/EBITDA <3 Dividend policy 30% of net profit 180 * Five year outlook
Slide 174: Poised to drive long-term shareholder value
Poised to drive long-term shareholder value • Good underlying global market growth • IVF cycles expected to grow 5-7% in coming years • Addressing short-term challenges • ERA testing • In-housing and customer consolidation • Investing for sustainable profitable growth and scalability • Focus on inno
Slide 175: Closing remarks
Closing remarks Bronwyn Brophy 182
Slide 176: Corporate Strategy Vitrolife Group
Corporate Strategy Vitrolife Group Our values Integrity Market Growth Labour and Patient megatrends in demand skills shortage Consolidation Regionalisation empowerment Quality Vision with a purpose Long-term growth and profit-targets ”Enable people to fulfil the dream of having a healthy baby” Innov
Slide 177: Q&A
Q&A
Slide 178: Slide 178