IVF centres · Healthcare
Cycle-level cost and package liabilities for IVF centres, tracked to completion
An IVF centre sells treatment as a cycle or a package of cycles, collects much of the fee in advance, and delivers it over months. We cost each cycle from drugs, consumables, laboratory time and doctor fees. We also track every package to completion, so the advance on the balance sheet reflects what is still owed to patients.
In one paragraph
Fertility centres and IVF chains, usually with one to fifteen centres and ₹10–250 crore turnover, sell treatment as a course rather than a visit. A patient commits to several steps, sometimes with financing and sometimes with a refund if treatment does not succeed. The centre may then store embryos or gametes for years. Founders and medical directors, often with the finance head, need accounts that follow that whole arc.
Founder or medical director, often with the finance head
The economics
How the money moves in this trade
A cycle combines stimulation drugs, culture media and laboratory consumables, embryologist and clinician time, procedures such as egg retrieval and embryo transfer, and optional add-ons. Its cost varies with the protocol and with whether the transfer is fresh or frozen. Much of the consumable cost is incurred whether or not the cycle progresses. Laboratory capacity — incubators, workstations and embryologists — is fixed and has to be filled.
Some centres sell packages covering several cycles, and some offer a partial refund if treatment does not succeed. Patients may pay through finance partners, who can charge the centre a fee for offering instalments without interest. Cryostorage generates small recurring fees over long periods. Marketing and referral costs per patient are high. Revenue recognition, refund provisions and the true margin on a package are therefore hard to read from the cash collected.
The problem
Where the numbers usually break down
Cycle cost is not known
Drugs, media and consumables are expensed as bought, so the centre cannot say what a fresh or frozen cycle costs, or how that varies by protocol.
Package advances are recognised too early
Fees for multi-cycle packages are booked as revenue when collected, though several cycles remain to be delivered and refunds may be due.
Refund exposure is not provided for
Refund-linked packages carry a liability that depends on outcomes, but no provision is made until a refund is actually paid.
Patient-finance subvention is netted off
Fees charged by finance partners are deducted from the amount received and never reported as a cost of the sale.
Cryostorage fees are not tracked
Annual storage charges are billed irregularly, renewals are missed, and long-stored samples have no current fee or consent status in the finance records.
What we do
The work, and the result each part produces
Cycle costing by protocol
Drugs, media, consumables, laboratory and clinician time costed for fresh, frozen and donor cycles at each centre.
Each cycle type has a known cost to set against its price.
Package liability register
Every package tracked by patient, with cycles delivered and remaining, advance held and revenue recognised as cycles are completed.
Advances in the books match the treatment still owed.
Refund provisioning
Refund exposure on outcome-linked packages estimated from the centre's own history and provided for as packages are sold.
Refund cost lands in the period of the sale, not the period it is paid.
Patient-finance cost reporting
Subvention fees and charges from finance partners reported as a cost against the packages they fund.
The real margin on financed treatment is visible.
Cryostorage billing and renewal
Stored samples reconciled with billing records, with renewal fees raised on schedule and overdue accounts reported.
Storage revenue is complete and current.
Centre and patient-acquisition economics
Contribution by centre after marketing, referral and finance cost per patient started on treatment.
Marketing spend is judged by what each patient contributes.
Where we start
The first steps of an engagement
Package terms and patient ledgers
We ask for package terms including refund conditions, patient-wise advance ledgers, cycle records from the clinic software, drug and consumable issues, finance-partner settlement statements and the cryostorage register.
Advances against cycles delivered
For every open package we set the advance held against cycles delivered and cycles still owed. Refund-linked packages are listed with their exposure.
Package liability register started
Each package is entered in a register by patient. Revenue is then recognised as cycles are completed, and refund exposure is provided as packages are sold.
Cycle cost and liability report
The first report shows cost per cycle by type and centre, advances held against treatment owed, and finance-partner fees set against the packages they fund.
How it is measured
The reports the work is judged on
Each is recorded as a baseline before the work starts, so later reports have an honest comparison.
- Cost per cycle, by cycle type and centre
- Package advances held against cycles outstanding
- Refund provision against refunds paid
- Patient-finance cost as a share of financed revenue
- Cryostorage fees billed and collected
- Contribution per patient, after acquisition cost
Who it suits
Written for, and not the right fit for
- You need help with registration under the Assisted Reproductive Technology (Regulation) Act or with clinical protocols; those are your responsibility with the regulator and your clinicians.
- You need the centre's statutory audit or tax-audit report signed — that is the work of an independently engaged CA.
- Fertility centres selling multi-cycle or refund-linked packages.
- IVF chains opening new centres and needing centre-level economics.
- Founder-led fertility groups preparing for investment.
Services
Services this work draws on
Costing and profitability
What each product, line and customer really contributes.
Explore service ↗Outsourced accounting
Your books kept current and reconciled, closed to a published calendar.
Explore service ↗MIS and financial planning
Reporting built around the questions you actually need answered.
Explore service ↗Internal controls and risk
Controls sized to your business, documented and actually tested.
Explore service ↗Every other service, also available in this trade
Common questions
Questions owners in this trade ask
When should we recognise revenue on a three-cycle package?
Broadly as each cycle is delivered, with any refund obligation provided for. The exact basis depends on your package terms, and we document a consistent treatment for your statutory auditor to review.
Is it worth tracking small cryostorage fees?
Yes, because they accumulate over years and missed renewals are rarely recovered later. Reconciling stored samples with billing usually brings up accounts nobody has charged.
Do you advise on ART Act compliance?
No. Registration and compliance under the Act are matters between your centre and the regulator. We work on costing, package accounting and controls.
5th Quadrant performs costing, revenue and liability tracking, reconciliation and reporting work. Registration under the Assisted Reproductive Technology (Regulation) Act, clinical protocols, consent and clinical establishment registration are the centre's own responsibility with the regulator and its clinicians. Statutory audit and tax-audit reports are performed by independently engaged licensed professionals. Full detail is on our Professional Scope page.
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