Monash IVF Group Limited (MIS.F) Earnings Call Transcript & Summary

Thank you for standing by, and welcome to the Monash IVF Group Full Year Results for 2021 Conference Call. [Operator Instructions] I would now like to hand the conference over to Mr. Michael Knaap. Please go ahead.

Thank you, Judith. And good morning, and thank you for joining us today for Monash IVF Group's results presentation for financial year '21. Our CFO, Malik Jainudeen, also joins me and will be later stepping us through the detail of the financials. By way of background, Monash IVF is a market leader in providing reproductive care in our core assisted reproductive services, diagnostics, genetics, and pathology services with a growing network of 47 IVF and women's ultrasound clinics and service centers across Australia and Southeast Asia. Our experienced and capable team include 123 doctors and in excess of 550 scientific, nursing and support staff. I would like to take this opportunity to thank every one of our team for their unrelenting patient-first mindset and continued agility in order to thrive during the pandemic. This focus and effort of our people is the reason we are delivering such a positive result today and have an optimistic outlook for the future. I'd now like to touch on the key points of the financial year for FY '21, which are represented on Slide 3 of the presentation. Our underlying profits were ahead of guidance underpinned by market share gains and record ARS industry growth, one might say a COVID baby boom. Our reported NPAT of $25.5 million increased by 116%, whilst our adjusted NPAT was $23.3 million, representing a 61.5% growth on the prior year. We delivered 26.3% revenue growth with significant growth delivered across all of our regions and services. Our IVF stimulated cycles grew by 36.6%. And in our women's ultrasound business, we experienced 12.9% of ultrasound growth. The IVF industry volumes were also strong at 31.3% growth on the prior year, whilst we managed to gain market share to represent 21% in our key markets. We continue the focus and measure our doctor engagement with the highest ever engagement results recorded. This represented a culture of success, which we're very proud of. Furthermore, we delivered $32.8 million free cash flow at 100% conversion of EBITDA and have declared a fully franked final dividend of $0.021. Our balance sheet strength is a strong enabler to drive organic and nonorganic strategic growth in the future. I wanted to touch on the attractive industry fundamentals as behavioral shifts support volume growth in this financial year and beyond. So I draw your attention to Slide 4. There continues to be an advancement in maternal age as a long-term trend as people have delayed starting a family, which continues to increase infertility rates. Although there has been a significant increase in IVF demand, our patients' average maternal age of 37 has remained constant since the start of the pandemic. We believe the ongoing pandemic has changed the mindset in the community with greater focus on family, health, and well-being. This is resulting in a redirection of priorities towards creating and extending their families into the future. To support that, we had a 40% increase in new patients accessing our domestic network for stimulated cycles, which is well above the industry growth rate. Growth in our service offerings and advances in technology is driving improved outcomes and appeal to the fertility value proposition. There is good growth potential in donor, social patient treatments and genetic services into the future. Our significant recent improvement of 4.5% in the clinical pregnancy rate over the last 3 years is a testament to the improved value proposition for our patients. The government funding regimes of both IVF and ultrasound services is stable and continues to support growth and affordability for our patients. There is also an increase in government support from the 1st of November 2021 for patients who are carriers of known genetic disorders. They will have access to new significant Medicare rebates for embryo testing and diagnosis to prevent their children from having genetic diseases. If we now take a look at Slide 5 to focus on the broader ARS Australian market where demand for services in Australia continues at record highs. The left-hand graph represents quarterly growth in stimulated cycles. There is significant growth experienced in the Q1 of FY '21 due to pent-up demand and the deferred treatment created in the fourth quarter of FY '20. The consistent and robust growth in quarter 2, 3 and 4 continued, demonstrating strong underlying demand for IVF services. It is worthwhile noting that the fourth quarter comparative is affected by the temporary IVF suspension of elective surgery, hence, the 63% growth number. And the right-hand graph represents the number of Australian cycles per year, noting a step change in volume in FY '21 with a 31.1% growth rate, with that year being a record year in the number of Australian stimulated cycles performed in any year. If we move to the specifics of the rapid recovery post elective surgery shutdown and our return to growth on Slide 6. In Australia, for our stimulated cycles in FY '21, the recovery was swift in the first quarter, and growth momentum continued to build throughout the year. This momentum is being carried forward into FY '22 as we have a solid new patient pipeline demonstrated by our strong growth in new patient registrations over the previous 6 months. That growth was 35%. On the international front, COVID-19 restrictions in Malaysia impacted consumer confidence. However, with these challenges, the clinic still delivered 1,008 stimulated cycles in FY '21, which was well up on the prior year. Furthermore, our women's ultrasound scan growth was 12.9% in FY '21, with the second half of FY '21 growth being 14.2%, again, further highlighting the baby boom. Having a clear picture of the recovery and growth acceleration of our Australian IVF volumes, I would just like to cover off in more detail our growth rates and the market shares on Slide 7. In our key markets, our stimulated cycles increased by 36.6% versus industry growth of 31.1%. This led to market share gains of 0.6% to a total market share of 21%. The key contributing factors to our market share gains included a significant increase in our marketing investment that has continued to grow the short- and the long-term patient pipeline as we continue to dominate share of voice during the last financial year. We have new fertility specialists in New South Wales, Queensland and Victoria that are rapidly developing their volumes. We also had a full year contribution from the Fertility Solutions acquisition in Queensland whereby, in the previous corresponding period, we had 9 months of contribution. We started to get contribution from our new Sydney CBD flagship clinic in New South Wales that continues to build good momentum. In Victoria, New South Wales, Queensland and the Northern Territory, we increased our stimulated cycle market share in FY '21 whilst South Australia maintained majority market share above 60%. I would now like to welcome the CFO, Malik Jainudeen, to take us through the financial results for the year.

Thank you, Michael. If we all turn over to Slide 9, I'll walk you through the revenue waterfall that's illustrated on that slide. You'll see that strong industry growth drove $27.5 million of additional revenue to Monash IVF. And what's important is that was demonstrated across all our domestic IVF markets. As Michael illustrated, that first quarter had all the pent-up demand created at the end of last year. And you'll see in the graph on the right side, our revenues in the first half was $90.8 million. But what was pleasing was, in the second half, it was $92.8 million. So that just illustrates that the first quarter pent-up demand was serviced but that growth continued in the second, third and fourth quarters. If you look at the next bar, our revenue increased by $3.3 million as a result of market share gains. And as Michael illustrated, our market share increased by 0.6% compared to last year. Looking at the next bar, we had a pricing negative impact of $1.8 million. And as mentioned at the half year, that is a reflection of no out-of-pocket stimulated cycles offered to patients impacted by the suspension of ni-PGT genetic testing program. If you'll have to look at the next one, International, our KL business has been extremely resilient. The environment in Malaysia is extremely challenging, but that business did over 1,000 cycles, which was very promising. If you look at the next bar, $1.7 million additional revenue from acquisitions. That is from our Fertility Solutions business that we bought in FY '20. That business is a hybrid business that has low cost and full service. What drove much of that growth is a higher proportion of full service cycles. What that tells us is the full service business in our Queensland region is extremely promising, and it's a strong reflection of how full service can grow in the pandemic environment. Our Ultrasound business generated an extra $3.8 million of revenue on the back of ultrasound scan growth, and we had additional revenue generated through our day hospitals. We turn over to Slide 10. Our reported NPAT was up by 117%, which included 3 nonregular items that included JobKeeper subsidies received for '21. Once you strip these out, our adjusted NPAT was up by 61.5%, reflecting a 37% increase in adjusted EBITDA and an EBITDA margin improvement from 23.9% to 26%. As a result of the 26% increase in revenue, we generated operating leverage, which allowed us to be aggressive in marketing to drive and maintain our strong new patient pipeline and support our doctors. We've invested heavily in our nursing and scientific workforce, which is improving our patient engagement and experience which, in turn, is increasing our staff engagement scores. As noted as part of the revenue slide, ni-PGT has had an impact on our business, both from a revenue perspective but also from a cost point of view. It added an extra $1.7 million of additional costs for us to focus on the response to our notification about the suspension of the test. Depreciation and amortization was higher, reflecting the full annual cost for the new Sydney CBD premise, which opened in November, and depreciation on assets that are increasing our capacity in our labs with best-in-class equipment. Turning over to Slide 11. We've had a very strong cash flow year. You'll see illustrated in the table, we've generated additional $44 million of operating cash flow. This reflects a 100% EBITDA conversion to pretax operating cash flows, which illustrates the cash generation ability of this business notwithstanding several cash outflows, which were deferred at the end of FY '20. CapEx for the year was $10 million. As illustrated previously, that includes the new Sydney site and new equipment in our labs. As you'll see on the next slide on the balance sheet, we've reduced our borrowings by $18 million, and we recommenced dividend payments during the year following a temporary hold on dividend payments at the end of last year. Turning over to Slide 12. Our balance sheet is obviously in a very strong position, and that will enable us to drive future growth, whether that be organic or nonorganic. We've got strong intentions to continue to improve our clinical infrastructure with projects in design or approval phase, largely for new infrastructure in Melbourne, Penrith and the Gold Coast. We have intentions to continue to expand our Southeast Asia presence with 2 clinics now in Malaysia, a minority holding in Jakarta and a soon-to-be-built clinic in Bali. This strategy will continue to evolve. Our net debt is currently cash positive, and our existing debt facility is due for maturity by January 2022 and our lenders have indicated strong support for the refinance. Given the current net debt position and strong earnings that we've generated during the year, there is substantial headroom available in our banking covenants. I'll pass you back to Michael.

Thank you, Malik. Now I'd like to take you to Slide 14, as we start to work through some of the details of our Australian ARS operational performance. I'll start with scientific leadership. We have continued our unrelenting focus on investing and building scientific capability to ensure we are giving our patients the best possible outcomes and differentiating our value proposition to all our patients. The chart at the bottom of this slide represents the continuous improvement in our clinical pregnancy rates across our group, with clinical rates consistently improving to ultimately a 4.5% improvement in 3 years. We have been on this journey of continuous improvement throughout our long heritage. However, it is worthwhile calling out some of the initiatives that will drive further improvements in our success rates into the future. We will continue to partner innovative organizations to advance new technologies, such as the safer and softer method of ICSI that is demonstrating improved fertility rates, therefore, creating more embryos for our patients. Another new technology we are working on in partnership with Memphasys is to develop a more effective sperm selection process, utilizing the Felix device. New partnerships and technologies, backed by an ongoing research focus through our various research bodies, will ensure we continue to evolve and improve our success rates. The submission and presentation of 21 scientific and clinical abstracts at national and international conferences is testimony to our research commitment. Furthermore, we are transitioning our genetic labs to G-Category status to enable best-in-class preimplantation genetic screening services. If we turn to Slide 15, an essential pillar of our strategy being doctor partnerships. We continue to strive to have mutually rewarding partnerships with all of our doctors in a very transparent, collaborative and supportive way. Our partnership with our doctors has never been stronger, and this is demonstrated through the recent engagement survey, as previously outlined, whereby we are reflecting a culture of success. Recruitment of doctors is a testament to this. We have recruited 5 new experienced fertility specialists that joined Monash IVF in the last financial year and will deliver future growth and support succession planning. Furthermore, we had 4 new fertility specialists graduating following completion of the Monash IVF training program. These doctors are now actively consulting and treating patients and are gradually building solid patient pipelines. We see that genetic sphere a key driver of growth. And with that, we have partnered with the only domestic genomic pathologist with a dual qualification in genomic pathology and obstetrics and gynecology. He is Monash IVF's Medical Director of Genetics and will lead our next-generation of genetic services. If we take a look at our clinical infrastructure progress and plans outlined, this is on Slide 16. The strategic priority of our clinic infrastructure continues to be a focus on the medium-term horizon as our clinics are paramount to the execution of our strategic growth objectives. Our new Sydney CBD flagship clinic opened in November, representing best practice patient experience with 4 fertility specialists now based of a new clinic, including 3 new experienced CREI qualified fertility subspecialists. We are pleased with the progress in having performed more than 200 stimulated cycles in June '21. The clinic will further improve its earnings in FY '22 given the caliber of doctors that have recently joined us. The transformation of our Melbourne footprint is well advanced with a new large-scale fertility clinic and day hospital expected to open in Cremorne located in the Inner East of Melbourne. We expect to open this clinic towards the end of the financial year 2022. Furthermore, a new Gold Coast fertility clinic complemented with a day hospital is expected to open late in financial year '22. And other fertility clinics are also expected to open in the latter half of financial year '22, including Penrith in Western Sydney and Darwin, both of which are a replacement and an upgrading of existing facilities. I draw your attention to Slide 17. Our people's positive engagement remains a key priority, and we are pleased with the further improvement in our employee engagement score, exceeding any previous year and demonstrating a culture of success. This also exceeded our Vision 2022 target and is well exceeding the industry benchmarks. Our employer value proposition has been a key priority. And we continue to position ourselves as a dynamic industry leader in reproductive care, offering dynamic workplaces for those driven to make a difference. We will continue working with our leadership teams to drive engagement to create high-performing, accountable, importantly, fun, safe and inclusive workplaces. Our significant strategic marketing investment is a key driver of our market share gains and, in particular, drove a 40% increase in new patient stimulated cycles, which was well above market growth as previously outlined. During the last 12 months, our new Monash IVF brand was launched with innovative targeted advertising. This brand launch was supported with a comprehensive online event strategy and website upgrades. A very important element to our referral pathway are through GPs, and we continued our GP engagement strategy to drive strong GP referrals and engagement. If we turn to our diagnostic ultrasound performance on Slide 18. Our FY '21 ultrasound volumes increased by 12.9%, and noninvasive prenatal testing increased by 17.8%, being the strongest growth we have seen in this service offering for many, many years. And yes, a baby boom is upon us. Ultrasound scan volume growth was experienced in all markets, with Sydney growing by 14.5% and Melbourne growing by 4.8%. Due to COVID-19 movement restrictions, outer suburban ultrasound clinic demonstrated significant growth, whilst inner city locations are yet to return to pre-COVID levels and, in fact, has softened further given recent lockdowns. However, we do have the flexibility with a good spread of suburban clinics in Sydney and Melbourne to effectively manage the geographical shift in demand. Following significant increase in demand for reproductive carrier screening services, we are soon commencing distribution of a new productive genetic screening kit that will be available online and through obstetricians, gynecologists and fertility specialists. This is a key strategic growth driver that will lead to future stimulated cycle growth to prevent genetic disease in children as awareness for the service grows. I just wanted to briefly touch on the group proceedings against Monash IVF as was previously announced. We have lodged our defense to that class action in June 2021 against the alleged claims. Furthermore, the matter to the claims has been indemnified by our insurers. Just wanted to move on to abroad with our ARS International operational performance on Slide 19. We have had solid progress in our Southeast Asian expansion strategy despite the COVID-19 challenges. Although movement control orders have and continues to heavily impact the operating environment in our Kuala Lumpur clinic, we delivered a stimulated cycle increase of 21.6% for the financial year, however, still slightly below FY '19 pre-COVID levels. Kuala Lumpur revenue increased by 5% to $10.4 million compared to financial year '20, reflecting volume increase, partly offset by a reduction in average revenue per stimulated cycle. This was due to promotional and discount offerings in light of the continued competitive pricing pressure and a weak macroeconomic and political environment. We anticipate the competitive pressure on pricing will dissipate when the international border reopens. In regards to progress in our long-term strategic expansion in the Southeast Asian region, our Johor Bahru, Malaysia fertility business acquired in June 2020 continues to be restricted by the closed border between Singapore and Johor Bahru. However, this remains a key long-term strategic growth asset in the region. In January 2021, the group, in partnership with a large Indonesian private hospital group, Mitra Keluarga, opened a greenfield fertility clinic in Jakarta whereby we hold a minority shareholding. That plant is currently impacted by the COVID-19 conditions in Indonesia. However, it's quickly building a brand and reputation in the region. In June 2021, we cemented another joint venture partnership as the majority shareholder with a private hospital group in Bali, Indonesia. Together, we will build and operate a new fertility clinic that will open during the next financial year. Given our presence in the Southeast Asian region and recent progress on expansion, we are very well placed to execute on acquisition and partnership opportunities, which continue to evolve and present in the Southeast Asian region. If I draw your attention to Slide 21 in reference to our strategy. Our Vision 2022 strategic road map has been upgraded with Vision 2026. Vision 2026 is the next generation of our strategic journey. And it is important to note that our Vision 2026 is fundamentally consistent with our objectives and aspirations of Vision 2022. We have made significant progress on our strategic pillars, as previously outlined. And with this platform established, we will continually evolve and improve in order to deliver our Vision 2026. Vision 2026 will continue to enable everyone to understand the priorities, actions and decisions required to achieve success and deliver profitable growth in the oncoming 5 years. I would also like to say that in the confusion, uncertainty and interruptions as a result of the pandemic, we successfully navigated our way through these challenges and continue to maintain momentum in our strategic growth initiatives. These will become more transparent in time. If we move to the all-important outlook statement for FY '22 and beyond on Slide 22. We believe there is a fundamental shift in the community whereby the ongoing pandemic has changed the mindset of our patient cohort with greater focus on family, health and well-being, resulting in redirection of priorities towards family extension. This shift has driven strong growth in FY '21 and is expected to be maintained in FY '22. I would like to emphasize our key initiatives that will support our future growth. The new fertility specialists we partnered in FY '21 will drive volume growth in FY '22, and we are well positioned to attract additional experienced fertility specialists. Opening of new clinical infrastructure in the latter part of FY '22, including new projects that are well advanced in Melbourne, Gold Coast and Penrith will continue to drive increased volume. The conversion of our current strong new patient and returning patient pipelines will continue to drive growth. Our second half '21 new domestic patient registrations were 8% higher than in the first half of FY '21 and 35% higher than the second half of FY '20. We will continue to invest in sustainable, innovative marketing that is expected to continue to maintain and build the new patient pipeline. We're also expanding our genetics capabilities and service offerings, such as the newly commercialized reproductive genetic screening kits. We will continue our unrelenting focus on improving our success rates, and we will enhance our patients' experience. We plan to identify and execute on nonorganic growth opportunities, both in Australia and abroad, including our expansion into Southeast Asia. Therefore, we see drivers of growth. We are confident revenue and earnings can grow in FY '22, subject to any adverse impact from the ongoing pandemic. We will provide you with a further update on our 2021 Annual General Meeting that's planned to be held in November. That concludes the formal part of the presentation, and Malik and I are happy to take questions. Thanks, Judith.

[Operator Instructions] The first question comes from Rachael Harwood of Macquarie.

I guess my first question is just around market share. So it looks like you gained some market share in Australia. I mean you touched on the reasons behind this briefly. But maybe could you just expand on what you're seeing just across the market at the moment just given this big increase in overall cycles and then, I guess, how you're thinking about market share in FY '22?

Yes. Sure. Look, I can sort of, I mean, only judge based on our internal data. Certainly, I suppose the industry's sustainability and growth into the future, our partner on it certainly suggests that it's going to grow on the pcp or on FY '21, which is a record year. Where I get comfort from that is that the inbound inquiries from new patients, which actually take sort of 9 months to convert to a treatment, is up on the previous years. And that was on high basis over the last sort of 3 months. But also our new patient registrations, which I outlined, is an indicator of the next 3 to 6 months' volume. And we had a 35% increase in our new patient registrations over the last 6 months. So that gives us some confidence that we've got the right engine to grow into FY '22. In regards to marketing, I think the other question was, yes, look, we've been quite active in the market and we're being really strong on investing in advertising in both above the line and below the line. But we've done 2 TVCs, radio campaigns and a second-generation campaign that was just recently launched that, hopefully, you've all seen, those that are in our target market, which is getting some great results as far as inbound inquiries. We've certainly done a lot of work in regards to digital engagement. Things like fertility retreats, Facebook Q&As with our fertility doctors, sessions with GPs on education and learnings and also contributed to build our digital presence through social media and also through reinventing and rebranding our website. So those type of initiatives will carry forward into FY '22, and we expect that, that will continue to drive volumes to support growth in FY '22.

Yes. That's great. And then, I guess, just following on from that. You did mention a big increase in new patient starts. Do you have a sense as to the split between new patients and returning patients? And then how do you think this translates into subsequent cycles of FY '22?

Rachael, it's Malik. And thank you again for Macquarie covering our stock. On that question, in a business-as-usual environment where we, prior to the pandemic, probably had about 48% to 49% of our activity on new patients and the remainder of returning patients. For the last 12 months, that flipped. That's just a reflection of the number of new patients that have accessed our network and probably access the general market as well. So in FY '21, that new patient numbers were at 52% of our total activity. So that will probably revert back to normal at some point in time. But given our current new patient pipeline is still quite strong, we'll still see a pretty high split of new patients versus returning patients.

Yes. That's great. And then I guess, just a final question for me for now. It's just, I guess, how you're seeing exit rates in terms of volumes in July and August and then how you're thinking about -- I guess you spoke to higher volumes with this increased pipeline in FY '22. But do you think that there's going to be any impact just given the current lockdowns at the moment?

So just to reiterate, I guess I'd cast your mind back to July and August sort of last year whereby we had sort of industry record highs, and that was catching up from the pent-up demand. So we're seeing that we can still grow on those volumes. And that comes through, through our new patient registrations growth, which is supporting that growth. The other question was, sorry, Rachael?

Yes. Just on COVID, do you see any impacts from it?

Yes. Look, the only shift in our Ultrasound business has occurred from CBD servicing to outer suburban servicing as people are staying at home. We're seeing no significant shift in regards to inbound inquiries, new patient registrations, doctor consults from an IVF perspective and, certainly, no shifts in people being hesitant to come through for treatment. So I haven't seen any impact at this particular point. In saying that, it's quite a dynamic environment and quite deep penetration of COVID in New South Wales particularly but also in Victoria. But I guess I'd cast your mind back to when Victoria was in that long lockdown last year. IVF services continued to be performed in that environment. I think Victoria had over 700 COVID-19 cases at that particular time. And the appetite for patients to want to come into an environment that's safe and protected, and we do a lot of work around ensuring that they feel safe and protected for our staff and for our patients, it didn't demonstrate any slowdown whatsoever and it isn't currently with the penetration of COVID in New South Wales and in Melbourne.

[Operator Instructions] The next question comes from David Stanton of Jefferies.

So firstly, you had quite a strong CapEx number in 2021 as we would expect. Can you give us any kind of color for CapEx for 2022, please?

Dave, it's Malik. Expect similar numbers. As we called out in the preso, we've got strong intentions for clinical infrastructure growth, and we called out Melbourne, Penrith as well. So they're going to be commensurate-type spend compared to the Sydney project, particularly in Melbourne. Penrith is a bit smaller. But again, expect $10 million, $11 million, $12 million in FY '22.

Great. And if we could move to the sort of fertility doctors, specifically in Australia, you had, from my analysis, and stop me if I'm wrong here, basically unchanged number of fertility specialists on a sequential half year basis. That's the first question. And the second question from me then is how many of those fertility doctors, particularly in Australia, are encompassed by profit share?

Yes. Dave, thanks for your question. In the second half, we did recruit a couple of new doctors, particularly in New South Wales and CBD, but there was also a couple of retirements that offset that number, which we have managed through from a succession planning perspective. So that's why you've got neutral results. In regards to profit share, most of our doctors are on a fee-for-service arrangement. So they get a percentage of the stimulated cycle or frozen embryo transfer that they perform or they're responsible for in regards to profit. The other, on the profit share, is that our doctors probably hold around about 5% of our shareholdings, profit share through that arrangement. And dividends applicable to those shareholdings is relevant to those doctors that are holding shares. But there's no, I guess, structured general profit share arrangement outside of the way they've been remunerated and whether they're owners in equity.

Understood. And my final question, coming back to market share. Firstly, where are we in terms of remediation cycles? How many more do you guys have to do into '22 compared to what you've done in 2021, please?

Just in terms of patients that access ni-PGT prior to October, Dave, there's been a number of different offers to patients throughout the journey. It's very individualized. Some patients have had more than one cycle in terms of remediation. Others, haven't had any. So it's really on an individual basis. We think the majority of patients have washed through, but each patient that's impacted has a different journey. So I don't think there's any material cycles to come, but we'll just have to see how that plays out.

But Dave, we can see the tail. I mean we're into 10 to 20 sort of cycles a month now as opposed to what it was in the initial phase. So it's diluting its impact on overall margins.

Okay. And then, I guess, how much of the 60 basis point increase in market share or the, call it, 2,600 increase in cycles has come from remediation cycles? Can you give us an update on that, please?

Yes. The overall remuneration cycle was just in excess of 500. But David, in our view, that hasn't exacerbated our market share. These are patients that were with us, that were in a treatment program, that continued on their treatment. We just financially supported them as a result of the implications of the suspension of noninvasive PGT. So we expected that, that market share was going to continue to grow regardless of that financial offer.

[Operator Instructions] We have a follow-up question from David Stanton of Jefferies.

Happy to dominate the questions here. I guess just to reiterate your final statement then, you this those market share -- bottom line, you think those market share gains that you've had in F '21, whether they're from remediation or other, can be maintained into F '22, we should be thinking yes?

Yes. Absolutely. And we have an optimistic view that we can grow some market share given our pipeline into FY '22 as well.

Okay. And then you've also had price increases in F '21, towards the back end of F '21. What should we be thinking about potential price increases into F '22, please?

We increased by between 2% to 3% again in every market during FY '21, except for VIC. Victoria moved on the 1st of July by just under 3%. So that's the impact that we'll have in our top line next year, no doubt about it. Those prices are executed. Quotes are at those new pricing, and we think that will come through.

Understood. And I guess, it's interesting to see that you're talking about second half domestic patient registrations were about 8% higher on a sequential basis. Just to confirm what you said on a previous question that you tend to see that volume come through in around the 6-month mark. Is that correct?

Yes, it's probably the 3 to 6 months for the market, depending on circumstances. So probably a higher percentage coming through 3 to 4 months than they do at 5 to 6.

And Dave, just on our comfort on that conversion, we know 7 out of 10 convert. And that conversion rate has not changed for a very long time, and it hasn't changed during the pandemic. So once they are registered, we expect 7 out of 10 to come through.

Okay. And finally from me, would it be fair to say that during this COVID or post COVID, more than anything else, we've seen an increase of willingness by at least the Australian consumer to go into sort of the higher-end cycles that have potentially higher levels of success rates? How should we be thinking about balancing the industry between low-end and high-end cycles going forward in your view?

Look, we only play at the premium end of the market, and that's our strategic decision. And clearly, based on anecdotal evidence and with some numbers that have been published probably more so in the first half, the premium end of the market has grown at a greater rate than lower cost. Probably maybe a part of the financial impact during COVID had sort of been that lower demographic but also, given people's concern and willingness to go have a family and they've probably got a few extra dollars in their pocket at that age group that we target, that's allowed them to get the best service, the best science, the best brand, the best reputation and ensure that they pay for that and can afford that. So that's what we offer, that's our clientele and our patients. And certainly, there seems to be a heavy focus on that top end of the market as opposed to what's been impacted at the lower end of the market.

There are no further questions at this time. I now hand over back to Mr. Knaap for closing remarks.

Thanks, Judith. I'd just like to thank you all for your time and your interest in Monash IVF Group, and we certainly look forward to seeing many of you in the oncoming week and also sharing some of the exciting future that we see for the Monash IVF Group. Thanks very much.

Thank you. Ladies and gentlemen, that concludes our conference for today. Thank you for participating. You may now disconnect your lines.