There is no Asian counterpoint to KKR’s USD 3.2bn acquisition of IVI RMA in 2023 and its subsequent buildout of the Spain-headquartered IVF provider across 15 countries in Europe and the Americas. But Hong Kong’s Templewater could be the closest to create one with its newly launched Women’s health platform, albeit at a smaller scale.

There is a sense that Asia’s complexity in terms of cultural and regulatory differences makes regional IVF plays difficult. Australia’s leading players have a history of probing Southeast Asia, notably the likes of Monash IVF and Vertus Health, but there is little faith in Australia as a suitable staging ground for a thoroughly pan-Asian expansion in this space.

Templewater is taking a different approach, recently securing anchor assets for its women’s health platform in Hong Kong and Singapore. Malaysia, Japan, Vietnam, and Thailand are on the bolt-on agenda.

The private equity firm purchased Singapore’s Ascensus Health from Dymon Asia Private Equity late last month, six weeks after acquiring The Women’s Clinic Group (TWCG) of Hong Kong from Lunar Capital. Both are now held in Templewater’s second private equity fund, which targets companies with enterprise valuations of USD 100m-USD 200m.

The fund remains in the market with a view to collecting USD 300m-USD 400m. Simon Chuk, a partner at the firm, said he expects a final close on target by the end of next month.

“You’re talking about a USD 4bn-plus market with high single-digit growth going forward. Just from a market sizing and market growth perspective, the fundamentals are strong,” Chuk said of the women’s health market for Hong Kong, Singapore, and Malaysia.

“Then we think about the value-add we would bring. We generally feel that standalone clinic groups in each city or country in the region are too small to think about investment into technology to improve the patient journey, patient experience, and patient outcomes. We see size and scale as the key criteria to help these practices grow.”

Building a platform

Templewater had been tracking TWCG for three years, plotting its entry into the industry and developing relationships with the relevant counterparties. This allowed it to negotiate a proprietary transaction with Lunar, which had acquired a 65% stake in the business in 2021 for about USD 35m.

Likewise, Templewater has been following Ascensus since at least 2022, when the company, then known as Singapore O&G, was 93% acquired by Dymon in a deal worth about USD 110m. It was sold to Templewater via an auction.

TWCG operates six clinics, three IVF labs, and one blood lab with 150 staff across Hong Kong and Singapore. Ascensus has 13 clinics and 60 staff in Singapore and Malaysia. The Malaysia presence is small but planned to expand.

Chuk said both businesses have been exhibiting single-digit to low double-digit annual growth with “very healthy” EBITDA margins and cash flow conversions. This traction is significantly attributed to momentum in the underlying market, including medical inflation.

Together, their offering spans obstetrics and gynaecology, fertility treatment, gynae-oncology, paediatrics, dermatology, traditional Chinese medicine, and related disciplines. More will be added. “We’re trying to cover all stages of a female patient, starting from paediatrics and adolescence to fertility needs to postpartum needs to menopause,” Chuk said.

M&A is otherwise the crux of the plan, with Templewater hoping to replicate its success with Asian integrated oncology platform Tamarind Health.

The firm launched Tamarind in 2024 after a take-private of Singapore’s TalkMed Group at a market capitalisation of about USD 473m and the acquisition of cancer treatment centre OncoCare. Within two years, the platform comprised eight assets with 140 specialist doctors across Southeast Asia and Greater China serving some 180,000 patients a year.

The goal for TWCG and Ascensus is to stay asset-light. However, local regulations around the kinds of facilities that can provide IVF may require add-on assets in markets such as Malaysia and Vietnam to be hospitals rather than small outpatient centres.

Operational agenda

Templewater envisages an M&A phase lasting 2-3 years after which the business should be of sufficient scale to appeal to larger financial sponsors and strategic investors. It will pursue economies of scale, particularly in marketing, although uniform branding will be introduced gradually and thoughtfully. There is as yet no name for the overarching company.

Technology is also essential to presenting the platform as a consolidated group. Many service functions will be moved to a central app, allowing for online bookings and clearer scheduling for both patients and doctors. Back-end data analytics are also on the to-do list, but investing in certain areas of technology will only become economically viable when it goes hand-in-hand with M&A.

“How do we improve patient experience and clinical outcomes – that’s the angle. Without size and scale, I don’t think we would be able to do that. It’s not just lab automation and AI embryo selection. It’s day-to-day interaction with patients in a digital world,” Chuk said.

“A lot of these clinics are still on paper records. If you do manual phone bookings and nobody picks up because the nurses are too busy, you might lose that patient.”