Why the fertility market is poised to explode

Our deep dive into the space including analysis, predictions, a market map and interviews with a wide range of experts.

My co-author for this post, Leslie Schrock, is the author of a new book called Fertility Rules, published by Simon & Schuster. She also publishes a Substack with a weekly roundup of fertility-related news.

So how big is the fertility market really? Well, that’s the question that investors are grappling with as we speak. It’s a difficult one to answer, we think, because the sector today is a bit like the luxury travel market before the introduction of Airbnb. Demand is through the roof, but access is restricted to those who can afford it. The most widely-used interventions like In Vitro Fertilization (IVF) remain out of reach for most people, particularly in the United States where there is almost zero public funding. But in the next few decades, we expect to see more democratization driven by a few key areas: health delivery advancements, new methods for testing and treatment, robotics and automation, artificial Intelligence, and novel biotechnology. All of that could burst the market wide open and create a lot of excitement about the category. 

“IVF treatments will soon be more readily available and affordable, particularly over the next 10 to 20 years,” Brian Levine, a New York-based fertility doctor with CCRM, told us.

In this post, we’ll walk you through all of these areas in detail and what they mean at a societal level. We’ll also throw out some ideas throughout for those thinking about starting companies in the space (and we sincerely hope you do). To better understand the key drivers and trends, we reached out to some of the foremost experts in the field, as well as a variety of folks in our network who have been through it personally. 

Okay, so let’s start with the need and landscape. 

What is the prevalence of infertility today? 

In April of this year, the WHO reported a jarring stat: 1 in 6 people globally are affected by infertility at some point in their lives. It is not a problem that discriminates based on income or geography and occurs equally in prospective parents as primary infertility and secondary infertility for parents with existing children. So if you have one baby easily, there’s no guarantee that it will continue to be easy. One-third of the underlying cause of infertility is women, one-third is men, and one-third is either a combo or unexplained. If you’re of the age when people start having kids, chances are that you have friends going through this in the form of difficulty getting or staying pregnant. Or you may be personally struggling. 

That’s a big reason why we see an opportunity here. If 1 in 6 people need some form of treatment or lifestyle intervention, that is already millions of people in the U.S. alone. Fertility problems can also point to chronic conditions and other issues, so they’re important to check out. And yet, clearly, only a small portion of these patients are receiving treatment, and nearly all of them are women. From 1987 through 2015, only 1 million babies were born in the United States using IVF or some kind of assisted reproductive treatment. So we anticipate that once cost comes down and more clinics or home-based alternatives pop up, we’ll see skyrocketing demand. In addition to couples struggling with infertility, there are also LGBTQ couples or single parents by choice looking for support in starting or expanding their families. We’re barely scratching the surface when it comes to addressing their needs. 

Why are we seeing a rise in infertility?

There are so many theories, ranging from aspects of modern life like the rise of obesity, more sedentary lifestyles, processed foods, exposure to endocrine-disrupting chemicals, climate change, and the increasing prevalence of chronic conditions like diabetes. For women, we’re also seeing the growth of gynecological conditions like PCOS and endometriosis, which combined now affect one in five women and take an average of 10 years to diagnose. 

Men are not immune from this either, and the causes of their issues are even less understood and discussed. This subject more than any other elicited the strongest reactions in Leslie’s research. An infamous review and meta-analysis on sperm count indicates that semen quality may be on the decline globally. It mostly blames endocrine-disrupting chemicals, especially BPAs and phthalates, which are found in many household items ranging from food storage to water bottles and sippy cups. But there is another missing piece: basic education. Men are never taught what impacts their semen parameters (or anything else about sperm), so many continue behaviors like THC use, cycling, and utilizing saunas and hot tubs which also have negative impacts. Bring it up, and you’ll be met with a mix of strong opinions that include this study is rubbish and there is no real decline. We’ve also heard the opposite perspective, that things are dire and we should all be worried. No matter which hot take you find most compelling, more research is needed to determine definitively whether sperm is fine or not fine - and if not, why.

How big is the opportunity to treat male factor infertility?

Male factor infertility is the exclusive cause of around one-third of all infertility. Another third of the time it’s female, and another third it’s either a combination or unknown. So in the end it’s about 50/50, you’d assume. And yet in 25% of infertility explorations, men are never even examined. The fertility industry is still marketed almost exclusively to women, and ultimately this lack of care has made women treatment surrogates for male factor infertility. It is also leading to more and sometimes completely unnecessary procedures. But we do see signs that this is changing. 

Unlike women who are born with all the eggs they will ever have, men regenerate sperm constantly; a new batch is created every three months. So men who find themselves on the low end of the parameter pool can walk some of it back if it’s lifestyle-related. Even physical issues like varicoceles are mostly treatable. While it’s not an instant improvement most can see meaningful positive change by making simple lifestyle changes—trading processed foods, trans fats, and added sugar for a Mediterranean-style diet, avoiding cycling and saunas and other hot places, and ensuring they steer clear of endocrine-disrupting chemicals at home and in the workplace. Yet in part because of men’s laissez-faire relationship with the health care system, no one is giving them any of this guidance. 

There are lots of opportunities in men’s health, we think, but we’ve only recently started to see companies emerge in this space. We think it’s because women (incorrectly) tend to take full responsibility for any problems related to infertility. Leslie, in the course of writing her book, has talked to many a reproductive endocrinologist—the physicians that specialize in fertility—who told her that they are doing IVF with twentysomething women who have far older husbands with kids from prior relationships—and the husband is often barely involved in the process. Go figure. 

But several companies are starting to gain traction. Pam Pure, the CEO of Posterity Health told us that in two years she went from struggling to get meetings to signing several national contracts. Posterity’s goal is to provide better access to reproductive urologists, an endangered species of physician in the US that are dedicated to treating male factor infertility. While there is a well-documented shortage of reproductive endocrinologists (REs), just for a sense of how bad the situation is for RUs, there are around 1300 REs and only 200 RUs. She noted that via their partnership with Progyny, an increasing number of men are initiating fertility conversations before women. Many who show interest either have a family history or health history that indicates they could have trouble conceiving while others are just fertility-curious. Her hope, and ours, is that getting men tested and treated sooner will lead to a lower number of IVF cycles required per live birth, and the success rates will increase too.

Why is fertility treatment so expensive?

All this brings us to one of the biggest problems with fertility today - and that’s price. There have been far too many stories in the press about couples that went bankrupt trying to have a baby. One guy even robbed banks to pay for IVF. IVF is more expensive in the U.S. than in most other countries. There are plenty of reasons for that. But the major ones include the lack of insurance coverage, the finite number of reproductive endocrinologists, reproductive urologists, and embryologists, and the dearth of clinics in many geographies. But there are other reasons we’ll get into too, including the sometimes unnecessary treatment add-ons. 

If you’re not making a generous six-figure salary, the cost of infertility treatment can be prohibitive. And even then, it’s an incredible drain on people’s bank accounts and resources. Direct medical costs for a single round of IVF often exceed the annual income of patients in low and middle-income countries. Here in the U.S., we’ve both had friends that had to delay home ownership or get a second mortgage because of the expenses related to infertility treatment as not all companies cover it. Those that don’t have any collateral to put up can access loans from fertility financing companies. But for all of these reasons, we’ve seen spreadsheets floating around that identify companies that offer coverage for treatment. Take a moment to consider that. People are making decisions about where to work solely based on the presence (or lack) of fertility benefits. Name any other benefit that’s equally impactful and sticky. Hence why we’re bullish on companies like Maven (to be transparent, Leslie is an advisor) and Carrot Fertility, which target self-insured employers. 

Need further proof? Maven asked 500 people who sought fertility care if they’d be more likely to work for or stay at a company that offered fertility benefits. 97% of women said yes. Kate Ryder, Maven’s founder and CEO, added “Our data shows that patients feel the emotional strain of infertility as much as the financial burden of treatment, and it’s encouraging to see so many employers step into these gaps and really care for their people as they grow their families.”

IVF isn’t the only treatment, but it’s what people first think of when they first start thinking about infertility. So we’ll focus there when we talk about price, but it’s also worth mentioning that interventions like Intrauterine Insemination or IUI still range between $500 to $4000 per attempt. And many people are not successful on the first go. If you’re not familiar btw IUI involves placing sperm directly into the uterus using a small catheter. If it’s not successful over multiple rounds, which is often the case, many couples ultimately opt for IVF. In the case of unexplained infertility, IUI is successful around 7-10% of cycles so it requires at least 3 tries to get to the same efficacy as IVF. While you may be reminded of the turkey baster method, that is actually another approach that can be done from home with an FDA-approved kit as intracervical or intravaginal insemination (ICI and IVI.)  

The average cost of a single IVF cycle is $23,474, and the final bill depends on your geography. Most people will need more than one cycle to achieve a live birth. Studies on this range widely. The most widely accepted stat is that most individuals or couples will need three cycles to achieve a live birth. The exact number is driven by a number of factors—age, underlying conditions, and lifestyle to name a few—and sometimes, we don’t know why a cycle doesn’t work. Many couples lack insurance or coverage and cannot afford even one attempt. Currently, only 19 states require insurance infertility coverage, but the laws are also confusing so it’s difficult to know what’s included or excluded. 

What can we do about it?

Well, we’re seeing some innovation in the space, which could be compelling. These range from scientific breakthroughs to new models that make it more likely that women will freeze their eggs younger (therefore making it more likely they’ll need fewer retrievals). There might also be some important shifts in health delivery, such as the rise of large-scale consolidated labs. Levine from CCRM thinks this will bring prices down in the near-term as clinics will no longer need to be physically attached to their respective labs. “Instead, multiple clinics will benefit from the efficient and cost effective services of large, high volume labs.”

There could also be biotechnology breakthroughs that fundamentally change the egg freezing and retrieval process, making it both cheaper and easier for patients. “IVF is a long process that requires clinical monitoring and a lot of medications, which are expensive,” noted Dr. Dina Radenkovic, a physician whose company Gameto is working on an alternative to the current IVF treatment protocol that helps women produce eggs with fewer medications and monitoring appointments. Her company’s goal involves maturing the eggs that Gameto collects outside of the body. 

Radenkovic said this shorter, easier process, if successful, would cut down on costs substantially. Other key innovations, she thinks, will involve encouraging women to freeze their eggs younger (thereby hopefully requiring fewer cycles) or via programs like CoFertility that make it easy to split the cost. With CoFertility, a woman could choose to freeze her eggs in college - then keep half, and the other half would go to a couple that needs donor eggs. And that cycle would be paid for by the family receiving the donor eggs. 

“I can't wait for the day when we can create egg cells from stem cells, completely smashing the biological clock, helping cancer survivors have biological children, and giving same-sex couples the opportunity to both be genetic parents,” Halle Tecco, co-founder of CoFertility and digital health investor, told us via email. 

Why is America more expensive to get treatment than other countries?

The answer depends on who you ask. The fertility industry is not dependent on Medicare or Medicaid reimbursement like the rest of health care, making it an attractive target for investors, especially private equity. Fun fact: fertility is the medical specialty with the greatest market share owned by private equity firms. There has been a lot of consolidation (see the recent US Fertility and Ovation merger which combines 120 US Fertility physicians and Ovation’s network of labs and outside physician practices into one mega-company as one example). As of 2018, 14.7% of the practices on the CDC’s annual clinic success report had a private equity affiliation, and 29.3% of all assisted reproduction treatments (ART) happened at a private equity-affiliated practice. 

What does all that mean? The consolidation creates less competition when it comes to price or choice of clinic, and also, the types of patients that are treated. Each network has its own requirements around contested characteristics like BMI indicating whether or not a treatment is likely to work. Nearly all clinics in the U.S. publicly report their data to the CDC and the Society for Assisted Reproductive Fertility (SART) every year, so their successes (and failures) are on full display for future patients. You can access this data yourself fairly easily on sites like FertilityIQ too, although know this: the clinics with less successful outcomes are sometimes the ones willing to take on poor prognosis patients.  

Another reason IVF is so expensive is the slew of add-ons, most of which have questionable evidence for widespread adoption. Intracytoplasmic sperm injection (ICSI) is one such example. ICSI was developed as a therapy for male factor infertility, especially in the case of low sperm count, as it only requires one single sperm to be selected for its visual qualities and shot directly into an egg with a micro-pipette. When used in cases of male factor infertility, it’s proven effective. However, ICSI is now used in over 90% of IVF cycles regardless of whether male factor is the reason, even though it does not improve the only outcome in IVF that matters—live birth rates. When it’s presented to patients, providers express both a sense of control and peace of mind that only the best sperm will be used. The only problem is, there is a lot we don’t understand about sperm, and not all sperm that looks normal under a microscope carries normal DNA. Regardless of whether it’s used for its psychological benefits, ICSI costs between $800-2500 per round pending the clinic. The clinic’s cost to perform ICSI is just $50-250. 

So why would providers layer on these additional treatments if they lack solid evidence? One difference between for-profit, PE-backed clinics and clinics that operate out of academic institutions is the way they pay their providers. For-profit clinics can incentivize clinicians financially with a “productivity bonus” that rewards the amount of revenue they bring in the door. Unless you are a hard-core researcher, high-performing physicians can have difficulty justifying remaining in their posts when the financial opportunities elsewhere are so much bigger. Another reason, frankly, that Leslie uncovered while writing her book is that sometimes add-ons have psychological benefits for patients. Most describe how out of control they feel navigating and undergoing infertility and would do just about anything—even if the evidence is thin—in order to welcome a child. 

Will egg, embryo, and sperm freezing become more ubiquitous? 

Egg freezing saw a meteoric rise during the pandemic, and shows no sign of stopping. Clinics market having a bank on ice as a hallmark of “having it all” (and as the parents of a combined four children under five, we can tell you that there is no having it all, at least not all at the same time). What most women don’t know is that just 39% of women who try to use their frozen eggs end up with a live birth. Part of the problem here is women are waiting too long to freeze their eggs - and they may not have enough eggs to guarantee a live birth. 

When a woman undergoes a retrieval, the only information she receives at the end is a number; there is no way to test the quality of a single egg as an egg is a single cell, and testing it would destroy it. There is also a funnel that these eggs must survive in order to reach a woman’s endometrium: eggs must survive freezing and unfreezing, accept a sperm, grow into a five-day-old blastocyst, be frozen for genetic testing (which most couples who undergo IVF choose to do, despite some mixed evidence), unfreeze for use if found to be high quality during testing, then burrow its way into that cush lining and implant and successfully grow into a fetus and eventually, end with a healthy live birth. As you can imagine, this funnel sees a lot of drop-offs at each step. 

Embryo freezing gives you more information than egg freezing since you have real data on the quality and the egg bank has already traversed most of the funnel. However, the much-lauded unfreezing rates versus eggs are actually much closer (95% embryo survival versus around 90% for eggs). Many providers today warn patients to exercise caution when freezing embryos, as there are other things to think about. The first is today’s more complicated reproductive landscape and the possibility that personhood statutes (that a fertilized egg should receive the same rights as a person already born) will pass in some conservative-leaning states. This could mean that embryos created for IVF that are not needed cannot be discarded or used for research, among other possibilities. The other is that while eggs are a single person’s genetic material, an embryo takes two. And if you freeze embryos with a partner and later part ways, embryos are considered an asset and split equally in a divorce. We’d recommend having these conversations with a partner ahead of time, and many clinics suggest going a step further and papering this agreement.

One thing that we’d love to see change here - which incidentally is the innovation that Dr. Levine would most like to see - is an AI engine to optimize egg freezing cycles. Something that could both predict the likelihood that the patient will only need one or two cycles, as well as ensuring the best outcomes for thawing and using eggs down the line. “Patients freeze eggs and likely won’t use them for 5+ years. If we can give them the real insurance policy they hope to get from one cycle of egg freezing, then we are achieving our shared goals,” Dr. Levine told us. 

Sperm freezing, historically reserved for members of the military and cancer patients, is also seeing a tick up in popularity, in part because of the headlines claiming spermpacolypse is around the corner. As we explored earlier in this post, sperm count zero is unlikely. But if something negative is going on with men’s swimmers, that isn’t good either since semen quality is a biomarker for a man’s overall health, not just their ability to conceive. The process involved with freezing sperm is much simpler than it is eggs and requires just a quick trip to the clinic or FedEx pickup. Its accessibility and relatively low-cost add to its appeal, as does its status as a much more likely insurance policy than egg freezing. Legacy, a series B startup with $45.2M raised to date, is building a digital fertility clinic for men, mostly focused on sperm assessment and freezing. “Men need to be aware, that’s step one,” said Khaled Kteily, the company’s CEO, who pointed to the need for more press coverage to raise awareness and help educate the public. Things will change rapidly, he thinks, once the male fertility topic becomes more “Zeitgeisty.” 

This may be TMI, but as the mothers of three boys between us, fertility preservation is definitely something we plan to discuss with them once they turn 18. If they’re up for it, we’d encourage them to get some sperm banked at age 18. Because with what we know today and where we believe things are headed, why not. The process isn’t invasive, the storage costs will continue to decline, long-term storage technology will continue to improve. Because there are so many sperm in a sample, it is a better insurance policy than freezing eggs. 

Will infertility be a covered condition at some point? 

For any condition to become a covered benefit in the United States, it must be formally declared a disease. Infertility differs from other medical conditions since it is the absence of a condition, namely pregnancy, rather than the presence of symptoms. Infertility was first officially classified as a disease of the reproductive system by the WHO in 2009. In 2017, the American Medical Association (AMA) finally adopted a resolution supporting this designation, so the qualifying criteria have already happened. But not much has changed for patients. There is no federal agency in the United States that manages infertility, and no law requires payors or other entities to underwrite it either. Perhaps more chillingly, infertility treatments and the inability to build a family are still viewed as optional. Infertility is not viewed by many health plans as a disease. 

One big step forward is the recent introduction of equal coverage for male factor infertility by companies like Maven and Progyny. Until now, there wasn’t a guarantee that all of those costs were covered or reimbursable. So in a trend we’ve seen a lot in recent years, much of the innovation is happening in the employer channel - because at least, there’s a path for payment. 

Could the Dobbs ruling negatively impact infertility care? 

To add needed context to this discussion, let’s start with a quick refresher on what an abortion actually is. An abortion is the ending of a pregnancy—whether spontaneously as a miscarriage or therapeutically when a life-threatening condition during pregnancy occurs or as a planned decision to terminate a pregnancy. More than 92% of planned abortions are performed in the first trimester, around 6% happen between fourteen and twenty weeks, and less than 1% are done after 21 weeks almost exclusively to save the life of a pregnant woman or due to a fatal condition in a fetus. 

The Dobbs ruling is already affecting infertility care in a few ways. One example: infertility isn’t always the inability to get pregnant. For some couples, staying pregnant is the problem. Miscarriages happen in as many as 1 in 4 pregnancies (that we know of) and do not always resolve on their own. There are two ways to manage a miscarriage: expectant management a.k.a the wait-and-see method, and an abortion either as medication or a dilation and curettage (D&C). Leslie personally needed two of these procedures to resolve two failed but very wanted pregnancies. Ectopic pregnancy, which should be renamed as it is not a real pregnancy, is a sometimes fatal medical condition in which the embryo implants in the fallopian tubes instead of the uterus. There is no way to transplant an ectopic to the uterus, or otherwise make it viable—the only way to manage it is with an abortion. In states without access to abortion, medical providers are forced to challenge their pledge to do no harm and instead do nothing if it cannot be proven in some cases that an abortion is necessary to save the life of a mother. Miscarriages that do not resolve on their own and go untreated can cause sepsis and in some cases, death. 

Personhood laws without specific carve-outs for IVF would make it difficult if not impossible to create embryos due to the risks at each step. The embryologist that freezes and unfreezes an embryo that doesn’t survive could theoretically be accused of performing an abortion. Clinics with freezers that fail could be held responsible for those “abortions” too. Every frozen embryo that is created but not needed after an IVF cycle would be bestowed with the same rights, taking disposal or donation to research off the table, or in an extreme version of events, a woman would be forced to transfer and carry each embryo she creates. Right now, some states use language to create exceptions for IVF, namely that the law applies only to embryos or a fetus that is inside the body of a pregnant woman. However, it doesn’t help with multifetal pregnancies. They are more common to IVF than natural conception and are associated with a 5x increased risk of stillbirth and 7x risk of neonatal death. Multifetal reduction is how high-risk pregnancies are treated. It is rarer today since most of the time only a single embryo is transferred, but the procedure is illegal in states with heartbeat laws, as it is performed later in the first trimester. 

So the short answer here is yes. And only time will tell how bad it will get, especially as 75% of prospective ob-gyns are not even applying to residency programs in abortion-restricted states. The women that live in these states, which have the worst maternal health outcomes in the country, will ultimately be the ones to pay the price for these obstetrics deserts too. Watch this space. 

Where are most companies focused now and why?

Most venture-backed companies that we’ve seen today are focused on a few different areas ranging from cycle tracking to helping couples navigate their fertility benefits. Another crop of companies provide financing options to those who need it, including those who don’t have access to coverage via their health plan.

We’re seeing more momentum today around innovations that we think could bring far more precision to the process, help people get diagnosed earlier, and/or bring the price down. We’re particularly compelled by solutions that are taking on the embryology lab, which is a big cost center and bottleneck. There’s a finite number of embryologists. Many of the companies in this space will be born inside of university labs using mini lab-on-a-chip technology. One of the furthest along here is Overture Life, a Spanish company staffed by top geneticists and engineers. 

AI is also highly promising as there are millions of people globally who have now received treatment. Every year, we perform some 2.5 million IVF cycles as well as other treatments. Could we use an algorithm to help determine the most optimal treatment protocol for each patient and take some guesswork out of the equation, thereby cutting down on unnecessary cycles? We believe this is inevitable, although it remains to be seen how the long-term business model will play out as clinics are notoriously difficult to sell into. 

Another area that we’re enthused about involves what we refer to as “labor arbitrage.” We’re seeing a few companies pop up that attempt to involve the obstetrician more in fertility care. Reproductive endocrinologists have extra training than OB-GYNs specifically in fertility treatment, but there are fewer of them. Studies have found that OB-GYNs can be uncomfortable talking to their patients about fertility, particularly those that are delaying the decision to have a family. Going forward, we may see more attempts to bring OBs into the fold, both to talk to patients earlier and to even manage more aspects of fertility treatment where they’re qualified to do so. Better screening for infertility could also occur at the primary care doctor's office. These days, it’s typical to hear that if you’ve been trying for a year or less without success to sit tight if you’re under 35. The same is true for nurse practitioners that are trained in fertility and are more than equipped to perform procedures like embryo transfers. On the flip side, however, Jessica Bell van der Wal, CEO of Frame Fertility, cautions against the overuse of OB-GYNs because of the existing burnout problem. Adding to their workload isn’t ideal. Overall, a win here would involve more screening and care for patients with less complex problems, such as those who might only need a prescription, reserving the most complex patient cases for our limited pool of reproductive endocrinologists with the most years of training.

We also believe that preventive reproductive care that goes beyond pap smears could help with earlier identification of potential infertility. One example: what if there was a standard fertility assessment conducted by PCPs and OB-GYNs when a woman turns 25 or 30 years old? Today’s tests cannot give a timeline for menopause, but they could provide a baseline that helps women make more informed choices around family-building and fertility preservation. 

What are the major go-to-market strategies for fertility companies?

• One path is to sell to fertility clinics, which in theory have money to spend. Anecdotally though we’ve heard this is tricky unless the value is extremely clear from Day 1. Clinics tend to be very discerning about new technology. That said, we have seen startups have success leveraging fertility clinics for distribution and access to patients. 

• Another option is to sell to patients directly. That’s usually the approach that IVF financing companies have taken. This can make sense in cases where the startup is attempting to solve the problem of affordability or improve some aspect of the experience. There are lots of concierge services, for instance, which make it easier for patients to inject themselves with medications at home. This is also the case for fertility coaching companies that help build customized programs to help optimize fertility, and at-home solutions that provide an intermediate option like intracervical or intravaginal insemination like Mosie Baby or Bea. 

• Another opportunity involves the self-insured employer. Companies like Progyny, Maven, Carrot Fertility, and Frame Fertility have taken this approach. What we’re seeing work particularly well these days is allowing employers to offer a flexible pool of capital for employees to use as a way to help finance their fertility treatment. Some employers might determine that they’ll reimburse up to $10,000, while others are more generous. And that pool of funds can be used towards surrogacy, IVF, IUI, fertility medicines, or other treatments. 

What’s the number 1 thing we’re most excited about?

For Chrissy, it’s any innovation that makes IVF easier on patients. Between the shots and the monitoring appointments, the whole process is brutal as well as time-consuming. So anything that provides emotional and financial support, and connects women to others going through the same thing sounds like a first step. Halle Tecco, who’s been through IVF at three different clinics over an 8-year period, said mental health services were never offered to her including after losing her twins at 17 weeks. Studies have shown that people going through infertility often have anxiety and depression, just as patients would with any other serious (and potentially untreatable) disease. Another missing piece here is that women and couples are often pushed to treatments that are unlikely to work, versus getting advice that’s evidence-based and direct. A lot of that is because of how hard it can be to deliver bad news and coach patients through their options. 

For Leslie, it’s opening up the fertility market to men. This means improving awareness of and access to testing and treatment for male factor infertility. Beyond the ability to conceive or not, sperm health can indicate other health conditions like cancer. Men die younger and are unhealthier than women generally, and unhealthy sperm impacts women in the form of increased risk of pregnancy complications and also shapes the health of future kids. Women carry the burden of making 80% of healthcare decisions, and 75% of all caretakers are also women. We hope that in addition to improving outcomes within reproductive health, once men take more control of their bodies they become more involved partners and fathers too. 

Well that’s it for now folks. If you want to learn more on any of this, check out Leslie’s new book Fertility Rules. If we’re missing anything on our market map or there’s a company we should know about, please drop us a note. Thanks for reading!