The New York Times | Elise Craig

April 19, 2020

Credit…Armando Veve

This article was originally published on December 19 in NYT Parenting.

Over the course of 2019 alone, investors have put more than $150 million into companies like Modern Fertility and EverlyWell, which make at-home fertility-testing kits for women (each $159); Dadi, which provides sperm testing, freezing and storage (starting at $99; see sidebar); as well as start-ups like Kindbody, which are trying to make the egg-freezing process — and its pricing — more transparent (consultations are $300). There are also companies working with employers to offer fertility benefits, like Carrot Fertility. CB Insights, a company that tracks business trends, pegs the global market for fertility at $25 billion.

“It’s about big societal changes,” says Kirsten Green, whose Forerunner Ventures led a $15 million Series A round into Modern Fertility earlier this year. “It’s about people thinking: Jeez, how am I going to balance my fertility against the backdrop of my career or relationships and being a mother? When is the right time to do that? Life has gotten more complicated.”

[What to know about I.V.F.]

The surge in funding represents a big change in barely a decade. A dozen years ago, investment in fertility start-ups was less than $10 million, according to CB Insights. By 2017, that figure had gone up by an order of magnitude.

Gina Bartasi, chief executive of Kindbody and a founder of the fertility-benefits company Progyny, built her first fertility start-up a decade ago after she went through in vitro fertilization and realized how few resources there were for people like her — women in their late 30s looking to conceive. “I would tell investors that this was going to be big, and they would look at me like I was crazy,” she says. “About four or five years ago, the tide started to turn.”

Bartasi says she believes the main driver is growing awareness. “Almost everybody either has been through treatment or knows somebody who has been through treatment,” she says. “There’s a visibility to it, and how widely affected people are from an emotional standpoint, and what a financial pain point it is.”

For Green and the Forerunner team, whose previous investments include retail companies like Warby Parker, Glossier and Dollar Shave Club, the appeal came from recognizing that low customer satisfaction in health care, and a dearth of investment in women’s health specifically, had left an opportunity for companies to connect with female patients. That’s something Debora Spar, a professor and associate dean at Harvard Business School, has noticed, too. “I’m sort of besieged by students who want to go in this area,” she says. “There’s a strong sense among women and men that fertility has been marginalized because it’s about women’s health.”

[Wait, is that another ad for egg freezing?]

It’s important to note that though the funding of the last couple of years is significant for the space, most of it is in an early stage, and the numbers pale in comparison to, say, the $175 million that one scooter company, Bird, raised in just one round of funding. The technology behind a lot of these companies isn’t radically new, either. Sperm-freezing has been widely available since the 1970s, and the female hormone tests are the same ones you might get at a doctor’s office. Period- and ovulation-tracking apps are a handy addition, but they’re not held to the same privacy standards as a doctor’s office, and can even use personal data to tailor the ads they serve users. Many of these products aren’t F.D.A. approved, either. The innovation these companies are providing is access: sperm tests you can take from home, a check on the hormone that can give you a sense of your ovarian reserve, clear pricing for your tests.

To Dr. Marcelle Cedars, the director of the Division of Reproductive Endocrinology and Infertility at the University of California San Francisco Medical Center, the benefit of the growth in start-ups is increased awareness: more people willing to talk about fertility issues, and potentially catching low fertility early. If young men and women find their screening-test results low, it might spur them to see a doctor sooner than they otherwise would. And if a proliferation of start-ups can drive down costs and increase access, it could open doors for couples who can’t afford to spend $40,000 to conceive, or women who can’t drop $20,000 to freeze their eggs. “It feels like it’s overdue,” Spar says.