VC Investment Soars For Fertility Services Even As Birthrate Dips

Deena Shakir, partner at VC firm Lux Capital, spends a lot of time thinking about the future of fertility. 

Lux Capital, which specializes in early-stage investments in science and technology, has led funding rounds for multiple fertility and related startups in recent years. Shakir, who helped lead the charge on those investments, also spends her free time writing think-pieces on the subject.

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She’s not the only one thinking about fertility. While the service was once almost always sought out and paid for out-of-pocket by individuals, is increasingly becoming a mainstream part of company benefit packages. Many of those benefits are offered through partnerships with startups that aim to expand access to reproductive health care or improve success rates among people trying to get pregnant. 

“It’s a huge, huge market, and one that is only getting bigger, if you look at demographic data, declining sperm rates, global numbers and … the way that trends are moving, it’s clear this is only going to continue to be a challenge,” Shakir said. “We need to figure out how we can help to address the inequities, the inefficiencies and the economics so that we can actually help families and hopefully help to improve lives.”

Indeed, venture capital funding for fertility startups increased steadily between 2017 and 2020. But Crunchbase data shows the industry attracted unprecedented interest this year, with global investments increasing by 89 percent so far—from $93 million in 2020 to $176 million in funding as of Oct. 15, 2021.

That trend comes as U.S. birthrates dipped during the pandemic, according to data from the Centers for Disease Control and Prevention—a decline that researchers at the University of Michigan say is temporary. 

Those researchers estimated at the start of the summer that people would begin growing their families again this year. If that is true, the approximately 15 percent of couples UCLA Health says struggle to conceive may look to their employers or the innovations of startups for help. 

Benefits boom

Such benefits are still a relatively new concept. Fertility as a company perk first became a talking point around 2014, when Facebook and Apple started offering egg-freezing to their female tech workers, a cohort already small in number that tended to shrink as those women reached childbearing age. 

The new benefits were hailed by many as generous and trailblazing, but also tone-deaf by some, who wondered if the perks were really a ploy to encourage woman workers to stay at their desks in lieu of offering more generous parental leave and support programs so they could more easily start their families and continue to work. 

As of 2021, fertility benefits have evolved from a couple of the largest employers in tech offering to help with egg-freezing services to a growing set of perks that include in-vitro fertilization, male infertility treatments, and other family planning assistance at companies across the country. 

Business basics

Fertility services aren’t just good for employees, there’s a business case for them, too, according to Carrot Fertility co-founder and CEO Tammy Sun. Carrot provides fertility benefits to employers, and in August closed on a $75 million Series C funding round.

“For employers, increasingly, the risk of people going out and pursuing these types of [fertility] treatments and services without that care navigation and that clinical guidance is actually more expensive than not investing in this program altogether,” Sun said. 

Offering such perks means a worker might be able to get a positive pregnancy test in fewer appointments, or the company-provided services could cut down on time an employee spends researching care options or fretting the financial burden of that care. 

But the conversation around fertility and benefits took an especially large turn in 2017, when a study by scientists at the Hebrew University of Jerusalem that analyzed samples from 43,000 North American, European, Australian and New Zealand men concluded that male fertility in those places was on a rapid decline, more than halving in the 40 years between 1973 and 2011. 

Suddenly, the focus was not almost exclusively on women, but people were taking a hard look at male fertility, too. 

While some remain skeptical of the data, others warn that the trend could threaten humanity’s very existence. 

Today, however, practitioners find infertility occurs roughly equally among women and men, with about one-third attributed to each gender and the final third of cases being unknown in origin or the result of both male and female infertility, said Khaled Kteily, CEO of Legacy, a startup that this year announced a $10 million Series A funding round and a slew of Hollywood investors. Legacy stands out because it focuses exclusively on male infertility. 

“In part, we are working very hard to rebalance these responsibilities around family planning to change this outdated view that fertility is just an issue for women,” Kteily said. 

Legacy’s staff is made up of about two-thirds women, in part, Kteily estimates, because the issue of fertility may have a greater draw for women than men. But men are taking a growing interest in family planning, he adds. 

“During COVID, you had all these men who traditionally go to the office to work, who are now at home with their kids, and they get to see their kids first steps, or they get to go cuddle their daughter in the middle of the day … when otherwise you’d be having a business lunch,” Kteily said. “At all levels, you’re seeing more interest in men who want to be more equal when it comes to parenting and fatherhood and family planning.” 

Kate Ryder, founder and CEO at New York-based unicorn Maven Clinic, an expansive virtual clinic focused on women’s and family health, agrees with Kteily that babies remain top of mind for many people.

In fact, demand for family-building, pregnancy and parenting services at Maven has quadrupled since the start of the pandemic as people settle into a world where they have easier access to health care from wherever they are, Ryder said. 

Maven Clinic raised a $110 million Series D funding round in August. Overall, the company has raised a total of $202.1 million across seven rounds, Crunchbase data shows.

“What we are seeing now is the result of a generational shift in consumer preferences,” Ryder said in a statement to Crunchbase News. “The convenience, ease of use, and personalization you recognize from the rest of your digital life is finally here in health care, and it’s only going to get richer and more capable.”

And that’s where fertility startups hope to come in. 

‘Massive opportunity’

One of those startups is San Francisco-based Alife Health, which aims to decrease overall IVF costs by developing a program that would gather fertility treatment data and use artificial intelligence to analyze the information for clinicians. 

Once launched, the platform would help doctors decide what treatments to use to improve a patient’s chances of getting pregnant faster by analyzing what has—or hasn’t—worked in similar patients around the world. No such platform to democratize and analyze information exists in the industry today, founder Paxton Maeder-York told Crunchbase News.

“The challenge with this industry is that historically, there has been a lot of difficulty finding new ways to improve clinical success,” Maeder-York said. “Of course, if you can’t measure something, it’s very difficult to improve it.”  

Shakir, who helped lead a $9.5 million seed funding round at Lux Capital for Alife this year, said this kind of technology is just the beginning for an industry that has “massive opportunity for innovation.” 

“This is an outsized challenge in particular for families of color and that’s also health equity and health justice, which is something that’s personally very important to me,” Shakir said. “If you ‘double click’ on these challenges, you know that as many as 90 percent of the cases can actually be resolved through science and technology, and that’s where some of our investments come in.”

Illustration: Dom Guzman