The path to parenthood often comes with unexpected and emotional challenges. Today, one of the most common is infertility, which affects one in eight women. When constant ovulation tracking and major dietary and lifestyle changes are insufficient, navigating opaque and expensive fertility treatments are often the last available option.
The fertility treatment journey is lengthy and burdened by high costs, disparities in access, and physical and emotional demands. On average women must go through three-to-four failed cycles of Intrauterine Insemination (IUI) and six rounds of In Vitro Fertilization (IVF) before they successfully conceive. As author and fertility expert Leslie Schrock is quick to point out, most men are unaware that they are responsible for half of all fertility problems. Conditions like DNA fragmentation in sperm are a cause of recurrent miscarriage, but the test is not yet a part of standard semen analysis. As a result, women are still treated before their male partners are ever evaluated. The already significant barriers to treatment dramatically intensified during the pandemic. Fertility clinics across the nation abruptly closed their doors, disrupting or prematurely cancelling an estimated 100K IVF cycles in the first months alone. But the rapid and sustained increase in treatment utilization since signals future challenges for an already capacity strained system.
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The hurdle laden path to parenthood
Most Americans are unable to access IUI or IVF treatment in the first place. An estimated 62% of women with suspected fertility issues do not seek out fertility testing or advice and an even larger share choose not to undergo care. Men are rarely tested at the same time as their female partners, or at all, which means their problems are often missed. High out-of-pocket expenses with uncertain outcomes, inadequate services for underserved communities, and a lack of consideration for the mental toll of infertility exacerbate an already long and isolating journey.
The high price of fertility
Today, it costs nearly $60K to conceive a child through IVF and 75% of private insurance policies lack adequate coverage of fertility services. With only 19 states mandating fertility coverage, no national mandate outlined in the ACA, and increased enrollment in high deductible health plans, Americans experiencing infertility are left to shoulder the heavy financial burden alone and choose to do so by any means necessary. More than half of all IVF candidates use credit cards, nearly 25% take out personal loans, and 14% make withdrawals from their 401(k) to pay for treatment.
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Alyssa Jaffee Alyssa Jaffee is a Partner at 7wireVentures, where she focuses on investments in digital healthcare and technology-enabled services that empower consumers to be better stewards of their health in today’s changing healthcare ecosystem. Alyssa sits on the board of Caraway and Ayogo Health and is a board observer with Zerigo Health, NOCD, Jasper […]
Disparities in access
Provider bias and disparate geographic distribution of fertility clinics are additional barriers to fertility care. As late as February 2021, paid surrogacy was illegal for individuals in the state of New York, making it nearly impossible for LGBTQ+ couples and heterosexual couples who are unable to carry a child to term to become parents. There are also an estimated 18 million women of reproductive age that live in geographies without Assisted Reproductive Technology (ART) clinics. While certain elements of the fertility journey are immutable, like the impact of age or genetic factors, societal and systemic barriers should not be.
Lack of holistic care offerings
The beginning of an individual’s fertility journey, which is full of invasive and expensive tests and diagnostic procedures, is often described as emotionally overwhelming. As struggling patients navigate treatment options and undergo procedures, the roadblocks can take a devastating toll on their mental health, so much so that half of women and 15% of men rank infertility as the most upsetting experience of their lives. This stress, anxiety, and depression can have deleterious effects on treatment adherence and efficacy.
Where do we go next?
From virtual care to remote patient monitoring, digital fertility solutions that meet patients where they are can achieve what the traditional health system has failed to accomplish at scale: empowering women and men to make informed decisions about their own reproductive health journeys. Challenges will continue to exist for anyone undergoing fertility treatment. But I am optimistic that digital health solutions will reimagine the path to parenthood by increasing access and affordability of testing and treatment services, improving care delivery through whole-person clinical models, and enhancing the consumer experience through convenient, personalized modalities.
Managing mental health alongside fertility
A key characteristic of successful digital fertility solutions, particularly those providing virtual or in-person care, will be the integration of mental health interventions into their clinical model. Psychological interventions have been shown to reduce stress and anxiety for patients struggling with infertility, ultimately improving pregnancy outcomes.
From coping with the side effects of infertility treatments to addressing tensions associated with infertility, digital health solutions can alleviate the stressors experienced along the difficult journey towards parenthood. Maven’s holistic care model is a prime example of how mental health can successfully be positioned at the core of fertility services. The company offers users on-demand virtual appointments with licensed mental health providers, 1:1 emotional support from Care Advocates, a supportive community of new and prospective parents, screenings for mental health issues, and access to relevant curated content. Internal build out of mental health services by fertility solutions will likely continue as well as targeted M&A of fertility solutions by broader sexual health and wellness solutions with existing mental health capabilities, such as Ro’s recent acquisition of Modern Fertility.
Moving beyond treatment to personalized, data-driven care
Digital fertility solutions will provide highly curated data on the physiological changes men and women undergo during infertility treatment. Personalized engagement that supports self-management and on-demand access to fertility specialists for higher acuity needs will encourage consumers to remain engaged even during the discouraging moments. When paired with this guidance, remote monitoring devices and digital companions provide patients with highly personalized ways to navigate their fertility journey, and much needed support for complex treatment protocols. Rescripted (formerly Best Shot and The Fertility Tribe) serves as a true digital companion through its medication management platform, prescription fulfillment service, community forum, and fertility focused small groups for counseling.
Similarly, health coaching and remote ovulation and hormone monitoring increase the opportunities for positive treatment outcomes. Data captured through increased remote monitoring devices and adherence platforms can create a repository of robust clinical information to enhance diagnostics and the development of therapeutic options. This clinical data will be the foundation of predictive capabilities to understand hormonal levels, optimal times to retrieve eggs, and physiological changes that are associated with positive egg implantation outcomes. Eli, for example, offers an at-home device that monitors invaluable clinical data on hormone levels, enabling women to optimize infertility outcomes and non-hormonal contraceptive methods. Ultimately, companies like OathCare are taking the power of collective knowledge to offer a complete support community for parents while also bringing medical providers, like-minded peers, and a trusted facilitator together in an intimate group setting.
The potential in this area is truly limitless, and with the aligned incentives of individuals, clinicians, and researchers, improved treatment outcomes are highly likely.
Employers stepping up to shoulder the cost burden
As the demand for fertility treatments continues to increase, I’m hopeful employers will step up – especially those attempting to attract and retain top talent while providing cost-effective care options. In 2020, coverage for IVF and cryopreservation in employers with 20,000 or more employers was 42% and 19%, respectively, signifying a clear barrier to reproductive services.
In the long term, as state mandated fertility coverage becomes more ubiquitous, employers will increasingly partner with low-cost digital fertility treatments that also optimize outcomes, such as Kindbody. Kindbody partners with employers to deliver care through the company’s end-to-end fertility program, which starts with an initial consultation and follows patients through IVF and preconception care. Other solutions are focused on streamlining the testing and diagnostic processes, going from days to minutes. For example, Pera Labs uses AI and microfluidic chip sorting to rapidly analyze and identify the best reproductive cell candidates for IVF treatments, streamlining the fertility assessment process, reducing the need for multiple expensive treatments, and increasing treatment success rates. Alife is addressing the inequities rampant in this industry by building the largest, most diverse dataset in the world and using it to reduce the number of cycles needed and costs while also improving outcomes.
Despite meaningful progress in fertility therapeutic development, the consumer journey is fraught with challenges. There is still a lack of awareness and education on treatment options accompanied by unaffordable testing and procedures, which leaves infertile individuals and couples in a bleak position. However, digital solutions will improve the fertility treatment experience and accelerate the development of consumers who are better equipped to make decisions about their fertility options. Through thoughtful consumer-centric design and application, these innovative solutions have the potential to smooth the path towards parenthood for countless couples and individuals around the world.
Photo: Natali_Mis, Getty Images
Alyssa Jaffee is a Partner at 7wireVentures, where she focuses on investments in digital healthcare and technology-enabled services that empower consumers to be better stewards of their health in today’s changing healthcare ecosystem. Alyssa sits on the board of Caraway and Ayogo Health and is a board observer with Zerigo Health, NOCD, Jasper Health, and Brightline, and MedArrive.
Alyssa's prior experience in venture capital includes her time as an investor at Pritzker Group Venture Capital where she led investments in Bright.md and Tovala as well as worked closely with Apervita, Mingle Health, and AiCure. Additionally, she worked at Hyde Park Angels (HPA), one of the Midwest's largest angel organizations and Healthbox, an early-stage healthcare innovation firm, supporting their accelerator program called the Studio. Alyssa is also a Co-Founder of TransparentCareer, a 2016 NVC winning company focused on helping people make more data-driven career decisions.
Prior to business school, Alyssa worked as the Senior Director of Performance Technologies for the Advisory Board Company. There, Alyssa was charged with expanding new business through the sales of technology platforms. With an extensive travel regimen, Alyssa met with hundreds of hospital executive teams to understand their strategic needs and recommend various solutions. She has copious amounts of experience in launching new products and thinking about go-to-market strategies.
Alyssa holds a bachelor’s degree in Marketing and Spanish from the University of Wisconsin-Madison and an M.B.A. from the University of Chicago – Booth School of Business. Her work and accomplishments have been featured in Fortune, Stat News, MedCity News, Crain’s, and more.
