So much for being here for having me. Yeah. So we are going to talk business of fertility. And first up full disclosure, I am pregnant if you have not noticed, that was [ LAUGH ] not a prerequisite for moderating this session, but I'm thrilled to be doing it. So I kind of wanted to kick it off by talking about you know. Why the sector has been ignored for so long, right. Like it's hard to even put a number on the size of this market because it hasn't really existed before. I mean, what's going on? Why have we not really considered this a big market in the past? Yeah. Well, I think that there's three major things that are happening right now three trends that I would kind of speak to that Really are behind the energy and shift to the rise of fertility and even the conversation. The first is that women are waiting to have kids later in life. The average age of first birth and major metropolitan cities in the US is 31 years old and Millennials are waiting longer than any other generation in the history. Throughout the US to start our families, and as a result, we're having more trouble doing so. So today one in six couples have trouble getting pregnant. So one is just the the broader, we got things to do and we're waiting longer. Actually, I just want to throw a stat That in there, the only age group that recorded increases in fertility rates in 2018 more women in their late 30s and early 40s. So, That's right, I was totally seeing a shift there. Sorry. Go ahead. Yeah, No spot on spot on and so the second. As 20 % of millennials identify as LGBTQ. And so when you have this significant portion of millennials, where this idea of actively trying to conceive for nine to 12 months before any infertility coverage if they happen to have that as a part of their care, That just doesn't work for 20 % of millennials now and we need better solutions. And the third is just the the world that we're living in in 2019. We have personalized information about what ingredients are in our beauty products. We have mortgage calculators that tell us about saving for our homes. Yeah, fertility is just the this total black box and so what we're seeing is women saying, know that this is not okay this is not good enough. Women are demanding more information about what's going on in their their bodies more information about their biology, so that they can make the decisions that are right for them. And so I think that that momentum has allowed our companies to have customers and therefore Fuel the broader momentum in the space which is really exciting. We're gonna dive into how you guys are doing that. But first tell me your company [ UNKNOWN ] helps companies implement fertility benefits. Why have fertility benefits not been sort of considered traditionally part of the typical Benefit package and even more broadly, why is fertility not been considered part of sort of our core health care system? Almost. Yeah. So, when we look at sort of this particular moment in history, we're really excited because, for many, many decades mean IVF was invented about 40 years ago. Fertility Care and access to fertility treatments were very much considered a luxury consumer. Good. And only a certain type of person could afford access to that type of care. Because of some of the trends that Afton pointed out, when you look at millennials and employees who are coming into the workforce even younger, sort of the trends are very similar to how dental and vision became a standard part of compensation when people go to work and we believe that fertility is sort of that fourth pillar Medical dental vision and fertility care will be a standard part of company benefits Park as it is when people go to work and it's because people are having kids later and later and both women and men for the first time ever more females above the age of 30 or having children than below the age of 30 and sort of the way that LGBT people think about. Family forming and how they pursue Parenthood is changing. And so, you know, I think if you ask any of us or really anyone, whether or not they consider Fertility Care, luxury or a perk, I think the answer would be no. I think all of us really think about whether we actually do ultimately want to have children are not we think about fertility as a fundamental part of human health. And that's how we think about it, it's some some sort of very human, both men and women. So where are we in terms of that path to making the sequel benefit. I think we're making really exciting progress, I mean we are seeing a lot of interest, sort of in the economy From all different parts of the economy, so we have customers in food and beverage and transportation and retail, obviously technology, financial services, and others and I think one of the biggest myths about fertility benefits is that it is something that only large Through corporate technology companies, can afford or should frankly want, and what we're saying is that that's not true. Again, this is something that all people want access to and so all companies are feeling pressure from employees to think about this issue in a thoughtful way. So often you talk about modern fertility as a fertility company not an infertility company and that's a really interesting decision, can you talk a little bit about why you guys made that choice. Yeah, okay I actually made, so I Our name of our company is Modern Fertility. We had so many discussions when we were even naming our company of my gosh, fertility it's such this loaded and stigmatized word there's no such thing as the the word fertility and the traditional healthcare system It's only infertility. And so, part of even naming our company was a very intentional decision to say no, fertility has all of the stigma around it. We're going to have it as part of our name. And then our core customer who we're going to focus on, is educating women. before they're actively trying to conceive, have that conversation and have that dialogue with them so that they can have more information about their own bodies beforehand to continue to navigate this process. And so I think you know, when you look at the the healthcare system today, you look at the education system today we're only focused on preventing pregnancy and planning for it as a black box. Fox and I think where we see the amazing efforts of legislation which is pushing infertility into these broader coverage plans fertility in thinking about proactive Fertility Care is still a step behind that and so When we took a step back and looked at the entire fertility space and really, what do women need today, we really saw information as the biggest gap and an opportunity today. How could we give women access to information about their own bodies, their own biology. So that they could help, help them to navigate that process today, before they might have to choose to access some of these options down downstream. I think some of the some of these points around language is super important when we are looking at this category. I think a lot of the language just like the legislation, the policies at work. The products and services in the market haven't really been updated in a really, really long time. And even in the past few years when you look at the word fertility there's this evolution from infertility to this concept of fertility and sort of product of fertility, health. But if you were to look at products in the fertility market a few years ago, you would mostly find cycle or period tracking apps, and those would be called fertility apps. And I think one of the great things about this category as it grows and as it matures is that it is maturing into a more full throated Sort of idea of what this category of health means. And it's sort of innate complexity. So are we doing a disservice then when we call it femme tech by grouping it into that area. I think anything that Prompts the conversation and dialogue about women's health and fertility as positive. So when it's called Femme tech, when it's called other things, I'm excited that we're that means we're having a conversation about fertility and women's health, which is it's net net positive and wonderful. But to me, reproductive health is a core part of overall health. And the more that we can integrate Technology, the more that we can integrate fertility care into this broader healthcare conversations. So we're talking about fertility hormone testing in the same way that we're talking about getting a pap smear. We're talking about infertility as a normal part of conversation, not as something that's stigmatized. The more that we can do to normalize this conversation and have it Just be a part of our health, a part of our lives that would be true progress. So you, I'll love it if you talk a little bit about more [ UNKNOWN ] modern fertility system works, you created this company because of your own experience trying to find out more information about your fertility what happens Yeah, so I feel that I was able to have this really unique lens into fertility, fertility rates in fertility at a really early point in my my life in my career so my first job out of school was working at a healthcare private equity funded in New York. So my job was to look at sectors of healthcare that were interesting growing, had some consolidation potential. And because of my personal interest, I ended up spending a lot of time in women's health and within women's health started spending a lot of time in fertility and which is looking at these massive growth. Raise these caterers looking at these infertility clinics with these wait lists that were months and months long and so from a private equity perspective, that meant it was a great investment opportunity. [ LAUGH ] And so I spent a lot of time in this space but there was something about it that didn't sit right with me. That this model wasn't aligned completely with the best interests of women. And so, I was 22 at the time and I don't think I fully knew what that meant or how to process it. But as part of doing work in this space I understood that the business of infertility, I understood the science of infertility. But it was the emotional aspect that stuck with me the most. And so it was going into these infertility clinics And talking to these high powered women that I respected so much and hearing, no one told me that fertility defined with a jerk, no one told me that IVF wasn't going to work 100 % of the time and so, fast forward Ended up leaving finance and tried to get my own fertility hormones tested while I was leading the consumer tools division at 23. And me, because I was waiting until later in life to start my own family and I remember this Baseline testing that I have learned about back in private equity. I went to my OBGN and they said no, you're not actively trying to have a baby and failing. So therefore, no you cannot have these tests. They're not covered. So I had to go into an infertility clinic. Pay. In San Francisco, $ 700 out of pocket for that appointment. [ LAUGH ] And then when I finally got the testing done, that's a story for another time. It was complicated, I just had such an empowering conversation with my doctor, with my partner. I got a PCOS diagnosis along the way, it's a condition, leading cause of infertility affects one in ten women And I think that the aha moment for me in modern fertility was really having that conversation with my fans and friends and hearing them say, yes, I want that. How can I get that? I want that information about my body. And it was just this energy and the shift and this excitement Women just demanding more information about their bodies. And that was the start of it all. [ LAUGH ] So yeah, I mean, I think that's a super interesting way of looking at it. And Tammy on your end, I know that you're really seeing employers drive this, right? So again the coverage landscape is changing completely. What's really shifted there? Why are employers now taking a lead on this when we didn't used to see that at all? Yeah, I mean, I think employers are, first, for [ UNKNOWN ] what we believe is that in most cases access to fertility care will be gated by affordability. Not enough people who want access to fertility treatments can or are willing to pay for it. In this country, more than 150 million people get access to health care through their employer. That's more than Medicare and Medicaid combined. And so when we think about sort of expanding access, the question was, how do we do that at a fundamental level. And what we're doing is we're partnering with employers to create more dollars. For coverage that allow people to access care that starts from a fertility consultation to understand what your response will be to increasing your IVF all the way through to IVF, egg freezing, adoption or anything within three, the suite \ g of third party reproduction. And I think there's lots of motivations for employers who are thinking about this, but the main ones I think are the most motivated employers that we engage with are those who actually hear from employees. Those who sort of have heard from even a single person This is something that they care about and that the team wants all benefits. People are looking for the highest impact way to deploy that dollar and to deploy their budgets and so hearing from employees often creates a much higher level of motivation. The second is employers who sort of look around and are trying to understand within their category what is the competitive landscape look like for talent. And so talent retention is a big one, as well as overall long term matter. Medical spend and the reduction in costs through deploying what we call a managed care program that helps manage the outcomes of fertility treatments in a way that makes everyone happier and healthier and the end and ultimately save the employer a lot of money, particularly the self funded ones. Great. Let's we have any questions in the audience. Any questions? [ BLANK_AUDIO ] Okay, start thinking, We have one over there. And if you could tell us who you are. I Nela Richardson Edward Jones. I'm just curious what's covered in fertility at health care. I remember a couple years ago a lot of tech firms Facebook and such, decided to cover eggs harvesting. Yep, like recently So can you give us kind of the degree of the scope and detail when it comes to health care coverage in companies? Yeah. So about half of the companies that we work with have never had any sort of fertility or infertility coverage ever before. So we're building programs from the ground up and in that way Because of the flexibility of our product companies can sort of design it from the ground up. If you have infertility coverage at your company through an insurance or health plan. What that means is as after mentioned, there's this classic Diagnosis of infertility that's required to people of the opposite sex trying and failing to get pregnant after six to 12 months depending on your age. In those cases, you might get access to some coverage, although in many cases it's limited. There's different state mandates as well regarding that, as you sort of move up into sort of larger companies that are self funded, they have a little bit more flexibility. Facebook is a great example you mentioned. So they're able to sort of work with the health plans to design additional coverage, for example around fertility preservation, but even in those cases, there's lots of gaps that needs to be filled. So, we have a question over here if you can just wait for the mic and tell us who you are .>> Awesome. Hi. So my name is Wenzer, co founder of Her Canvas media and question is when should women start thinking about Their fertility is there. I know it declines after a certain point, but is it? I'm gonna get pregnant in my 20s and that's my plan. We're good or should every woman because of PCs get tested? I love that question. So I think it's a really personal decision to think about how you want to access information around your health and life. And our view is it's up to a woman to decide how she chooses to access that information for us the modern fertility hormone tests that's accessible to women ages 21- 30- 45. And our worldview is that this type of testing should be as routine as a pap smear. When you're starting to understand your own body, your own biology, understanding if you have PCOS as a part of fertility but it's also a part of your general health. So the treatment for PCOS which affects one in ten women is often going on birth control. And so if you go on birth control with with PCOS, you're suppressing a lot of the symptoms in a positive way. But then when you go off birth control, in many cases, you still have PCOS and might have trouble getting pregnant. And in some cases, you might even be [ UNKNOWN ] Which means you're not ovulating and if you're anovulatory, it can create this unbound estrogen in your ovaries put you at a higher risk for endometrial cancer, lots of health concerns associated with that. So just this Fundamental understanding of where's my body, where's my health and being an advocate within that with your healthcare provider. I think that's where modern fertility sits within the ecosystem. That's where we stand at the beginning of the journey of You know what's the first step. Where is my body? And how I can use that to navigate the system with my provider. When I'm in control of that information. So, women as early as they can owning this information. And being able to use it to make the decision is that right for them. Tami very quickly we have 20 seconds. Yeah. What is the area that you're most excited about? What needs the most investment, the most research stil in your mind? I think a lot of the exciting research within the fertility category is really thinking fundamentally about how to change some of the economics of fertility treatments in the lab and in the clinic. So at the sort of science level What are the things that we can do to make IVF for increasing sort of retrievals you know, hundreds of dollars, you know, versus thousands of dollars and I think those types that type of research and development and those those things will really change the fundamental economics and allow many millions more people to access the care that they need and that they want to access. Yeah. Temi [ UNKNOWN ], thank you so much Thank you. [ APPLAUSE ] Thank you. [ BLANK_AUDIO ]

The Business Of Fertility And Why It Took So Long

Luxury

Silicon Valley and the broader investment community are finally starting to pay attention to a major unmet need in the market: fertility.