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Why investing in women’s health innovation is a smart bet

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By David Buller, Managing Partner at KELES

The macro opportunity: women are half of the population

In 2024 alone, women’s health start-ups raised a record $2.6 billion, up 55 per cent from the previous year.

In addition to increasingly recognised health needs in menopause, fertility and female-specific cancers, there are conditions such as cardiovascular disease, diabetes and Alzheimer’s, to name a few, that affect women disproportionately as compared to men, which then leads to the creation of large care gaps.

Whilst conventional care pathways, medications, dosages and treatments are often geared to accommodate males, this has created gaps in clinical pathway guidelines for women and their health.

The opportunity for transforming and investing in women’s health is growing. Where should investors focus capital, and what will substantially improve women’s health for the future?

Venture Capital will back scalable, system-level solutions

Despite the growing attention on women’s health and FemTech, successful venture-backed companies need to attract the female healthcare population.

The technologies that do this will be those that are payor-reimbursed (government, insurance or employer), can embed into patient care pathways, address wide-scale unmet needs, and have a clear exit strategy. Women’s health companies, just like any other digital health venture, need to consider how they integrate with the health system as a whole and forge a clear route to market.

The best companies will drive the new standard of care and address critical needs, for example, those improving essential surgeries, or developing new therapies, and those that substantially increase quality of life for a significant number of women.

With these considerations about scaling and prevalence in mind, the opportunities for founders and investors are great. What kind of technologies should we consider?

  1. Those combating major gaps in existing care pathways. For example, endometriosis affects an estimated 10 per cent of women, yet diagnostic delay still averages eight years. Technologies that shorten diagnosis transform millions of lives and are rapidly adopted by payers.
  2. AI and platform technologies. Utilising the latest AI capabilities can improve accuracy and speed in health, especially in diagnostics and drug development, and support the vision of care for women. We must ensure that data is representative of women and female patient groups. Greater assimilation and integration of truly representative datasets can allow more informed care decisions, and can enhance female patient selection for clinical trials.
  3. High-prevalence conditions and health issues. Some conditions affect a startling number of women and can contribute to significant strains on global health systems. Fertility and pregnancy, post-partum depression, endometriosis, menopause and osteoporosis, breast cancer and diabetes are just some examples of highly prevalent and widespread health needs. AI and tech enable a huge step change in addressing issues that were completely undertreated.

Building a women’s health ecosystem that thrives: future innovation will originate from women

Achieving a healthy ecosystem of market-ready innovations in women’s health requires more than collaboration between start-ups, healthcare providers and investors. It needs a momentum of female-led founders to break the barriers, and get the right tech, innovation and products to the women who need them.

Breakthrough ideas often come from those who have experienced the pain points firsthand. Yet, if we look at women’s health, fewer than one in five digital-health start-ups is founded by a woman, and the percentage drops further in med-tech and biotech.

Encouragingly, the raw talent already exists. Across Europe, women already dominate many healthcare practitioner positions and master’s level qualifications in health and life sciences, and in many EU countries, they hold a slight majority of PhDs in these fields. Cities such as Lisbon, Copenhagen and Barcelona are making progress on gender balance among principal research investigators.

The challenge is in the translation: channeling the expertise into biotech and health companies that will scale well and make a significant impact on women’s health. So we should continue:

  • Encouraging women in the scientific and healthcare ecosystem to experiment and innovate, and bring new technologies to market.
  • Building an inclusive environment for female founders.
  • Investing in female-led companies producing scalable solutions for women’s health.
Measuring returns by better health: an investor’s framework

Adhering to strong ethical principles is a core foundation of any good investment in healthcare. By embedding these principles into an investment framework, we are more likely to see capital deliver sustainable, long-term value.

At KELES, we evaluate our portfolio companies against core criteria. Applying these criteria to solutions for women’s health, companies can drive significant innovation and progress to support equitable healthcare. Many women’s health companies have the opportunity to meet and exceed these principles, and drive significant innovation and progress to support equitable healthcare.

  • Accessibility – does the solution broaden access and availability of healthcare for women?
  • Ethical use of data – is sensitive health data handled with the highest standards of privacy and fairness, and includes truly representative data?
  • Improved outcomes – does the technology enhance healthcare outcomes for women?

By tying capital to these measurable goals in women’s health, and prioritising investments in women-led ventures that show clear market value, we can accelerate innovation that truly meets women’s healthcare needs – and has real impact worldwide.

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UK reviews surrogacy firm over rejected insurance claims

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The UK government is reviewing a surrogacy firm after complaints that medical insurance claims involving surrogates in Mexico were rejected.

The Department of Health and Social Care (DHSC) is considering whether UK-based provider My Surrogacy Journey should remain listed on gov.uk as one of four domestic surrogacy agencies available to intended parents.

The review follows allegations concerning its Mexican sister company, where surrogates are based.

Health minister Diana Johnson said: “The department is looking into the allegations about My Surrogacy Journey.

“As part of that assessment, the department will consider whether it is appropriate for that company to remain on the gov.uk list of agencies.”

Emails sent by My Surrogacy Journey chief executive Michael Johnson-Ellis and seen by the Guardian suggest multiple surrogate women in Mexico had their insurance claims rejected.

The emails also suggest 300 couples using the company were moved to a new insurance provider because of the increased risk of claims being rejected.

Commercial surrogacy is banned in the UK, where only altruistic arrangements are permitted.

My Surrogacy Journey operates a not-for-profit UK branch alongside for-profit sister companies in Mexico and the US. All three companies have the same owners and chief executives.

The reported insurance issues relate to surrogacy arrangements in Mexico.

One couple told the Guardian they paid tens of thousands of pounds to cover medical costs after their surrogate had a hysterectomy during childbirth and an insurance claim was refused.

The Guardian said it understood that at least five sets of parents said they had to cover medical costs after insurance claims were rejected.

In an email to the couple whose surrogate underwent a hysterectomy, Johnson-Ellis wrote: “We have already told you that the insurance companies have been declining some of the claims and we are actively working with the broker to get this issue resolved but you should also consider that they may not be paid out and there is nothing we are able to do to change this …

“We appreciate this is not an insignificant sum but this genuinely is out of our control.”

Johnson-Ellis also said the company had switched insurance providers, writing: “We’re also managing this for 300 other journeys, which is a complex position to be in.”

Lawyers acting for My Surrogacy Journey said the company did not comment on individual cases, but that existing insurance policies were in place and claims continued to be accepted and processed.

They said the company understood that a small number of claims had been rejected and was supporting people seeking to resolve those claims with an insurer.

Under the surrogacy arrangements, intended parents are understood to be contractually required to cover medical costs not paid by an insurer.

The couple said they had been recommended the company’s Mexico option. Its website advertises that intended parents using the route can have a baby in “under 18 months”.

They said they were told the UK route could take up to five years and that the US option was much more expensive.

Lawyers for My Surrogacy Journey said prospective parents are given information about typical timelines, costs, legal frameworks and practical considerations, and that the 18-month timeframe is indicative only.

The couple said their surrogate developed placenta accreta, a serious condition in which the placenta attaches to the wall of the uterus.

Emails from Johnson-Ellis acknowledged that the insurance provider investigated the birth after the surrogate experienced health complications.

The parents are considering legal action, while the Guardian said it understood at least four other couples were reviewing their options.

Phil Brickell, MP for Bolton West, raised concerns in parliament about a separate couple who had used My Surrogacy Journey.

He said: “Two of my constituents recently travelled to Mexico, where their children were born by surrogacy.

“Those births were facilitated by a company called My Surrogacy Journey, which is listed on gov.uk.

“While in Mexico, they had repeated traumatic experiences with the company relating to issues including insurance for their children, accusations of bullying towards staff and repeated efforts to silence any constructive criticism.

“I understand that other members of this house have received similar complaints.”

Brickell called for My Surrogacy Journey to be removed from gov.uk pending a review by the Human Fertilisation and Embryology Authority.

Lawyers acting for My Surrogacy Journey said the company was communicating with DHSC and was confident any issues could be resolved.

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Research uncovers potential new target for breast cancer therapy

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Targeting CD1d altered immune cells slowed tumour growth and improved immunotherapy responses in mouse models of breast cancer, researchers found.

The findings suggest blocking the molecule could make the environment around breast tumours more favourable to anti-cancer immune responses.

Further work is needed to understand how these immune changes occur and how the approach could be safely used in patients.

Researchers from King’s College London, the Francis Crick Institute and University College London investigated how immune cells inside breast tumours influence cancer growth.

They focused on myeloid cells, a group of immune cells found in large numbers within tumours that can either support an immune attack against cancer or contribute to tumour growth and immune evasion.

The team examined CD1d, a molecule found on the surface of myeloid and other immune and tissue cells that helps regulate immune responses.

When CD1d was genetically removed from cells in a mouse model of breast cancer, the mice were more resistant to tumour growth. Researchers also saw changes in myeloid cell populations, including increased activity among cells that can help attack cancer.

The team then blocked CD1d using an antibody and again observed changes in myeloid cells and slower tumour growth. Blocking CD1d also improved responses to immunotherapy in the mouse model.

Researchers used single-cell RNA sequencing, a technique that examines gene activity in individual cells, to investigate the immune changes in more detail.

They identified a population of myeloid cells called monocytes that expressed genes associated with inflammation, an important part of the immune response. These cells were particularly important in restricting tumour growth in the mouse models.

A similar pattern of gene activity was identified in data from human breast cancer tumours. Its presence in myeloid cells was associated with positive responses to immunotherapy in breast cancer patients.

However, the findings in people were based on gene expression data and did not test CD1d-targeting treatment in patients.

Professor Patricia Barral, professor of immunobiology at King’s College London and senior author of the study, said: “Many breast cancers do not respond well to current immunotherapies.

“Our findings reveal a previously unrecognised mechanism by which immune cells within tumours are regulated.

“While CD1d is best known for helping immune cells recognise lipid molecules, we found that it also plays a role in shaping the behaviour of myeloid cells within tumours.

“These findings suggest that targeting the immune cells that surround and support tumours could boost anti-cancer immunity and potentially improve treatment responses in the future.”

Researchers now plan to investigate how the immune changes occur and how they can be safely harnessed in patients.

They also want to examine whether targeting CD1d could enhance existing treatments and influence treatment responses in different cancer types.

The work was supported by UKRI BBSRC, Breast Cancer Now and the Cancer Research UK City of London Centre.

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Fertility rate in England and Wales hits record low, new figures reveal

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The fertility rate in England and Wales fell to a record low of 1.39 children per woman in 2025, down from 1.41 a year earlier.

New figures show that parts of London and cities with major universities accounted for many of the areas with the lowest local fertility rates.

The City of London recorded the lowest rate in 2025 at 0.37 children per woman, followed by Cambridge at 0.87 and the London boroughs of Islington and Westminster at 0.90.

The Office for National Statistics (ONS) defines the fertility rate as the average number of live children women would expect to have over their childbearing lives.

Brighton & Hove recorded a rate of 0.95, followed by Southwark at 0.97 and Norwich at 0.98.

Exeter, Oxford and York, along with the London boroughs of Camden and Hammersmith & Fulham, each recorded 1.01 children per woman.

At the other end of the table, Pendle in Lancashire and Luton in Bedfordshire had the highest rate at 1.93.

They were followed by Oldham in Greater Manchester at 1.87, Bradford in West Yorkshire at 1.84 and Barking & Dagenham in London at 1.83.

The overall fertility rate for England and Wales declined from 1.41 in 2024 to 1.39 in 2025.

A rate of around 2.1 is needed for a population to remain stable over time when the impact of migration is excluded.

Twelve of the 25 local authorities with the lowest fertility rates in 2025 were in London.

In Wales, Swansea recorded the lowest fertility rate at 1.18, while Carmarthenshire, the Isle of Anglesey and Newport each had the highest rate at 1.48.

There were 585,396 live births in England and Wales in 2025, down from 594,677 in 2024 and the lowest number since 1977.

Live births fell across every region in England. The West Midlands recorded the largest percentage decline at 3.1 per cent, while the North East had the smallest at 0.3 per cent.

The average age of parents also increased slightly.

Mothers had a provisional standardised mean age of 31.1 in 2025, compared with 31.0 in 2024. Fathers had an average age of 34.0, up from 33.9.

In 1975, the average age was 26.4 for mothers and 29.5 for fathers.

The proportion of births where the mother was born outside the UK also increased, from 20.8 per cent in 2005 to 27.5 per cent in 2015 and 34.6 per cent in 2025.

India was the most common country of birth for non-UK-born mothers in 2025 for the fourth consecutive year.

It was followed by Pakistan, Nigeria and Romania.

In 2025, 56.4 per cent of births were to parents who were both born in the UK, down from 62.7 per cent in 2015.

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