Fertility
“IVF has the potential to change healthcare forever, but greed stands in the way”
By Lorin Gu, founding partner at Recharge Capital
Finding common ground and embracing technology has the potential to fundamentally redefine fertility treatment, says Lorin Gu.
Reproductive technology is one of the fastest growing healthcare sectors in the country. From 2015-2020, the US in vitro fertilisation (IVF) market grew from 231k cycles a year to 326k cycles a year, representing a CAGR of 7.13 per cent.
In addition to growing demand, IVF technology is also improving, with the rate of successful pregnancies increasing from ~30 per cent to ~45 per cent over the same period.
While reproductive technology has experienced significant growth in recent years, a 45 per cent success rate at an average price of US$20-25k per cycle means that IVF remains an inaccessible option for most people who wish to conceive.
To tackle part of this problem, many start-ups have created AI solutions to further increase the success rate of IVF while decreasing the number of cycles required for fertilisation.
The offerings from these companies mainly revolve around utilising AI to provide accurate embryo selection, implantation prediction, and end to end clinical workflow software.

In short, these companies allow embryologists to make non-biased, high quality decisions, while saving them from spending precious time in the lab on laborious data entry and manual processes. The appealing new innovations of these companies have drawn in nearly US$100m in funding from top investors.
There is clear excitement and conviction around reproductive technology, and it will be very exciting to see these solutions reach their full potential once they receive FDA approval.
However, while we should be optimistic about these developments, there is an important caveat that could potentially derail the growth of fertility technology.
Although all reproductive practices claim that they want to increase their success rates, there is an intrinsic conflict of interest between fertility clinics’ profit seeking business model and technologies that promote higher success.
Over the past five to ten years, there has been drastic consolidation in the IVF space, primarily driven by the entrance of private equity groups and expansion of large clinic chains.
Looking at data from the ~450 US clinics that report to the CDC, over half are held by only eight chains. When these stakeholders are added into the mix, the end goal almost always turns to profit rather than service. There are three main factors driving this relationship.
First, we can start with whether or not clinics really need to increase their success rate in order to attract more patients. In general, the fertility treatment industry is significantly supply constrained with outsized demand.
In the US there are about 450 clinics and 1,700 reproductive endocrinologists to fulfil the demand of 10.85 million females that are infertile in reproductive age. This would equate to roughly 22,000 cycles per clinic, while in reality the average cycle per clinic is only around 700.
While there are more nuances that factor into the demand, such as cost, social acceptance, and other medical conditions, the stark disparity in these numbers makes it fairly obvious that clinics are not compelled to increase their success rate due to the supply constraints of the industry.
Second, we can look at the typical customer acquisition cost for an IVF clinic. The average CAC per cycle ranges between US$1,000-US$3,500, or 5 per cent to 17.5 per cent of revenue per an average cost of a US$20k cycle.
These numbers are significant compressors of profitability, and clinics want to keep the customer acquisition cost low. As a result, retaining an existing patient that has failed their first cycle treatment could be extremely cost efficient.
Finally, we can look at the cost associated with software integration. The average cost to integrate software at a clinic ranges between US$180k-US$370k, compared to an average annual revenue of US$9m. Conservatively, this adds up to around 2 per cent to 4 per cent of revenue.
The question then becomes whether or not this is an additional add on to existing software or this software takes over the complete clinic flow. The latter is clearly more attractive, while the former could be problematic at a profit standpoint.
Given these factors, it is easy to see the potential conflict of interest between profit seeking operating model and technologies providing higher success.
While there are many reasons to be bullish on the tech companies revolutionising workflow in fertility clinics, prices in the industry will only be reduced if technology is allowed to come in to help. In order to resolve this conflict of interest, clinics and startups must work together to find a solution that benefits all parties.
While it may cost clinics some profits in the short term, finding common ground and embracing this technology has the potential to fundamentally redefine fertility treatment across the globe.
Lorin Gu is a founding partner at the New York-based venture capital firm Recharge Capital. Prior to founding Recharge, he previously worked at Cyrus Capital, a US$4b+ hedge fund in New York, and the Blackstone Group. Lorin is also the founder of Recharge Foundation, founding chair at Peterson Institute of International Economics’ Global Future Council, and an executive board member at the Museum of Art and Design, and the New York Foundation for the Arts.
Fertility
France urges 29-year-olds to start families now
France is urging 29-year-olds to have children as part of a 16-point plan to boost fertility and raise birth rates.
Health officials say the aim is to prevent men and women facing fertility problems later in life and thinking “if only I had known”.
The strategy comes as the country, like many western nations including the UK, faces tumbling birth rates.
The trend is creating concerns about how governments can fund pensions and healthcare for ageing populations with fewer younger working people paying taxes.
But policies to raise fertility rates globally have produced limited results, and critics of the scheme suggest better housing and maternity provision could be more effective.
The government will send out “targeted, balanced, and scientifically sound information” to young people on issues including sexual health and contraception.
The material “will also reiterate that fertility is a shared responsibility between women and men,” the country’s health ministry said.
The plan includes efforts to increase the number of egg-freezing centres from 40 to 70. The process involves extracting and storing a woman’s eggs for potential future use.
The country’s health system already provides free egg-freezing for people aged 29 to 37, a service that costs about £5,000 per round in the UK.
The country’s fertility rate of 1.56 children per woman is below the 2.1 needed to maintain a stable population.
However, it is higher than rates in China, Japan and South Korea, and the UK, where the latest figures show it dropped to a record low of 1.41 in England and Wales by 2024.
Professor François Gemenne, who specialises in sustainability and migration at HEC Paris Business School, told Sky News: “This is something that demographers had known for a long time, but the fact that there were more deaths than births in France last year created a shock effect.”
He said the country’s “demographic worry” is exacerbated by the design of its pensions system and its “obsession with immigration and the fear of being ‘replaced'”.
The plan also includes a new national communication campaign, a “My Fertility” website advising on the effects of smoking, weight and lifestyle, and school lessons for children about reproductive health.
The health ministry has acknowledged its maternal and infant mortality rates are higher than neighbouring countries and is beginning a review of perinatal care to address the “concerning” situation.
Channa Jayasena, professor in reproductive endocrinology at Imperial College London, told Sky News: “On the female side, societal changes leading to older age of motherhood are certainly important.
He said obesity was also a problem as it increased women’s risk of polycystic ovary syndrome and endometriosis.
Allan Pacey, professor of andrology (male reproductive health) at Manchester University, said for most people globally, deciding to have children was “down to [non-medical] factors such as better access to education, career opportunities, taxation, housing, mortgages, finance, etc.”
“Medicine can’t help with those things,” Pacey added.
Fertility
Covid vaccine not linked to decrease in childbirth, study finds
Insight
Parents sue IVF clinic after delivering someone else’s baby
A Florida couple have sued an IVF clinic after giving birth to a baby who is not genetically related to either of them.
Tiffany Score and Steven Mills hired IVF Life, which operates as the Fertility Center of Orlando in Longwood to help them conceive about five years ago using in vitro fertilisation.
The couple had an embryo implanted in April and welcomed a baby girl nine months later, but soon suspected the clinic had made an error.
Both Score and Mills are white, but the baby had the appearance of a racially non-Caucasian child, according to the lawsuit.
Genetic testing confirmed that the baby is not biologically theirs. The couple filed the lawsuit on 22 January after allegedly trying to contact the clinic multiple times without getting a response.
Jack Scarola, one of the couple’s lawyers, told the Orlando Sentinel: “They have fallen in love with this child. They would be thrilled in the knowledge that they could raise this child.
“But their concern is that this is someone else’s child, and someone could show up at any time and claim the baby and take that baby away from them.”
Score and Mills are also concerned that one of the three fertilised eggs they had frozen at the clinic may have been mistakenly implanted into someone else.
They have demanded that the clinic share what happened with all other patients who had embryos stored at the facility during the year before Score gave birth. They also want IVF Life to pay for genetic testing of every child born as a result of its services over the last five years, and to account for their remaining embryos.
The couple said in a statement: “We love our little girl. We would hope to be able to continue to raise her ourselves with confidence that she won’t be taken away from us.
“At the same time, we are aware that we have a moral obligation to find and notify her biological parents, as it is in her best interest that her genetic parents are provided the option to raise her as their own.”
A family spokesperson said: “Based upon leads discovered to date, and despite the lack of help or cooperation from the clinic, there is hope that we will be able to introduce our daughter to her genetic parents and to find our own genetic child soon.”
The lawsuit names IVF Life LLC and Dr Milton McNichol, who runs the clinic.
The Fertility Center of Orlando had posted a notice on its website stating it is “actively cooperating with an investigation to support one of our patients in determining the source of an error that resulted in the birth of a child who is not genetically related to them.”
The notice was removed after a court hearing on Wednesday.
During the hearing, the judge ordered the clinic to submit a thorough plan for handling the situation by Friday.
McNichol was reprimanded by Florida’s Board of Medicine in May 2024 after an inspection of the clinic in June 2023 revealed several issues, including equipment that did not meet current performance standards, failure to comply with a risk-management plan and missing medication.
He was fined US$5,000.
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