My eggs are back there somewhere.
Wave to the eggs.
There's a growing trend in the United States — more and more women are freezing their eggs.
I think in the last two years alone, I've had 10 to 12 friends that have
gone through the process. It gives me options in the future
and I think it's exciting. I mean, technology enables this to happen,
where you didn't have that option 10, 20 years ago.
Simmons shared her egg freezing journey on social media, showing how
despite its recent popularity, the process is still very involved and very expensive.
Believe this was my bed right here.
Luckily, a handful of start-ups are trying to change that. As one of only
two female venture capitalists at her firm, Simmons realized she could
help. And as more investors have experiences like hers, the start-ups are
seeing more funding.
I believe in the next year, there'll be a lot more innovation in women's
health in general. And there are more and more entrepreneurs in the last
year that I've seen that are trying to tackle different parts of the pie,
so to speak, with women's health.
Once a solution designed solely for women who might struggle to conceive
because of serious medical conditions like cancer, egg freezing is now a
mainstream elective process.
You typically have to do between two and four injections a night in your
stomach. It was a process. So I share the ups and downs of the journey.
The time commitment. Somedays I didn't want to do anymore an injections. I
hate needles.
After two weeks of these hormone injections, which are meant to stimulate
the ovaries to ripen multiple eggs, the woman undergoes transvaginal
surgery under sedation. A needle with a suction device attached is entered
through the vaginal wall and into the ovarian follicle to retrieve the
eggs, which are then immediately frozen. In 2012, the American Society for
Reproductive Medicine stopped classifying it as an experimental procedure.
I think there were seven retrievals the day that I did mine.
As a result, the industry has grown 14 times in the last decade. In 2009,
only 500 women underwent egg freezing cycles. In 2016 there were 9,000
cycles and that number is much higher today. And that means big business.
U.S. fertility clinics generated $1.9 billion in revenue in 2017. Now
start-ups are popping up everywhere.
There should be more capital invested in women's health companies. And if
you look at healthcare in general, from medicine to the studies, they've
been based on men. If you look at tampons, for instance, they were
originally designed during the war for wounds and then it transferred into
something for women. And there hasn't been a lot of innovation just in
that in the last hundreds of years. So the more that women are thinking
about, how do I rethink this problem? Why is it this way? How could it be better?
Simmons is part of a boom in investment in women's health, a global market
projected to reach $50 billion by 2025. The majority of investments are
early stage deals like those Simmons is pursuing: a few hundred thousand
or a million here and there. But in all, $500 million was raised by
start-ups in 2018, up from $350 million five years ago. Despite the money
pouring into the market, egg freezing is still too expensive for most
women. One cycle can cost between $13,000 and $15,000.
These little black dots are the starting follicles.
Extend Fertility has cut costs for women by streamlining the process. Its
New York clinic is unusual because it's solely dedicated to egg freezing,
with a lab on site. Most clinics include other costly fertility treatments
like in vitro fertilization. In 2018, Extend did more than 1,000 egg
freezing cycles at their clinic alone. The high number of clients allows
them to bring down the cost for each cycle by about 50 percent, to $5,500.
Another way to bring down the cost is for employers to cover it and that's
become a big trend in big tech.
Facebook and Apple started offering the benefit in 2014, to somewhat of an
uproar. Critics argued the company wanted to keep its female employees
from having babies, ensuring more time in the office.
The request came from the employees. This was not a top down, "We want you
to stay at your desk." It was actually just from women who they're working
hard to recruit and retain saying, "Hey listen, we need a benefit."
Two-thirds of millennials will change their job for better fertility benefits.
Schlanger's start-up Progyny works to get more companies on the bandwagon,
helping them attract top talent by providing fertility coverage. With one
in eight women struggling with fertility, he says the need is big.
Women are waiting longer and longer to have children for the first time in
history. Last year, the birth rate for 30- to 34-year-olds exceeded the
birth rate for 25- to 29-year-olds. And as women wait longer to have
children, the incidence of infertility grows.
Studies show that 80 percent of women choose to freeze their eggs because
they're waiting to find the right partner to have a baby with, not because
they're focused on their career. Today, Schlanger says that approximately
25 percent of large employers provide some level of fertility coverage.
Google, Yahoo, Uber, Microsoft, to name a few. Another big barrier for
women hoping to freeze their eggs: it's time consuming and
cumbersome. Start-up KindBody has set up mobile clinics in San Francisco,
Los Angeles and New York where women can get some basic testing done to
tell them if they should freeze their eggs. The AMH test these women are
lined up for is a reading of the hormones and ovarian reserves that give a
general indication of fertility.
And then when those results come back, you're just empowered. Knowledge is
power. So whether or not you choose to freeze your eggs today, not at all,
in five years, you now are equipped with a tremendous amount of data and
confidence.
The biggest advancement in egg freezing came in the early 2000s when slow
cooling of the eggs was widely replaced with vitrification, a
flash-freezing process that reduces the chance of damaging ice crystals
forming on the eggs. One cycle used to yield one or two viable eggs; now
it yields 10 to 12. Even with vitrification, freezing is nowhere close to
a guarantee. Only 14 percent of cycles later thawed for fertilization and
implantation result in a live birth.
The Pacific Fertility Center in San Francisco says a piece of storage
equipment lost liquid nitrogen for a brief period on March 4th.
And last year, two major fertility centers had freezer failures that
resulted in the loss of thousands of eggs. To better the chances of
pregnancy, KindBody is developing an online data analyzing system to
predict how many egg freezing cycles each woman would need for the number
of children she wants.
Let's solve it with AI. Let's get a predictive algorithm. You know, if
you're 32 or you're 35 and your pregnancy history is this and your AMH
level is this, you look like other 32 year olds whether they're sitting in
Houston or Chicago or New York. And so with that knowledge, you would
build an automated algorithm for complete transparency into success rates.
Some women fall off of that fertility cliff in their 20s. Some women don't
fall off of it until their 40s. So we have to personalize it.
Start-up Celmatix developed a genetic test to predict what your success rate will be.
Some women are aware that maybe their mothers went into early menopause or
had difficulty conceiving. But unfortunately for many of us, our mothers
had babies much younger than us, so we don't have the information on what
that would have looked like for our family history if they had waited
until their 30s or 40s to start their families.
One in 50 women has the gene for early onset menopause, which means they
would need to freeze their eggs at a much younger age.
Celmatix Fertilome test allows women to take a spit test at home, or a
blood test with their doctor, to test for these genes.
I was actually one of the first people who used our genetic test. What I
found was that I had inherited a genetic risk factor for premature
menopause, and I think of the decisions I would have made a little bit
differently when I was in my 20s if I had known that my clock was ticking
a bit faster than the average woman.
Dr. Beim fast-tracked her pregnancy plan, having three healthy children in five years.
We also need to be pushing the envelope and thinking about why in 2019,
when we know so much about the biology of how the ovary functions, why
don't have drugs that can help a woman actually extend her ovarian function?
We have drugs for heart failure. Why don't we have drugs for ovarian failure?
Celmatix's next phase: a biosciences division to work on just that.
I think when women are taking contraceptives, the contraceptive should be
spiked with a drug that helps preserve their ovarian function. If they're
delaying childbirth, they should be also preserving their ovarian functions.
Simmons is seeing more start-ups run by women like Dr. Beim, with fertility stories of their own.
And so personally through going through this, I'm passionate about
rethinking this for women altogether, so it's a better experience and it's
easier for women and there's more information out there in the world about it.
The future of reproductive health, on the female side at least, is that a
woman, in her first OBGYN visit, will get a full panel of tests. She will
know what her risk factors are. She'll be offered egg freezing, or ideally
even a drug that can help her, in a more natural way, extend the function
of her ovary into the future. And she'll look back on our time in absolute
horror and say, "I can't believe that you all just waited and hoped it
would work out for the best." And so these are tools we can build. It's
science that we have. We're really just missing the dollars to build these companies and build this future for women.