In a clinic in leafy Orinda, California, Anthony, a 45-year-old medical sales rep, lies facedown on an examination table, a sterile sheet draped over his bare bottom. Orthopedic surgeon Chad Roghair uses an ultrasound machine to locate the posterior iliac crest of Anthony's pelvis, and then numbs the area. Roghair makes a tiny incision with a scalpel and inserts a pencil-size tube called a trocar, through which he drills two centimeters into Anthony's hipbone. Attaching a syringe, he slowly draws out 60 milliliters of marrow.

It's a rich, dark red. Like beet juice.

A nurse immediately places the vials in a container lined with dry ice, which she will send to Ann Arbor, Michigan, where a company called Forever Labs will place their contents into cryostorage.

On his feet moments later, Anthony explains why he's here: Coronary artery disease runs in his family. Should he suffer a heart attack in the future, clinical trials currently under way suggest the stem cells in his marrow could help regrow heart muscle. Or maybe he'll have a stroke, in which case there's equally good evidence suggesting those same stem cells will help restore brain tissue. Of course, Anthony could be lucky and avoid any major health problems for 25 years. But then he may choose to have the cells, which have the ability to turn into several types of tissue, infused into his bloodstream as an all-purpose antiaging treatment.

All of that is what Forever Labs offers to the hundreds of people who, like Anthony, have paid $1,500 to have their cells extracted and are spending another $250 per year to have them cryobanked. Consider it a down payment on a future in which health care may be more about maintenance than disease treatment, and aging is a condition to be managed--if not cured outright.

Forever Labs grew out of the research of Mark Katakowski, a doctor of medical physics who has been studying adult mesenchymal stem cells (which are found in skeletal tissue) since 2001. He'd been on the first team that used MSCs to treat stroke in animals. Now, there are hundreds of human trials, many of them Phase 3 studies, in which a treatment already proved safe and efficacious is evaluated against existing options. "I basically have lived the development of mesenchymal stem cell therapy," Katakowski says. (The past decade has brought rapid advances in the applications of adult stem cells, which come without the ethical baggage of embryonic stem cells, the subject of a strict federal funding ban from 2001 through 2009.)

One particular property of MSCs intrigued Katakowski: Their regenerative powers degrade over time, in lockstep with the aging process. Human stem cells lose their potency slowly from about age 20, and then more quickly after age 40. "As your stem cells go to pot, your risk of age-related disease goes up," Katakowski says.

The conventional interpretation has been that stem cells, like tissue, wear out with age. But maybe that was backward, Katakowski wondered. What if the symptoms of aging result from a decline in the body's population of healthy stem cells, which, when abundant, keep disease and decay in check? "Think of it this way: If you've got a city and you start losing firefighters, there's going to be a point where it's hard to keep up with all the fires in your city," he says. Hoping to investigate this hypothesis, Katakowski wrote a pair of grant proposals in 2015, but he found no takers.

After the rejection, he commiserated with his friend Steve Clausnitzer. The two had been close since meeting through their wives a decade earlier and had even teamed up on a business, launching a Reddit-like website called Hubski. "I told Steve, 'I'm not mad I didn't get the grants,' " Katakowski recalls, " 'but I'm turning 40 and I want to bank my stem cells, and there's no way to do that.' "

Clausnitzer, a business-development executive and veteran of American Express and Wolters Kluwer, was intrigued. He mentioned the conversation to a friend of his, an orthopedic surgeon, who told him that autologous stem cell injection (which uses cells harvested from one's own body rather than cells taken from a donor) was increasingly a first-line therapy for sports injuries. There were many services available to new parents who wanted to bank their newborns' stem-cell-rich umbilical-cord blood, but nothing for adults looking to stash away their own young cells. So Clausnitzer and Katakowski agreed to start Forever Labs. "I always tell people it was born out of my midlife crisis," Clausnitzer says.

For Katakowski, the inspiration came when he was 14 years old. That's when his father injured his spinal cord in a water­skiing accident in Michigan, where the family lived. He was confined to a wheelchair for the rest of his life and, in 2009, he died at age 63. Had the accident taken place today, stem cell injection would have helped him, Katakowski believes.

Their idea got a boost when Clausnitzer and Katakowski were accepted into the 2017 class of Y Combinator, the influential Silicon Valley startup accelerator. Through that program, they connected with Mark Batsiyan of Northwestern Mutual Future Ventures, who led a $2 million seed round. "I look at it as a new form of insurance," says Batsiyan.

But while youthful MSCs make a nice insurance policy, the bigger market opportunity for the company is in treating those who are healthy and seeking to stay that way--people like the founders themselves, who were among the first to make deposits in their own cryobank. "Your young stem cells are an incredibly valuable asset that only get more valuable as you grow older," Katakowski says. "For the rest of my life, I'll be able to draw on my 40-year-old stem cells." (Because stem cells can be cloned indefinitely, there's no danger of running through your principal, so to speak.)

Unlike others' stem cells, which can trigger immune system responses or mutate into tumors, autologous MSCs injected into the bloodstream migrate naturally to the body's stem cell reservoirs, like bone marrow and the pancreas. As those reservoirs begin to run low with age, a Forever Labs client can top them off every few years. In theory, that is--MSCs have demonstrated effectiveness in treating specific conditions, but the idea that they represent a fountain of youth has not yet been established. In hopes of winning acceptance of MSCs' potential as a life-extension therapy, the company contracted Katakowski's former lab to test them on mice. "The results are looking pretty damn good," he says.

If the same eventually proves true for humans, it won't be without controversy. In an era when basic health care is increasingly unaffordable and the employer-based insurance model is breaking down, an offering like Forever Labs' $7,000 lifetime extraction-and-storage package might seem like the ultimate perk of wealth: extra life for sale.

Katakowski hopes it won't be that way--and notes that he and his co-founder both come from middle-class families. "I have no interest in building an elite class of people who'll live forever." More likely, he thinks, regenerative stem cell treatments will prove so effective at forestalling the diseases of aging--by far the biggest collective financial burden on the health care system--that, one day, insurers will be happy to pay for them. "The economics are going to drive it," he predicts. "It's not cheap, but compared with the costs of age- related disease, it's much less. Eventually, storing your biology is just going to be a cornerstone of good medicine."

Not far from Forever's offices in Ann Arbor is the Henry Ford Museum of American Innovation. There, visitors can ride in a car that was built more than a century ago and is maintained by the regular replacement of parts. "We're getting to a point where we can do that" to ourselves, says Clausnitzer. "We're at the beginning of something."