Inside the Fertility Tech Gold Rush

On May 26, 2022, Randy Morris, a reproductive endocrinologist in Naperville, Illinois, posted a video to YouTube issuing a cutting rebuke of a company called Proov. The startup makes at-home fertility test kits and supplements, plus an app for people to monitor their journeys toward parenthood. 

Morris took aim at one of Proov’s marquee products, a urine test kit to measure a chemical called PdG that was cleared by the FDA in 2020. With enough PdG in the urine, the company claims, it’s likely a woman will test positive for ovulation — the fertile window when an egg is released by an ovary during a woman’s reproductive cycle. The trouble is, it’s a misleading portrayal of the science, Morris says. 

“There have never been any [credible] clinical studies which prove that measurement of urinary PdG helps identify people who are more or less likely to become pregnant,” Morris says in the video, which has been viewed more than 14,000 times. On its website, Proov links to two clinical studies that showcase how the detection of urinary PdG can confirm ovulation. But Morris’s video suggests the company is ignoring a critical fact: That women who ovulate still might not be able to conceive, due to any number of other fertility issues. So the tests are most valuable for people who have already eliminated all other possible reasons for not conceiving. 

Proov is only part of a burgeoning marketplace. Morris, a practicing reproductive doctor for more than 30 years, has created around 400 videos, some of which discuss a number of products attempting to innovate and technologically advance the field of human fertility. Many products on the market are designed to gauge or increase a woman’s chances of getting pregnant, from biometric finger rings to at-home ultrasound devices, plus a dizzying number of fertility supplements and prenatal vitamins. 

It’s an industry that’s certifiably booming, spurred on by concerns about population decline and the emergence of employee benefits packages that cover in vitro fertilization (IVF), the process of fertilizing a woman’s eggs in a lab. Around 40 percent of U.S. adults say they’ve used fertility treatments, according to 2023 research from Pew. The overall U.S. fertility market, currently valued at $5.34 billion, is expected to climb to $8.69 billion by 2033, according to Precedence Research. 

Venture capitalists see ripe opportunity in the space. In 2022, businesses building fertility-related products and technologies raised $854 million from VCs, according to Pitchbook data shared with Inc. Even as AI continues to surge, health care companies have maintained a grip on VCs’ attention: Health tech welcomed the most funding of any category in Q1, with $15.7 billion flowing to U.S. companies. Health care and biotech companies are leading Series A investments in 2024. 

The industry’s potential merits an investment in its technological progress, say VCs. With respect to IVF in particular, innovation has been lacking, explains Deena Shakir, a general partner at Lux Capital. “It’s this absolutely groundbreaking technology — the actual process of IVF — and yet, if you go through it, you’ll see not much has changed since its invention.”

As it’s grown, the industry has sparked very real concerns for would-be parents. Regulatory oversight is either sparse or, in the case of supplements, nonexistent. Some medical experts worry that consumers may be encouraged to forego the oversight of a physician in favor of unproven technology or spurious DIY treatments. Those concerns are amplified when couples are willing to spend big to start a family. “For couples experiencing infertility, the pain point is so incredibly great that the willingness to pay is correspondingly extremely high,” says Elizabeth Ruzzo, a geneticist and the founder of Adyn, the maker of an at-home diagnostic test for women to determine their best birth control option. 

“It’s hard for an individual, even with a scientific or medical background, to navigate what’s really been robustly validated versus not, or even just how to interpret what the use cases are,” Ruzzo argues.  

Behind the Surge

Amy Beckley, the founder and CEO of Boulder, Colorado-based Proov, understands the struggles of infertility. The entrepreneur, who holds a PhD in pharmacology, founded the company in 2016 after experiencing seven miscarriages. The company, which has more than $10 million in venture investment, has four medical advisers, all of whom are certified reproductive endocrinologists. The company has sold more than 320,000 test kits across its slate of products. It also has more than 100,000 accounts registered and 10,000 active users, a spokesperson said.

Beckley argues that there is a lack of easily accessible resources for women struggling with infertility issues, and the medical industry’s usual recourse is to recommend costly IVF treatment. “Women are thrown out there with no education,” she says.

Many investors and founders say they want to bring the cost of care down and provide consumers with the ability to avoid the often-byzantine health care system. Shakir is especially focused on lowering the cost for IVF, which can range anywhere from $15,000 to $30,000. “If we eliminated the cost factor, how many families would actually be seeking it?” she says. 

Proov says it strives to give consumers a sense of agency, as mistrust of the medical industry grows. A survey conducted last year by Harris Poll found that 75 percent of Americans believe the medical field is failing to meet their individual needs. The cost of care is also burdensome for many: An April survey by KFF (formerly the Kaiser Family Foundation) found that a quarter of Americans delay seeking care due to the expense. In February, KFF estimated the total sum of medical debt in the U.S. to be $220 billion.