Fertility’s access problem

Fertility treatments are expensive and difficult to access. Confusing guidelines and a lack of financial support also prevent patients from receiving fertility treatments.

The desire to start a family is a powerful biological imperative, but not everyone is given the same chance.

A single cycle of IVF treatment can cost £5-10,000 in the UK or $20-60,000 in the US, with no guarantee of a successful outcome.

Access to state-funded IVF varies wildly, depending where you are in the UK. In England, decisions about who can have NHS-funded IVF are made locally by Clinical Commissioning Groups (CCGs). The provision of IVF treatment varies from zero to three funded IVF cycles, depending on location and different eligibility criteria, often based on age. While NHS Scotland funded 62% of cycles in 2019, this figure fell to 20% in some parts of England¹.

Fertility treatments are also typically not covered by private medical insurance, which results in high and unpredictable out-of-pocket expenses for the one in seven couples who have difficulty conceiving ².

One cycle of IVF can cost £5-10k in the UK or $20-60k in the US. With success rates around 30%, couples can pay $60-180k across three cycles, with no guarantee of success.

Explore the key issues below

Treatments are unaffordable, funding is limited and clinical guidelines are not enforced

According to the UK’s National Institute for Clinical Excellence (NICE) guideline “IVF should be offered to women under the age of 43 who have been trying to get pregnant through regular unprotected sex for two years” . This two year wait is regardless of age and ignores the fact that the likelihood of live birth rates decreases from 29% for those aged under 35 years old, to 3% for women aged 43 to 44 . Even then, NICE’s guidelines are ultimately just guidelines and the CCGs within the NHS are not required to act on them. This means there is relatively limited public funding available.

“Menopause, fertility, pregnancy and parenthood are natural life journeys that can quickly become workplace issues. Organisations need to provide support to their people through these periods in life when their health is most vulnerable.”

Dr Mridula Pore, CEO and Co-Founder, Peppy

Pioneering solutions to accessibility and pricing barriers are being developed

Startups are tackling the infertility challenge by developing novel pricing models, launching digital platforms and adopting new distribution channels.

Outcome-based fertility financing

Companies such as US-based Future Family and UK-based Gaia are tackling the affordability challenge in a novel way by providing outcome-based pricing for Assisted Reproductive Technology (ART).

These startups are essentially replacing the role of insurers by providing smart risk pricing for treatments such as IVF. The ultimate cost of IVF does not change for users, but unsuccessful patients pay less, and successful patients pay a little more.

Future Innovation

The rise of employers as a go-to-market strategy

The pandemic has further accelerated this trend, having underlined the crucial role of employers in supporting employee wellbeing. This is a significant shift, and in the short term represents the most effective lever to improve patient outcomes by dramatically increasing access to treatment. For fertility startups, treatment as part of an employee benefit package also represents a sizeable new distribution channel.

The need for inclusive employer support

More employers are offering fertility support as a benefit, but it is still rare and remains focused on IVF and egg-freezing. While some communities, including many in the LGBTQIA+ community, have fallen back on adoption, financial support for this is limited. More inclusive employer/employee fertility support will not just present a further opportunity for innovation, but also expand the reach of ART, making it more accessible to a wider cross-section of society.

Companies to watch

Get in touch with our Health team to find out more

Octopus Ventures is the most active health investor in the UK, investing across all stages but with a bias towards the earliest stages (Seed and Series A). We are committed to backing pioneers who are transforming the health industry from digital therapeutics through to biotechnology.

Navigate the rest of the report

Introduction – Future of Fertility
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Chapter 1 – Fertility Tech
Click here
Chapter 3 – Tackling the taboo
Click here