Fertility tech isn’t being adopted fast enough
A lag in the adoption of technology is inhibiting access to fertility and infertility solutions.
Greater technology uptake, better data analytics, and more tech investment stands to drastically improve Assisted Reproductive Technology (ART) across the wider fertility journey.
Despite significant advances in many areas of reproductive medicine and embryology, we’re now seeing the success rates stabilise¹ for some of the most common procedures, such as In-Vitro Fertilisation (IVF), with wide variation across countries and clinics.
The growing demand for more effective and affordable solutions, alongside expectations of a high quality patient experience, have increased the need for innovative technological solutions, some of which are being developed by startups. While it’s ultimately biology that sets the rules, and constrains the ability of technology to solve problems, emergent tools, techniques and data analytics present new opportunities for success.
IVF birth rates have significantly improved but appear to be stabilising – how do we keep improving success rates?
Explore the key issues below
Slow adoption of technology
The fertility sector has not yet fully embraced deep tech advances in robotics, automation, data science and omics technology.
Within IVF, for example, embryology labs have benefited from the increasing understanding of reproductive biology but less so on the engineering, automation and data science fronts. During IVF treatment, embryologists, technicians and nurses rely largely on manual workflows and their own personal assessments, which alone cannot sustain the repeatable, systematic, and reliable workflows needed to meet ART demand.
Although decision-support tools, such as AI-led analyses of embryos or sperm could reduce the time and cost of treatments, further evidence (and funding) of prospective trials is needed to drive technology uptake at scale². Much of the analyses of these cells are morphological, which unveils just a fraction of the biological processes in reproduction. Although pre-implantation genetic testing has been on the rise, the use of wider omics is still in its infancy. Investment should focus on the most pressing research needs to fuel innovation in the sector, in turn improving success rates and access to care³.
The data gap
The fertility space has struggled to assemble, structure and make sense of the vast array of data available across patients, clinicians and research bodies.
Currently data sits in silos across universities, hospitals, GP surgeries and fertility clinics. This is not uncommon in healthcare, but used properly by reproductive endocrinologists, gynaecologists, embryologists and research bodies, the data – which includes blood tests, ultrasounds, partner information, demographics and past diagnostics – could produce personalised and predictive insights across ART, from more precise ovarian stimulation protocols to improved embryo transfer decisions. This data void also limits the progress in discovering and leveraging new biomarkers to further advance clinical research and the development of better fertility treatment drugs.
Investment remains patchy
Venture capital investment into fertility startups is rising fast, but it is still behind other sectors within healthcare. Between 2016 and 2021 (H1) venture capital investment into fertility-related startups totalled $2.6 billion, while investment into telemedicine over the same time period was $7.3 billion⁴.
Of the capital invested, much has been concentrated on hotspots such as fertility tracking, egg-freezing and IVF improvements. Investment in pre-clinical and at-home diagnostics earlier on in the fertility journey is lagging behind. This leads to late clinical interventions in an individual’s or couple’s fertility journey, which can result in higher out-of-pocket costs and a reduction in the success rate of treatments.
As demand for ART surges and infertility becomes front of mind as a challenge for Millennials and Gen Z, we expect to see more investment channeled into key infertility drivers such as male infertility, tubal disorders, and endometriosis, to ensure adequate preventative measures are taken before embarking on invasive and (currently) expensive procedures.
“The fertility market has been defined by a relative inattention to engineering and process development compared to the advances in the science itself.”
Dr David Sable, manager of the Special Situations Life Sciences Fund and former IVF specialist
Innovative startups are already engaging with many of these challenges
Technological advancements, leveraging data at scale, and making care readily accessible at home are all helping to bolster treatment success rates. Explore some of the potential solutions below.
Technological advancements boost efficiency and accuracy
Advances in omics technology, robotics, microfluidics, and machine learning are increasing the efficiency and accuracy of ART procedures.
Each step of the IVF process, from embryo and sperm analysis to fertilisation, is seeing major innovations. Overture Life, for example, is developing metabolomics technology to replace the need for invasive biopsies to assess an embryo’s completeness and implantation potential.
Better data improves the patient experience and the precision of treatments
Data consolidation and analysis has made headway to unveil biomarkers, classify patients more accurately and improve success rates. Companies like eIVF create specific electronic medical records and analytics tools for fertility clinics, leveraging patient biometrics, medical history and partner data to inform treatment and fuel research initiatives.
Other pioneering startups such as Inanna Fertility are tackling the data challenge by creating some of the widest patient data repositories from clinics and research bodies, in turn developing predictive biomarkers.
Access to care at home enables earlier intervention
Better products pave the way for better education, fertility planning and earlier intervention. Impli is creating an implantable, minimally invasive device to measure hormonal levels, replacing the need for repetitive doctor visits.
Selectivity and Bea Fertility are developing at-home devices such as biomimetic microfluidics to improve sperm selection, and cannulas that reach the cervix safely to aid in conception. Positive user feedback and clinical data gathered from these products should help allay the historical fears in investing into medtech.
What’s next for technology innovation?
In-vitro gametogenesis: making egg cells from stem cells
Some people don’t produce eggs or sperm because of cancer treatment, genetics or other unexplained causes. For them, current fertility treatments are only possible with donor eggs and/or sperm cells. Research focusing on how human stem cells evolve into germ cells, the precursors to sperm and eggs cells, could allow infertile individuals and same-sex couples to have genetically related children⁵.
Exogenic wombs or artificial gestation
The ability to grow a baby outside of the womb could provide women who have either lost, or were born without a uterus, with the chance of having a child. Single men and gay male couples could also become parents without a surrogate. The societal repercussions – as with most advances in fertility tech – are significant and the ethical discussion, for investors as well as innovators, therefore runs alongside the technological advances.
Genetic engineering for disease prevention in embryology
Genetic engineering could prevent certain genetic diseases. Dr Kathy Niakan’s team at the Francis Crick Institute was the first to receive permission from the Human Fertilisation and Embryology Authority (HFEA) to use the CRISPR-Cas9 gene editing technique on human embryos, allowing them to understand the characteristics of successful embryos. The ethical and regulatory concerns are many, but these tools represent a leap forward in genetic illness treatment. This could start with preventing monogenic disease from the first cell onwards⁶.
Companies to watch
Overture Life
Overture Life is automating the IVF process, developing medical devices and novel embryo testing methodologies, that will facilitate automation, lower costs and increase throughput for IVF practitioners.
Inanna Fertility
Inanna Fertility has created a clinical decision assistance platform, providing insights for tailored treatment recommendations by leveraging machine learning and a worldwide patient database.
Impli
Impli has developed an implantable, minimally invasive device to measure hormone levels in real-time. The device replaces the need for frequent blood tests and improves the personalisation of ovarian stimulation protocols, amongst other parts of the IVF process.
Bea Fertility
Bea Fertility is creating a new step in the fertility pathway to promote earlier intervention through an at-home intracervical insemination (ICI) to aid with conception for individuals and couples.
TMRW
TMRW has created the world’s first and only automated platform for the safe management and care of the frozen eggs and embryos used in IVF, setting new standards for transparency and safety.
ImVitro
ImVitro is using deep learning to detect hidden patterns and predict probabilities of implantation of embryos.
CytoSwim
CytoSwim is developing the next generation of sperm conditioning tools using a proprietary microstructure which gently selects the healthiest sperm cells from a sample.
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
1. European Society of Human Reproduction and Embryology, 2019.
2. Aparicio-Ruiz B et al. Selection of preimplantation embryos using time-lapse microscopy in in vitro fertilization: State of the technology and future directions. Birth Defects Res, 2018.
4. Pitchbook data – Global VC investment into fertility related startups between 2016 and 2021 (H1).
5. Chen D et al. Human Primordial Germ Cells Are Specified from Lineage-Primed Progenitors, 2019.