Breathing new life into the fertility market: how digital health is reinventing the path to parenthood
The path to parenthood often comes with unexpected and emotional challenges. One of the most common today is infertility, which affects one in eight women. When constant ovulation monitoring and major diet and lifestyle changes are insufficient, navigating opaque and expensive fertility treatments is often the last available option.
The course of fertility treatment is long and burdened with high costs, disparities in access, and physical and emotional demands. On average, women have to go through three to four failed intrauterine insemination (IUI) cycles and six cycles of In Vitro Fertilization (IVF) before successfully conceiving. As author and fertility expert Leslie schrock Quickly point out, most men don’t realize that they are responsible for half of all fertility problems. Conditions such as DNA fragmentation in semen are a cause of recurrent miscarriage, but the test is not yet part of the standard semen analysis. As a result, women are always treated before their male partners are evaluated. Already significant barriers to treatment intensified dramatically during the pandemic. Fertility clinics across the country abruptly closed their doors, disrupting or prematurely canceling about 100,000 IVF cycles in the first few months alone. But the rapid and sustained increase in treatment use since signals future challenges for an already limited capacity system.
The road strewn with obstacles to parenthood
Most Americans cannot access IUI or IVF treatment in the first place. About 62% of women with suspected fertility problems do not ask for a fertility test or advice and an even larger proportion choose not to receive treatment. Men are rarely tested together with their female partners, if at all, which means their issues are often overlooked. High personal expenses with uncertain outcomes, inadequate services for underserved communities and a lack of consideration for the mental toll of infertility exacerbates an already long and isolating journey.
The high price of fertility
Today it costs almost $ 60,000 to conceive a child through IVF and 75% of private insurance policies do not adequately cover fertility services. With only 19 states making fertility coverage compulsory, no national mandate outlined in the ACA, and an increase in enrollment in high-deductible health plans, Americans with infertility must shoulder the heavy financial burden on their own and choose to do so by whatever means necessary. More than half of all IVF applicants use credit cards, nearly 25% take personal loans and 14% make withdrawals from their 401 (k) pay for treatment.
Provider bias and disparate geographic distribution of fertility clinics are additional barriers to fertility care. Until February 2021, paid surrogacy was illegal for individuals in New York State, making it nearly impossible for LGBTQ + couples and heterosexual couples unable to carry a full term child to become parents. There is also an estimate 18 million women of childbearing age who live in geographic areas without assisted reproduction technology (ART) clinics. While some elements of the fertility journey are immutable, such as the impact of age or genetic factors, societal and systemic barriers should not be.
Lack of holistic care offerings
The start of an individual’s fertility journey, filled with invasive and expensive diagnostic tests and procedures, is often described as emotionally overwhelming. As struggling patients navigate treatment options and undergo procedures, roadblocks can have a devastating impact on their mental health, so much so that half of women and 15% of men consider infertility to be the most life-changing experience of their lives. This stress, anxiety and depression can have deleterious effects. effects on adherence and effectiveness of treatment.
Where do we go next?
From virtual care to remote patient monitoring, digital fertility solutions that meet patients where they are can achieve what the traditional healthcare system has failed to accomplish on a large scale: empowering women and men. men empowered to make informed decisions about their own reproductive health journey. The challenges will continue to exist for anyone undergoing fertility treatment. But I am optimistic that digital health solutions will reinvent the path to parenthood by increasing access and affordability of testing and treatment services, improving care delivery through comprehensive clinical models, and improving the consumer experience through practical and personalized modalities.
Managing mental health alongside fertility
A key feature of successful digital fertility solutions, especially those that provide virtual or in-person care, will be the integration of mental health interventions into their clinical model. Psychological interventions have been shown to reduce stress and anxiety in patients fight infertility, ultimately improving pregnancy outcomes.
From managing the side effects of infertility treatments to resolving the stresses associated with infertility, digital health solutions can alleviate stressors encountered along the difficult journey to parenthood. Maven’s The holistic care model is a prime example of how mental health can be successfully positioned at the heart of fertility services. The company offers users on-demand virtual appointments with licensed mental health providers, 1: 1 emotional support from Care Advocates, a supportive community of new and potential parents, mental health screenings and access to relevant organized content. Internal construction of mental health services through fertility solutions will likely continue, as well as targeted mergers and acquisitions of fertility solutions through broader sexual health and wellness solutions with existing mental health capabilities, such as than The recent acquisition of Modern Fertility by Ro.
Go beyond treatment to personalized, data-driven care
Digital fertility solutions will provide highly organized data on the physiological changes that men and women undergo during infertility treatment. Personalized engagement that supports self-management and on-demand access to fertility specialists for higher acuity needs will encourage consumers to stay engaged even during daunting times. Coupled with this guidance, remote monitoring devices and digital companions provide patients with highly personalized ways to navigate their fertility journey and much-needed support for complex treatment protocols. Rescript (formerly Best Shot and The Fertility Tribe) serves as a true digital companion through its medication management platform, dispensing service, community forum, and small fertility-focused counseling groups.
Likewise, health coaching and remote ovulation and hormone monitoring increase the chances of positive treatment results. Data captured through increased remote monitoring devices and adherence platforms can create a repository of robust clinical information to improve diagnostics and the development of treatment options. These clinical data will be the foundation of predictive capabilities to understand hormonal levels, optimal times for egg retrieval, and physiological changes associated with positive egg implantation results. Eli, for example, offers a home device that monitors invaluable clinical data on hormone levels, enabling women to optimize infertility outcomes and non-hormonal contraceptive methods. Ultimately, companies like OathCare use the power of collective knowledge to provide a full supportive community for parents while bringing together medical providers, like-minded peers and a trusted facilitator in an intimate group setting.
The potential in this area is truly limitless, and with the incentives aligned from individuals, clinicians, and researchers, better treatment outcomes are very likely.
Employers mobilize to shoulder the cost burden
As the demand for fertility treatments continues to rise, I hope employers will step up, especially those trying to attract and retain top talent while providing cost-effective care options. In 2020, coverage for IVF and cryopreservation among employers with 20,000 or more employers was 42% and 19%, respectively, signifying an obvious barrier to reproductive services.
In the long run, as state-mandated fertility coverage becomes more ubiquitous, employers will increasingly partner with low-cost digital fertility treatments that also optimize outcomes, such as Kindness. Kindbody partners with employers to provide care through the company’s End-to-End Fertility Program, which begins with an initial consultation and follows patients through IVF and preconception care. Other solutions focus on streamlining the testing and diagnostic processes, ranging from days to minutes. For example, Pera Laboratories uses AI and microfluidic chip sorting to quickly analyze and identify the best candidate reproductive cells for IVF treatments, streamlining the fertility assessment process, reducing the need for multiple expensive treatments, and increasing the success rates of treatments. A life tackles the inequalities that plague the industry by creating the world’s largest and most diverse dataset and using it to reduce cycle times and costs while improving bottom lines.
Despite significant progress in the therapeutic development of fertility, the consumer’s journey is strewn with pitfalls. There is still a lack of awareness and education about treatment options accompanied by unaffordable tests and procedures, which leaves infertile individuals and couples in a bleak position. However, digital solutions will improve the fertility treatment experience and accelerate the development of consumers who are better equipped to make decisions about their fertility options. Through thoughtful, consumer-centric design and application, these innovative solutions have the potential to ease the path to parenthood for countless couples and individuals across the globe.
Photo: Natali_Mis, Getty Images