Alice Lloyd George
Deciding if, when, with whom, and under what circumstances to have children is one of the most important decisions many of us face. For women in particular, the factors impacting this decision have changed dramatically. Gender equality has seen enormous strides over the last century — including women’s right to vote, own property, pursue education, careers, and make choices about their reproductive lives. With this newfound freedom, it turns out women across the globe are choosing to delay motherhood, and the shift has been rapid. As recently as 1970, the mean age of first birth was 21 years old. Now, for the first time, the birth rate for women in their 30s is higher than for women in their 20s.
Many things have changed, but one thing has not — biology. One of the last great battles is against time. Once a woman is in her late thirties about half of her eggs have abnormal chromosomes. For couples where the woman is over 35, a third have trouble conceiving. For women over 42, over half of pregnancies result in miscarriage. Yet many women aren’t aware of these statistics until it is too late. On top of that, the medical system is reactive and focuses on infertility, not fertility. Only once you’ve spent 6–12 months trying to get pregnant are you typically encouraged to seek care. Most women say they would have made different choices if they had known about the risks earlier.
Unsurprisingly, these trends are pushing up demand for both egg freezing and IVF, which have been growing at a 35% and 10% CAGR respectively. IVF has an expected TAM of $22 billion by 2024. This is in part because these technologies are now proven, standardized, and the playing field has leveled. It’s been forty years since the world’s first ‘test-tube baby’ Louise Brown was born. Since then there have been over 8 million births globally due to IVF and related treatments. Its been 33 years since the first birth from a frozen egg in 1986. In 2012 oocyte cryopreservation was deemed no longer experimental. 500 US women froze their eggs in 2009. That number shot up to over 10,000 in 2017. Studies show that there is now no significant difference between the success rates of fresh and frozen eggs. On a personal note, I have siblings that were cryopreserved for up to 10 years then born via IVF — and can attest to the efficacy of these techniques and the joy they have brought our family.
Despite these developments, access to reproductive technologies remains limited. The existing system is ill-equipped to respond to demand and provide an adequate experience for a few reasons:
Women’s healthcare is fragmented. If you take a hormone or AMH fertility assessment with an at-home kit, the picture is incomplete — you still need to do ultrasounds and get a follicle count. If you go to your OB/GYN for an assessment, they may well refer you to a fertility specialist. If you get pregnant through a fertility clinic, you must go back to your OB/GYN to care for your pregnancy. If you miscarry, you’re back to the fertility clinic. They may refer you to a therapist, nutritionist, or acupuncturist for anxiety. Patients find themselves scurrying between office visits, often navigating this mess of a system alone. There’s no roadmap and no single guide overseeing the process from start to finish.
Opaque decision-making. When it comes to egg freezing, data is often withheld from patients, misleading, or given to them without context. Decisions are driven by anecdotal suggestions. Women report feeling under-informed by clinics and that there’s a lack of discussion with their doctors about expected outcomes. There’s not a clear understanding of the tradeoffs between age and cost of options.
Prohibitively expensive. Despite the fact that egg-freezing and IVF have commoditized, there are no incentives for legacy clinics to reduce price. In New York the average freezing cycle costs $18k, yet the cost to the clinic at scale is ~$3k.
Quality of experience. The system is dominated by white, male, often celebrity doctors. But 80% of women say they would prefer a female doctor. And also someone who they can relate to. Freezing your eggs is an emotional process, and the current system can be paternalistic and unsupportive.
Enter Kindbody. The company is built around a core premise — if you want to create a better customer experience, improve outcomes, and lower costs, you have to be in the provision of care.
Continuity of care. Kindbody offers a full-stack, vertically integrated clinic with a patient-centric approach that brings all services under one roof — from fertility to gynecology, mental health, nutrition, and wellness. They are opening brick and mortar clinics in prime urban locations, in tandem with a mobile clinic that brings the conversation to the public. The team thinks holistically about a patient’s needs throughout their journey, not just when they are trying to conceive. As they expand into the self-insured employer market this year, this continuity allows employers to save costs and purchase benefits directly from a single provider rather than selecting from a maze of middlemen and separate solutions.
Transparency. Kindbody’s patient portal demystifies the process by consolidating and visualizing all diagnostic results in one place. Using the latest research, their fertility calculator helps patients understand that egg freezing is no guarantee of future success, and that a blend of factors drive outcomes — from age to ovarian reserve. The portal also allows for easy messaging, cycle tracking, and appointment scheduling.
Price. Kindbody is bringing down costs (more on how) starting with egg freezing, which they are offering at $5000 for the first cycle (vs the $18k NYC average) and can be supported via payment plans. Pricing is also clear and upfront— no more surprise add-on charges for things like medications and bloodwork.
Education & Empathy. No one should tell women whether to freeze their eggs — it’s an inherently personal decision. But knowledge is power. And providing test results alone is not enough. Kindbody’s providers are trained to have open, compassionate conversations and help patients contextualize their data. By equipping women with information and context they can assess risks and make a choice that’s right for them. The company is also focused on hiring female and diverse OB/GYNs and REIs. It is a company built by women, for women. Management is also committed to democratizing access to care and helping patients that are underserved or alienated — including LGBTQ and same sex couples, single mothers, and the african american population, which has doubly high rates of infertility.
Community. Taboo topics like egg freezing, infertility and miscarriage have remained behind the closed doors of doctor’s offices for too long. Women don’t realize how common their struggles are, and navigating a labyrinth of unverified and impersonal Google results is unhelpful. They report feeling like they’ve failed and that having a baby naturally is the only “right” way. Kindbody hosts open, informal 101 sessions where women gather to ask questions about their bodies in a non-sterile setting. These sessions are oversubscribed in minutes.
Clearly there’s a huge gap in both knowledge and the provision of care, and Kindbody is tackling a large and global problem. From RRE’s perspective there were a few key reasons why we were excited to invest in this company in particular:
We are bullish about companies building strong brands in consumer health — as reflected by our investments in Noom, Groups, Maude, and OneDrop. Fertility is a category that is especially high in emotion and spend, and there’s an opportunity to build a national brand that families trust. Kindbody is built by women who get it, and this is reflected in their brand, which is already resonating.
The potential for data network effects in women’s health is powerful, and vertical integration helps Kindbody achieve this. With each new patient that cycles, the company adds data and improves its predictive algorithms. When egg freezing patients eventually return for IVF services, that data will be continuous and connect to outcomes. Their proprietary EMR and tech stack allows for true research grade outcomes data.
Team: When we met Kindbody’s founders it was clear that their depth of experience makes them uniquely suited to solve this problem. Gina Bartasi is a four-time CEO with over 20 years in the industry, previously at the helm of Fertility Authority and eventually Progyny, the leading fertility benefit solution for many of the Fortune 100. Cofounder Joanne Schneider hails from Flatiron Health and Google, Founding Physician Dr. Fahimeh Sasan from 12 years at Mount Sinai, Chief Medical Officer Dr. Lynn Westphal from 23 years at Stanford University School of Medicine, and advisor Jacques Cohen is one of the world’s leading embryologists. The rest of the team includes execs from Quartet, Oscar, One Medical, and Equinox.
Women’s reproductive choices has long been a fraught topic and startups in the space will inevitably receive flak. Our rationale is simple — we trust women. We trust them to make their own decisions. We believe that providing them with information and options is the best way to do this. It is empowering to know about your body, and to plan for your future, on your own timeline in your own way.
We are thrilled to be leading the Series A in Kindbody and welcome Gina, Joanne and the whole team to the RRE family.