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The baby-making business gets a growth spurt

January 22, 2020, 7:24 PM UTC

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The fertility industry is experiencing a Gold Rush-level expansion at the moment, a phenomenon which has been expertly chronicled by my colleague Beth Kowitt in her most recent feature, “Fertility Inc.: Inside the big business of babymaking.”

Her story also begins with the best opening sentence I’ve read in a business publication in a very long time: “Sperm and eggs have invaded the Pennsylvania Convention Center.”

The fertility business is having a very big moment.

The first IVF-enabled baby was born in 1978, a harbinger of medical miracles that took some time to gain mainstream traction. That’s about to change.

“In the decades since, the sector has gone from living outside the traditional health care system, viewed almost as a luxury good, to a serious industry garnering serious money,” writes Kowitt. “Piper Sandler research puts the U.S. fertility market at $15.4 billion by 2023, up from almost $7 billion in 2017.”

For people who are wealthy enough to afford the now growing array of services—the tests, the fertility monitors, the egg-freezing and medical procedures—this big moment has an even bigger meaning.

“Some people really care about having genetic children, which makes it a huge source of suffering—and a huge market,” Stanford Law School professor Hank Greely told her.

Writing in Fortune’s Broadsheet newsletter, Kowitt explains the “why now”:

“Fertility treatment historically sat outside traditional health care, essentially considered elective and a luxury. But today, even as access remains a huge issue, several big demographic trends are starting to move the industry into the mainstream. Millennials are aging into fertility treatment, women are having children later in life, the LGBTQ+ population is increasingly turning to assisted-reproductive technology to build their families, and infertility is losing its status as a taboo topic.”

But it’s complicated. For one thing, most humans don’t know much about how reproductive age bodies actually work and even less about fertility. It means that part of the job of specialists, investors, and entrepreneurs is to take prospective customers—people who want to be pregnant and their partners —through the basics of it all.

To that end, expect lots more sperm and egg invasions in convention centers, in medical offices, investment portfolios and mutual funds, corporate benefit packages, and most immediately, in startup decks.

While reading this essential piece, I couldn’t help but wonder about the opportunity costs it implied, the intersection with an emotional marketplace driven fraught with suffering, and a medical and investment world still largely dominated by white people, mostly men.

“One thing I didn’t get into that I thought about a lot is how a lot of these startups fall into ‘femtech,’Kowitt tells me, “again, suggesting that infertility and reproduction is a female problem.”

Or, more specifically, a white female problem. As Kowitt writes, some founders are concerned that the newfound focus on fertility and pregnancy will divert what little attention the rest of the women’s health field has struggled to garner— issues including the maternal mortality rates of Black women, which are truly dire and mostly ignored.

It’s also worth considering how this new Gold Rush may perpetuate some of the very same gender inequities that currently exist. “Some people I talked to really think that it does a disservice to the entire field—relegating it to a ‘woman’s problem,’” says Kowitt. “Reproductive health is really everybody’s business.”

Ellen McGirt

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“You can’t educate your way out of this problem. You can’t health-care-access your way out of this problem. There’s something inherently wrong with the system that’s not valuing the lives of black women equally to white women.”

Dr. Raegan McDonald-Mosley, a board-certified obstetrician-gynecologist and chief medical director for Planned Parenthood Federation of America

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