Fertility doctors are in the business of helping people to grow their families. But between the high cost of treatments, availability of donor eggs and sperm that are not Caucasian and lack of coverage for gay, single and alternative individuals and couples, is everyone being helped equally? ELANZA Wellness's Brittany Hawkins talks to Gabriel Bogner, co-founder of MATE Fertility, which seeks to bring some balance to the fertility business.
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Brittany Hawkins
Hi, everyone, thanks for joining us. I am Brittany Hawkins, the co founder of ELANZA Wellness. And today I'm joined by Gabe Bogner, the co founder of MATE fertility. Thanks so much for joining us today, Gabe.
Gabriel Bogner
Yeah, of course. Thank you so much for having me. I'm excited to chat with you.
Brittany Hawkins
Yeah, thank you. I think it'd be really great if you don't mind just starting off telling us a little bit about MATE and what your your mission is.
Gabriel Bogner
Yeah, absolutely. So MATE Fertility is really kind of a new age fertility clinic with a focus on creating accessible and affordable fertility clinics. So our mission is really to create a simpler way to go from I want a baby to I'm a parent, there's a lot of things involved in that statement, including being clearly technology enabled, really creating the best patient experience possible, building a brand that people really love and trust, using the best science to create embryos and life, and then opening our clinics in traditionally underserved areas and making sure that we can provide accessible and affordable care for people.
Brittany Hawkins
Fantastic. I'm really excited about what you guys are doing. And one of the things I noticed is that you're not actually a doctor. So I just have to know, how do you start a chain of clinics?
Gabriel Bogner
Yeah, great question. I am not a doctor, which I actually think is really useful when you're going into the medical space because you're kind of outside of the realm of the actual patient. So you can really focus on the business side, the brand side and, and a lot of what patients care about. And sometimes doctors can forget that and can just focus on the clinical and not so much the patient experience and the business side of things. But starting this was really full circle for me. So I'm actually an IVF baby myself. So I've been kind of intrinsically tied to the space my entire life. And I've always wanted to go into the healthcare space. I actually got pretty sick when I was younger and ended up having my large intestine removed part of my small intestine spent almost a year in the hospital, and have not the best patient experience in terms of like being switched around from doctors, there was a lot of bills that I didn't know where they were coming from. I felt like I was always hearing a different message. And I always knew I wanted to go into business and I wanted to go to you know, create a better experience for patients because I didn't have the best one. And I'm also gay. So being part of the LGBTQ community, fertility services, fertility access is really limited for the queer community. And I co founded this with my brother and him and his fiance, she discovered that she was a carrier for the BRCA1 gene. So just means that she has much higher likelihood of developing breast cancer. So they went through the process of genetic screening out their embryos. And just over the past couple years, my brother and I have really kind of done a deep dive into the space and figured out it's really broken and there's a lot of areas open and kind of ripe for improvement and we're really trying to solve the root of the problem here.
Brittany Hawkins
Yeah, you talk a lot about democratising fertility. So I'm kind of curious, what does that mean for you and MATE?
Gabriel Bogner
Yeah, I think democratising fertility really just means like bringing down some of those barriers to access, I think there's two big ones that come to mind. The first is like education. So education on fertility services, and Fertility Care, especially for the queer community is lacking. People do not know how they can go about having babies, or they'll read an article about a very wealthy gay couple that had kids. And oftentimes, they want to have kids and they don't know where to even begin. And especially when it comes to things like egg freezing, there's a big conception or idea that a lot of people go to freeze their eggs when they're at the pinnacle of their careers. And oftentimes, it can be too late if you're in your late 30s, early 40s. And so we're, we need to change that narrative in that education to make egg freezing more accessible and more affordable, and educate people that you know, you should be doing this at the beginning of your career, not necessarily the pinnacle of your career. So you can preserve your fertility, your fertility, you can preserve your reproductive future and you can really control you know, when you want to have kids on your own timeline.
So I think that's the I guess one or the first one is just really educating people about IVF fertility services, how this is really common. There's a stigma that exists around talking about infertility. And it is really common, like one in eight couples have some type of infertility and about 20%, including the LGBTQ population needs some type of assistance with Fertility Care, it's actually more common than diabetes. But people are just not talking about it. So increasing access to education. And then the second one is access and affordability.
So oftentimes 80% of these clinics are located in like top 10 markets, LA, New York, San Francisco, and people in the rest of the US still need access to care, but they just have to travel a really long way, or they have to pay for expensive hotels, and they have to go really far better monitoring appointments, so opening clinics in areas that previously didn't have access to care. And then I guess there was three points. The third one is like affordability. So making sure that fertility services are, if that if it can be covered by insurance, it is and then also just bringing down that initial price point.
So right now, the healthcare industry views fertility as an elective procedure, similar to like plastic surgery, and so nothing's really covered by insurance. And so one of the long term, you know, purpose of big entrepreneurs of our company is to get a lot of these services covered by insurance and bring down some of those barriers to access and really, democratise Fertility Care for for everyone. Amen. Fantastic.
Brittany Hawkins
And yeah, I love this idea of access. And, you know, you just consider it simple geography. Like a lot of the people in the US don't actually live near a fertility clinic, or actually even an OBGYN. So which, which areas are you seeing are the most underserved?
Gabriel Bogner
Yeah, so we kind of go through a very complicated process to figure out what the best areas are, to launch. Um, a few things are important to us is like population, millennial population growth on fertility clinics, per capita. So we basically measure out the amount of people in the US and count, they're the fertility clinics that are located within like a 20 mile radius of them. And that's the most important data point for us when mapping out like where in the US is traditionally underserved. And we're seeing that it's still in pretty big market. So for example, Oklahoma City, that which is where our first clinic is launching, the number of fertility clinics per person is one of the lowest in the world. There's like 1.6 million people in the metro area. And currently, right now, there's only two fertility clinics. Imagine they're just being like to general practitioners for 1.6 million people like that number is insane. And that's how we really determine what the best places in the US are to go. And where care is really needed right now.
Brittany Hawkins
Yeah. And so do you actually think that there are enough fertility clinics already in the US? I think that today, we have about 460, maybe closer to 500? Where do you feel like, you know, how many clinics should be in the population that size?
Gabriel Bogner
Well, we want to open 1000 clinics in the next 10 years. There's only 460 clinics right now in the US, and that number is raizy. Considering how many people are actually impacted and affected by infertility. The number is just staggering. We think that the US can probably have with a busy clinic, upwards of 3000 clinics in the US. We want to be a big portion of that and open 1000 clinics in the next 10 years.
So even when you look at big cities like LA, New York, San Francisco, they're still underserved. That's why people keep opening clinics there. Because the amount of people who are diagnosed with infertility or who need care, oftentimes, these places will still have months if not a year waiting list even get treatment. So all signs are kind of pointing towards. We need more clinics, we need to actually solve the root of the problem which is increasing, increasing the absolute number of clinics and increasing the supply. Because right now the supply is not meeting the demand that's in the us right now.
And unfortunately, because of that, that creates really unfair market economics where because demand far outweighs supply a lot of these legs clinics are just kind of getting into a price war and price gouging each other because people are willing to pay that increased price. And when there's no ceiling, and supply, demand economics are not kind of kept out, then people and legacy clinics can just keep increasing the prices and people will pay.
Brittany Hawkins
So interesting. So where do you see I mean, 1000 clinics. I love that. So where where are you going to go? What's your next, your next market? And where do you feel like are the most important markets of the future?
Gabriel Bogner
Yeah. So our next market that we want to open is probably Eldorado, Arkansas and Arkansas right now there's one fertility clinic in the entire state. So the fertility clinic that we want to open them, that would be the only one for 500 miles. We are really interested in Michigan, we're really interested in underserved areas in Los Angeles as well. So Downey is a place that we want to open a clinic, I'm really interested in Ohio. Places like North Dakota and South Dakota, Montana, we are going to put a clinic in Anchorage, Alaska in Hawaii. So pretty much everywhere that there are people in the US we're going to put a clinic. And I wouldn't say that, you know, one area is more important than the other because everywhere is underserved right now. And unfortunately, it creates interesting markets, when you look at places where there aren't a lot of clinics and places where there are a lot of clinics. So in LA prices are still really expensive, because other clinics will just start pricing out each other. But then when you get to places like Oklahoma, where there's only one to two clinics, they set the market price, so they'll just charge even higher than the average. So Nowhere is it really fair. And I wouldn't say that Nowhere is more important than anywhere else.
Brittany Hawkins
So what is the difference between a market where there's competition and then a market where, as you mentioned, there is no price competition? What is the the price difference you often see in those markets?
Gabriel Bogner
Well, it is crazy like because these old fashioned reproductive endocrinologists fertility doctors, have been kind of playing with the strings behind the scenes, you'll see such a wide range of prices. On average in the US for a cycle, it says probably around 15 to $18,000. We've seen clinics as high as $40,000. And you know, a lot of these clinics will claim that, oh, we have the best doctors, we have the best science when Fertility Care is very standardised nowadays. It's an egg retrieval, you get on stimulation medications, egg retrieval, you fertilise the embryo. And then there's an M. And then there's a transfer. When you actually look at the statistical differences between some of these clinics that are claiming to have insanely different success rates, there's not much variation, because a lot of these procedures are just very standardised out the science is incredible. So there's not much that can really go wrong, almost. And so clinics will make this very robust claim. And then they think that they can charge a lot of money, or they can charge double triple the US average. So in places like Michigan, the average cost of a cycle is upwards of $25,000. In LA, it's around $18,000. But then when you get into places like that, really hills, they'll charge upwards of $40,000 for a cycle. So it really, really depends. And there's just such a wide variation and variety. And that's why the system is honestly broken because there's no standardisation or prices across the US right now. It's just up and down.
Brittany Hawkins
What do you guys going to charge for your treatments? How is that going to improve the access point you mentioned?
Gabriel Bogner
Yeah, so we're coming in at about 40% more affordable than traditional clinics. So one cycle of IVF for us is $9,600. And to go through egg freezing presses $5,000. And, you know, at the end of the day, it's still not cheap. And the way to solve this is to get these services widely covered by insurance. But before that can happen, we're trying to bring down that price point. And if people still can't afford it, which a lot of people can't that's still a lot. It's still a lot of money to be able to kind of shell out. We do probably Partner with financing companies as well to work on getting loans. And you know, if you don't qualify for a loan, or financing partner allows you to cosign with a friend or family member to make sure that you know, you can get access to treatment.
We're also in the conversation like these initial conversations of creating monthly payment plans for people. So a lot of clinics and ours right now is like paying upfront or a cash pay. But a great solution would be almost like a cell phone bill or rent where it just becomes a monthly payment. Because getting that initial like $10,000 upfront is not feasible for a lot of people, but monthly payments kind of breaks it down. So that's something that we're also working on, as well as just grants. And you know, for people who really, really can't afford it, but you know, want to start families, just seeing ways that that we can help out as a company.
Brittany Hawkins
Yeah, there's a lot of talk around the insurance coverage that is currently offered or could be offered. Do you have any insight as to where you think that's going to, to go? Do you think that it's moving fast enough? Where do you think there are the most opportunities?
Gabriel Bogner
Yeah, well, I think anything in the government never moves fast. So getting, getting the government to make fertility, care covered with insurance companies is a slower process. The way that we see this moving quickly, is through employers. And a lot of employers are starting to do this now, especially in like the Silicon Valley startup world, because it is really important that it is valuable for employers to cover some of these procedures. But oftentimes, when you go outside of Silicon Valley, or LA, New York, you get a little bit more the old fashioned employers who kind of just stick with their traditional health care benefits. So I think there's a really interesting opportunity there to get some of these kind of like old fashioned businesses, energy corporations, oil and gas corporations, electrical corporations that may not necessarily be totally up with up to the times in terms of like, infertility coverage to get them to cover some of these services.
But we do think that the US is moving in the right direction. But it becomes really sticky, because right now, there's a few states that do mandate infertility coverage. But when you get into the nitty gritty details, there's always things that still make sure you have to pay a lot out of pocket, or there's blockages or you have to go through a certain amount of failed cycles to actually qualify. And that brings us to another point, which is some of the discriminatory policies that exist in infertility coverage right now, specifically for the queer community. A lot of coverages will say, we will pay for an IVF cycle if you have failed to conceive naturally for three years of trying to, but you know, for queer couples, there's no failure because they can't conceive.
Naturally, basically, there's no sperm and egg that that can conceive just through sex. And so oftentimes, LGBTQ people in the queer community will be automatically disqualified from getting that coverage. So there's a bunch of policies that exists right now that hopefully as we get bigger, and you know, we can make more of a cultural impact that we can also be the forefront of leading some of that change in Congress, in the government. So make sure that these insurance companies are covering procedures and are covering the queer community as well.
Brittany Hawkins
That is such a good point. And, and one that I think definitely needs to be in the forefront of conversations at that level. But also on the in the private sector. What do you think that the Fatone fertility industry as a whole can do to better meet the needs of LGBTQ
Gabriel Bogner
people? Yeah. So yeah, for the I mean, for the private sector, I think they're actually doing a really good job right now. I think it's just getting more employers on board with offering fertility coverage across the board. So a lot of the the startups that you hear about right now, their coverage plans for infertility are very comprehensive and do include queer couples and queer communities.
So they're definitely on the right path there. It's really just like, honestly, the same problem with fertility in general is just making it more accessible, getting more employers on board. And I think a lot of that just starts with education and doing things like this educating people about infertility, educating about people about the inaccessibility of some of these services. And, you know, getting employers on board because it does help with retention rates, it does help with employee engagement. And if you're taking care of your employees, and at the end of the day your employees are going to perform better.
Brittany Hawkins
Yeah, that's a really, really great point. And I know we're sort of running out of time, but just a few more questions I would love to know, you know, as you expand, and you are going into different markets, like what are your what are the other things that you're trying to do outside of access points, potentially, around the experience, the patient experience, and what that looks like for mate versus other clinics?
Gabriel Bogner
Yeah, so as everybody's probably were going to the doctors, not the most enjoyable experience right now, especially if you're going to the fertility doctor. It's a very emotionally charged journey. Oftentimes, people have been trying for a really long time, they're frustrated, they're at their wit's end. And unfortunately, people there's a stigma around, and people going through, it can go through a lot of emotional ups and downs, it can lead to a lot of stress, it can lead to depression. So I think a big portion of this is like looking at holistic care as well.
You know, it's not only at the actual, like, physical going through IVF, taking the injections, but there's like a mental health aspect as well. There's a diet aspect, there's like, just an emotional well being aspects. So we really want to ensure that we're taking a look at like holistic care as well. So we partner, we always make sure that we're partnering with secondary services as well. And getting our patients like great deals, to go into yoga, to go in for acupuncture to go speak to a counsellor. At every stage, we always want to make sure that we're offering these secondary services as well. Because oftentimes, some of these more legacy clinics might forget about those things. And of course, like the brand, and the actual patient experience is the most important is not the most important, but it's very important for us.
Most of the consumers of these services nowadays are like millennials, so they've grown up in an age of technology. And they've grown up with a lot of these companies that show how important they are. They create an amazing experience. They listen to the consumer, they change. And they build honestly like beautiful store brands that people want to go into. And so we partnered with, actually the people who did the brand for Warby Parker, and who did the brand for Harry's razors. So they're the ones that built our kind of like brand book for us, called partners in Spain. And the people who are designing your clinics are the ones who design the Dry Bars. So we're making sure that every single time you walk into a main clinic, it doesn't feel like you're going to the doctor's office, it feels like you know, you're going to a spa, or you are going to a beautiful storefront. Even if you know, a lot of these procedures, and the medications and everything still going to be really difficult process if we can alleviate some of those pain points along the way, and just make it a more comfortable, welcoming, friendly environment. That's really what we're here to do.
And also just being like completely technology enabled. So a lot of old school doctors will still keep everything out of pen and paper, I'm sure you still walk into a doctor's office and just seeing filing cabinets from head to toe, a million patient files in the back. And that doesn't need to be done anymore. Like there's technology that can do all of this. There's technology that can allow you to check into your to your appointments before to have open lines of communication with a doctor to not have to like call 50 different numbers. If you can't talk to the doctor, if you need a prescription refills, just click click a button. So we want to make sure every point that we are completely technology enabled as well, to create really a more welcoming, friendly environment for patients.
Brittany Hawkins
Okay, last question. If you were going to guide a patient or a potential patient as to what to look for in a fertility clinic, I know that you're not in every city yet, but how would you guide them in the in the areas in which you are not already located? What do you think really matters? And what would you tell them?
Gabriel Bogner
Yeah, I think we so often hear that the most important person in your fertility journey is actually going to be the nurse. So I think finding a nurse and the office staff that is like welcoming, friendly, is willing to take your calls is willing to answer any questions is probably the most important thing when you're looking for a fertility clinic. Because the nurse is going to be your point of contact and nurses going to be the one that's like talking to you about that. vacations, giving you prescriptions, who's really like walking you through the entire journey, the nurse and the and the office staff, the doctor is really important. But a lot of doctors, you know, they go to school for a really long time. And they're great at what they do. And that's kind of what they do. They they come in, they do the procedures, they'll talk to you, but like the nurses are really what's going to make that experience, positive or negative for you.
So I'd say the most important thing when you're looking for a fertility clinic, is to not only judge the doctor, but take a really hard look at the staff too. Because at the end of the day, like the doctors have had pretty much all the same training and all know how to do these procedures. But you could have an office staff who has had absolutely no experience, or you can have an office staff who has been doing this for years and who knows how to talk to patients or, or who has been trained by the right people. And just somebody who is like empathetic towards you. Even better is and which we tried to do is to hire staff who have actually gone through these procedures themselves. So our nurse in our Oklahoma City Office, she's actually gone through IVF. And I think just being able to talk about it on a personal level like that is super important when you're having some of these difficult conversations with people.
Brittany Hawkins
I think that is such such good advice for anyone considering this. I just heard a stat that any doctor spends an average of six minutes with the patient, and then the rest is the nursing and clinical or the nursing and the administrative staff. So you're absolutely right. Just having a staff that really supports you is super important. Yeah. Anyway, thank you so much for joining us really, really enjoyed your perspective and your mission. It sounds awesome. And I really cannot wait to where there's actually the right fertility number of fertility clinics to patients that need it. So I really am excited about what you're doing.
Brittany Hawkins
So Gabe as we come to patients who are trying to navigate this picking a clinic side of the fertility journey. There is a lot of controversy around success rates. And I'd love to hear more about, you know, where you see those fitting into the equation as to how to pick a clinic.
Gabriel Bogner
Yeah, I personally think that looking at success rates is complete bogus, and you should be thrown out when you're trying to evaluate a fertility clinic. success rates, as I mentioned earlier, like a lot of these procedures are so standardised nowadays, like it is a egg retrieval with a guided ultrasound, and it is a an embryo transfer with a catheter. It's a very simple procedure for a doctor to do. There's not a lot of room for error. And this has been developed for the past 40 years. So what a lot of doctors will do is they'll actually like reject difficult patients. And because the success rates are so important for people, it takes a lot of these the actual data, and it's actually bad for patients, because patients will then get turned away from a lot of clinics if they don't fit the exact mould that some of these older doctors are looking for. And because there needs to be like less value placed on success rates, because success rates just should be and basically are kind of standard practice, but they can be easily manipulated because of doctors are only taking on patients that are under 30 years old, who have no history of disease who have only been trying for six months, and the only issue is that their partner has a low sperm count, obviously, their success rates are going to be significantly higher, because they're not taking on eating quote unquote, difficult patients. And this can just create a lot of I don't know it can be it can just be really sad for patients honestly, and it's not the best experience because then people will have to like doctor shop. So I would say don't place as much value on like, what the success rates are. Because if you see a really high success rate at a clinic, they might kind of be manipulating those numbers behind the scene.
So you want to look at a little bit more of like, qualitative data instead of quantitative. So like, what was the patient experience? Like? What was the wait time to actually get your your procedure done? Like, how long did you have to wait between first appointment to your retrieval? How was your experience with the nurses? So I think it needs to be like switched around from this.
Okay, this is the number this is the success rate to lead, what was the overall patient experience and get a lot more data points in there? Just how like, I use the example of GDP, like, everybody looks at GDP as like, oh, that should be the marker of how the US is doing or how the economy is doing. But like the US GDP will actually increase if there's an oil spill, you know. So that data point is misleading. So there needs to just be a shift into how we're evaluating like overall experience, similarly to how there needs to be a shift away from like, just GDP because environmental disasters technically increase our country's GDP.
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