Celebrations Are Over. What’s Next?
- orbitalinputs0u
- Jan 22
- 3 min read
Kaj Rydman
January 19, 2025
Honoring Our Pioneers
For decades, we have commemorated the remarkable achievements of fertility pioneers, reminding us just how far the field has come since its earliest days. In 2024, Sir Robert Edwards was honored with a play, a movie, and numerous events worldwide, marking what would have been his 100th birthday. Equally influential figures—such as Drs. Howard and Georgianna Jones in the United States, Drs. Wood and Trounson in Australia, and Dr. Dexeus in Spain—are all woven into the collective memory of this industry. Their groundbreaking work gave birth to “miracles” once thought impossible, igniting a field that has continued to evolve ever since.
From Early Breakthroughs to a Global Industry
An “industry” was never the original goal for these pioneers. Even the early commercially successful figures of the late 1980s and early 1990s—individuals like Ian Craft, Dr Kamal Ahuja , Mohammed Taranissi, and Paul Serhal in the UK, Zev Rosenwaks, Richard Marrs, Alan DeCherney, and Sherman Silber in the US, as well as Dexeus, Pedro N. Barri Ragué , and Antonio Pellicer in Spain—didn’t set out to create the global enterprise we know today. Yet here we are, with fertility services now firmly established as a thriving, complex sector.
“An ‘industry’ was never the original goal for these pioneers. Yet here we are, with fertility services now firmly established as a thriving, complex sector.”
Despite this transformation, we still celebrate each “little miracle” as though it were an art rather than a science. Fertility treatment remains deeply personal, raising persistent ethical and legal questions, prompting calls for or against regulation, and reshaping how we define and build families. From donated gametes and shared motherhood to surrogacy, the industry has spawned an entire ecosystem that must continually grapple with new frontiers in technology and medical science.
The Stagnant Operating Model
In many respects, the operating model behind fertility care is still the same as it was in the days of “Baby Louise” or “Baby Joy.” We know there is massive unmet demand, calling for greater scale and broader access—yet none of the innovative technologies introduced over the last decade can fully deliver their promise under the current system.
“None of the innovative technologies introduced over the last decade can fully deliver their promise under the current system.”
Ironically, the growing involvement of private equity (PE) in the past fifteen years has not led to a more scalable approach. Instead, PE investments seem to have solidified old structures. Funding has primarily fueled transactions that shift value from seasoned, deserving pioneers to new sets of professional investors—without fundamentally reshaping the industry. In many cases, large groups must continuously acquire new clinics to boost their top line, leaving little room for fresh thinking or operational reinvention.
Venture capital (VC) has also fallen short in triggering meaningful change. While numerous startups focus on narrow facets of the fertility journey—whether improving patient experience, enhancing data modeling, or automating lab procedures—most haven’t addressed the bigger picture. They are limited by an outdated fertility operating system, or “fertilityOS,” that remains largely unchanged.
Reimagining Fertility: Fertility OS 2.0
The familiar, single-point-of-access model can no longer accommodate the scale or accessibility demands of modern fertility care. Patient services, medical treatments, laboratory work, and the growing logistical needs of gametes and embryos exceed what a single, under-one-roof operation can provide—physically, operationally, and economically.
“The next step is a truly modern ‘Fertility OS’: a distributed, standardized, and specialized model that remains local where patients need it most.”
To address these challenges, we must reimagine how the industry functions. The next step is a truly modern “Fertility OS”: a distributed, standardized, and specialized model that remains local where patients need it most, but also leverages central infrastructure for efficiency and scale. This requires a genuine deconstruction of the current approach—unbundling services and rebuilding them into a cohesive, flexible, and scalable system.
Who Will Lead the Transformation?
The future hinges on who will take the first bold step toward “Fertility OS 2.0.” Can the major consolidators shed duplicated functions and evolve into leaner, more distributed operations, thus seizing an early advantage with new technologies? Or will a fresh market entrant, backed by sufficient financing, create a central infrastructure that empowers existing community-based providers with standardized tools and interconnected systems?
These questions loom large as the industry stands at a crossroads. New ideas and technologies are knocking at the door—yet they need a revamped platform to truly thrive. The quest for a modern, accessible, and scalable fertility model remains open, waiting for innovators, investors, and practitioners to lead the way.
After all, in a field that began by offering small miracles to a few, the time has come to re-envision miracles on a much larger scale. The pioneers would expect nothing less.
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