The demand for fertility treatments is on the rise, driven by a number of macro factors: People are starting families later, same-sex couples are seeking out services and studies show that male fertility has been steadily dropping.
U.S. births assisted by fertility treatments increased more than threefold from 1996 to 2015, according to the Pew Research Center.
Today, 1 in 8 couples struggle with infertility, and the treatment options are expensive. A single in vitro fertilization (IVF) cycle in the U.S. costs around $12,000, and that price can rise up to $25,000 with medication. And many patients don't just go through one cycle, but three to five cycles on average in order to have a successful pregnancy.
After two years of R&D, startup Alife launched new artificial intelligence software to help fertility clinics optimize and support clinical decision-making during critical stages of the IVF process.
"I founded the company in 2020 really with the focus on trying to bring advanced analytics and artificial intelligence to the IVF sector," said Paxton Maeder-York, founder and CEO of Alife, in an exclusive interview.
With a background in surgical robotics, Maeder-York said he saw an opportunity to leverage AI and data science to modernize fertility treatments.
"You have to really understand what [fertility clinics'] workflows look like today. Unfortunately, a lot of it is super manual and a lot of it is on paper. They print out a photo of the embryo and just hand it to you, it's not visually captured," he said. "A lot of the software in this industry is Windows 95 or older. They're running metrics on Excel and not with a streamlined dashboard. There's just a great deal of opportunity to bring modern Silicon Valley cloud-based infrastructure to this industry to streamline operations and really improve outcomes across the board."
He added, "There are significant macro factors that I believe are going to only make IVF and fertility treatments evermore important as we head into the next 10 to 15 years."
Alife leverages AI and large U.S. IVF data sets to analyze millions of data points from patient cycles. The company's technology can help optimize the IVF treatment process end-to-end, Maeder-York said, by streamlining clinic workflow and providing a more personalized experience to patients.
The company's commercial products include Alife Assist, a suite of products designed to provide clinicians, embryologists and clinic managers with data-driven insights.
The Alife Assist platform is made up of three products backed by the company's scientific research and collaboration with top clinics. One product, Stim Assist, is a set of AI-powered clinical decision support tools that helps reproductive endocrinologists choose the optimal medication dose and timing to maximize the number of mature eggs retrieved from an ovarian stimulation cycle. These tools use a large and diverse IVF data set containing millions of rows of historical data from previous patient cycles to provide insights on what treatment has worked best for similar patients. Alife's research indicates that, in general, more mature oocytes are associated with a higher live birth percentage.
The company also developed a tool called Embryo Assist to help enhance the embryologist's workflow to keep consistent records, save time and automate reports. This enables embryologists to digitally capture, grade, organize and report embryo grading data with real-time connection to an electronic medical record.
Alife developed an analytics dashboard as well to provide fertility clinic directors, managers and administrators the ability to monitor and visualize their clinic’s performance in real time.
The technology is now available for IVF clinics in the U.S., according to the company.
Alife has partnered with nearly 20 of the top fertility clinics in the country to collect data to help train the AI platform and to test the technology, Maeder-York said.
There are about 500 fertility clinics in the U.S., with many of them wrapped up in clinic chains.
"We're working with all four of the biggest clinic chains, which represent, you know, some 20% to 30% of the U.S. market. Many of them are data partners, so they contribute data to our overall data set, which allows us to train our algorithms and really kick-start our system. Many of those are testing or running clinical trials with us," he said.
Alife is in "early commercial conversations" with many of those clinics, Maeder-York said.
"The point of this launch is to transition from the R&D and testing phase into actually having the systems out there to be utilized by clinicians on patients," he said.
Leveraging AI, data science to transform IVF
Last spring, Alife raised $22 million in series A funding to support the launch of its commercial products and to conduct clinical studies for products still in development. The startup is backed by investor Deena Shakir at Lux Capital plus investors Rebecca Kaden at Union Square Ventures and Anarghya Vardhana at Maveron.
Maeder-York built an executive team that includes leading tech experts Melissa Teran, who has developed technology in the medical, robotics and AI spaces; Kevin Loewke, who has extensive data science and machine learning expertise; and Mark Lown, who also has deep experience in developing robotics technology for medical applications.
At first glance, it wouldn't seem that robotics and IVF would have much in common.
"Whenever you're building complex medical technology, there's a lot that goes into that. Robotic surgery has obviously a very complex integration across mechanical engineering, control systems, software engineering and analytics. A lot of that skill set is very transferable when applying artificial intelligence, which could be viewed as kind of a robotic system, just in software," Maeder-York said. "The core of it is seeing what's capable of being developed from a technological side, and then marrying that with really beautifully designed medical technology so that it can be utilized."
"We're really a research organization at the core," he noted.
Alife is able to take research on optimizing IVF treatments and integrate it into current practice at fertility clinics.
"There are a lot of people doing small clinical studies, but, with our approach, we're looking at orders of magnitude larger data, pulling out these insights and then taking that next step to actually make it clinically usable in a way that helps patients and helps clinicians better their care. That's really the magic of productizing this technology," he added.
In the wake of the Supreme Court's Dobbs v. Jackson decision on abortion rights, Alife executives expect there to be potential unintended consequences for infertility care providers located in states that restrict or ban abortions. As an example, many fertility clinics in those states are taking steps to store embryos in states where abortion is still legal.
"The real impacts here are going to be that IVF is going to be even more expensive and will require travel," Maeder-York said. "All the clinics that were already somewhat overloaded in the more progressive states are going to have an influx of more patients and both of those are actually problems that Alife is assisting with. Our technology will help to reduce costs, reduce the number of times patients actually have to go and travel and reduce the stress of the overall process."
Alife plans to add more functionality and features to the platform in the future. The company developed a patient-facing app and also opened an office in Zurich to build EU partnerships.
"Our goal is to get this AI-enhanced software into as many clinics as possible. We want to deepen the functionality for the clinic side and also expand the types of services we can offer patients as they go through this very opaque, challenging and complicated process," Maeder-York said.