France Brunel, who is thirty-six, first considered freezing her eggs after ending a two-year relationship, in 2018. She’s not sure she wants children, especially if she remains single, and she knows egg-freezing does not guarantee her a baby. But she felt it was the best chance she had to preserve the option. “I don’t want to regret it at thirty-nine—if I meet someone, and want kids at that time, to say, ‘Shit, I should have frozen my eggs,’ ” she told me.
Brunel lives in New York, where she runs an innovation-strategy firm while studying to be an Ayurvedic-medicine practitioner. About two years ago, she started seeing ads for Kindbody, the fertility-services franchise, on her Instagram feed. While attending a health-care conference, she spotted a Kindbody van parked outside; inside the van, she received a basic fertility screening, free of charge. Later, she visited Kindbody’s street-level studio in the Flatiron District, a loft-like space that used to house a high-end Mexican restaurant. There, she submitted to a suite of blood tests and a count of her follicles. (Each follicle has an egg that has the potential to mature, with the help of hormonal stimulation.)
The Flatiron flagship, on the same block as a lingerie shop and an athleisure store, can almost pass for a downtown boutique. There are displays of chia face oil and roll-on perfume vials in the sun-filled waiting room, which has lots of blond wood and pops of color. “It feels like you’re stepping into the Wing when you go there. It’s all pink and yellow,” Brunel said. She noted the “cool matcha-turmeric latte powders” and “millennial brands that retail at all the millennial places,” such as the spa chain the Well. “It’s very cheesy, Instagrammable, but it’s all about owning your future and you having control,” Brunel told me. “It’s—it’s empowering.”
Kindbody’s appealing environment and upbeat message compare favorably with any notion of a traditional fertility clinic, which might conjure a sad beige waiting room full of deflated couples. By giving infertility a breezy, stylish backdrop, Kindbody and its peers aim to destigmatize the sector, much as Thinx underwear did for periods, with its ubiquitous New York City subway ads. The aesthetic extends beyond the clinic space. Mosie Baby, a maker of D.I.Y. insemination kits, swathes its products in a familiar bouquet of saturated pastels. The Legacy at-home sperm-freezing kit comes in packaging that looks suited to a hand-poured soy candle.
In the U.S., where the average age at marriage and first birth continues to increase—especially in coastal cities such as San Francisco and New York, where women have their first child at thirty-two and thirty-one, respectively—an estimated eight to fifteen per cent of heterosexual couples will experience infertility. When you add queer couples and single patients who hope to become parents, as well as people with heritable genetic conditions or cancer, demand could be as high as 1.1 million cycles per year, according to an estimate by David Sable. (Sable, a former reproductive endocrinologist, is now a portfolio manager overseeing “a reproductive medicine focused venture fund.”)
Today’s fertility entrepreneurs represent a new, proactive attitude toward reproduction, centered on preëmptive treatments during one’s most fertile years. This shift opens up a potentially limitless market, as Lucy van de Wiel, a research associate at the Reproductive Sociology Research Group at the University of Cambridge, and the author of “Freezing Fertility,” told me. “You don’t have to wait for people to become infertile and then they look for a solution,” she said. Instead, “you can basically tell women that they need to manage their fertility, and they need your services to do that.” Anticipating regret—Brunel’s “Shit, I should have frozen my eggs” moment—is essential to the business model. If the old goal was to make a baby, accounting for lost time, the new goal is to make fertility, starting at any age.
With multiple locations across the U.S., Kindbody is perhaps best known for parking its bright yellow van on high-traffic corners and offering free fertility tests to passersby. Gina Bartasi, the founder and C.E.O., points to the van as symbolic of the future of health care: convenient, easily accessible, and built around the customer, who can stop by for a fertility checkup on her lunch hour. Bartasi has cited SoulCycle and Drybar, with their strong, recognizable branding, as inspirations for Kindbody.
“When I go into Soulcycle, I can be tired and cold, and I walk in and inevitably there are three people in yellow behind the counter who greet me, and they are cheery and bubbly, and they don’t have a care in the world,” Bartasi said. “You have to build that consistency of culture, of cheeriness, of customer service.” Bartasi’s last company, the fertility-benefits provider Progyny, managed fertility coverage on behalf of employers, acting as a middleman; at Kindbody, Bartasi sells fertility treatments directly to consumers and employers. (Progyny went public in October, 2019, and is currently valued at over four billion dollars.)
Kindbody has several competitors that focus on egg-freezing, including the New York-based Extend Fertility and Prelude Fertility, one of whose founders, Martín Varsavsky, is an evangelist for a universal fertility market. Varsavsky, who is based in Madrid and Miami, is the chairman of Inception, the parent corporation of Prelude. Nine years ago, he and his wife, Nina, were struggling to conceive. Varsavsky, who was then fifty-one, knew that his age could present challenges, but he was surprised to learn that even women in their early thirties, such as Nina, could have diminished ovarian reserve—a low number of eggs.
“Because I am a tech entrepreneur, when I’m in a waiting room, I’m always imagining how things could be,” Varsavsky told me. He envisioned a new norm for reproduction, one that would anticipate infertility rather than simply react to it. Young people in their reproductive prime could freeze their sperm or eggs in their twenties, live their lives, pursue careers, and then, when they finally met the right person, thaw their frozen gametes.
Varsavsky called his vision the Prelude Method. It consists of four steps: freeze eggs or sperm at a young age; combine them, at the right time, to yield embryos; test each embryo for genetic abnormalities; and transfer one embryo at a time to the uterus, to avoid multiple births. He looked to the U.S. both for investors and as Prelude’s first, and biggest, market. “If you want to raise money for crazy ideas, you have to come to America,” he said, as we sat in an empty office at the N.Y.U. Langone Fertility Center. “If you say, ‘Sex is great, but not to make babies; give me one hundred million dollars’—in Europe, you don’t get it. In America, investors are intrigued.”
The idea, he told potential investors, was not to compete for the infertility patients already being served by existing clinics. About seventy-seven thousand children are born through I.V.F. each year, he explained, but some three million are born after being conceived without medical intervention. Why not go after that much larger market, and turn babies who might otherwise be spontaneously conceived into Prelude babies? “When they meet,” Varsavsky said, picturing a Prelude couple, “and they want to have children—which now tends to be in the late thirties—they say, ‘Ah, I have frozen sperm and I have frozen eggs!’ They say, ‘Hey, why don’t we have sex for fun, but make a baby in the serious way.’ ” In other words, through I.V.F.
Making a baby in the serious way would include the use of technology such as pre-implantation genetic testing (P.G.T.), which is performed on cells removed from embryos. P.G.T., Varsavsky said, would prevent needless suffering, create a healthier population, and spare people the painful decision of whether to abort a fetus with genetic abnormalities. In a 2016 LinkedIn post, Varsavsky argued that investment in embryo testing is one way to bring U.S. health-care spending under control, alongside more commonplace suggestions like reducing smoking and encouraging exercise. “The best way to lower health care costs is for people not to get sick,” he wrote, “and preventing severe congenital illness helps wellbeing and to lower the health care system cost as a whole.”
Varsavsky’s rhetoric seemed to complete the severing of sex from reproduction that began with the invention of modern contraception. He acknowledges that some observers may detect a whiff of eugenics in his enthusiasm for universal P.G.T., but, he noted, as a parent of seven himself, “You’re only as happy as your saddest child.” He continued, “People say, ‘Oh, I want to have a baby, I want to have a baby’—but they really want to have a healthy baby, right?”