Gentlemen, here’s a question: Do you know your sperm count? While this may seem personal or even awkward, it’s a conversation that’s becoming more common. For years, fertility tech has focused primarily on women’s reproductive health—think egg freezing and IVF. But now, the spotlight is shifting. Male fertility startups are gaining traction and attracting investor interest. So, why the sudden focus?
The Story of Legacy
Khaled Kteily, founder and CEO of Legacy, leads a prominent startup in the male fertility space. After completing a successful Series B funding round in 2022, Legacy has become a key player by offering services like sperm testing, quality improvement guidance, and sperm freezing. In fact, the company is known for making sperm testing more accessible and helping to break the taboo surrounding male fertility care in the U.S. “What we learned in biology class is wrong,” says Kteily. “We’re taught that infertility is a women’s issue, but infertility is just as likely to come from the male partner as the female partner.”
This is true: historically, infertility was often viewed as primarily a female issue, resulting in a surge of solutions focused on women. This view was not only scientifically incorrect but also culturally biased, neglecting the fact that male factors contribute to nearly a third of infertility cases. Another third is due to female factors, while the remaining cases are either unknown or involve both partners, according to the National Institute of Health. Despite male infertility being simpler and cheaper to diagnose and treat—often with lifestyle changes—almost a third of fertility clinics do not test male partners. This gap is frequently driven by business interests. As Kteily points out, “By the time you’re at a fertility clinic, they push for IVF, because that’s their business model. They’re not interested in making a few hundred dollars on a semen analysis when they can make $15-20k per IVF cycle.”
Kteily stresses the importance of a solution like Legacy, given men’s general reluctance to visit fertility clinics unless absolutely necessary. “No man is going to go to a clinic unless he absolutely has to,” Kteily notes. “But with declining sperm counts, DNA damage, the impact of microplastics, and the fact that men are waiting longer to have kids, it’s clear there’s a need for men to have access to sperm testing without needing to visit a doctor.”
As our understanding of fertility evolves, investors are increasingly turning to peers with expertise in the field for insights.
A Conversation with Chantal Noble Haldorsen from Freya Ventures
Chantal Noble Haldorsen is an early-stage investor specializing in healthcare and family tech, with a diverse portfolio of over 40 investments in Europe and North America. She previously ran early stage investing at private equity firm Certares, and holds an MBA from Harvard Business School. Recognized for her expertise in the fertility sector, her investments span IVF access, male fertility testing, menopause management, hormonal testing, and in vitro spermatogenesis.
Q: The World Health Organization estimates that 1 in 6 people globally experience infertility. What trends are you seeing in the fertility tech market, particularly in addressing both male and female reproductive health?
Until recently, most of the startups I came across in the fertility space were focused on making egg freezing and IVF more manageable through consumer-facing apps. Although these platforms solve a salient pain point for patients, many of them have struggled to find business models to support sustained growth.
Personally, I’m less interested in investing in band-aid solutions that modestly improve the patient experience within today’s overburdened reproductive healthcare infrastructure. I spend my time looking for technology that can improve access, efficiency, and success rates of fertility preservation and IVF cycles – or even better, reduce the need for IVF for some couples altogether. Key areas that excite me include hardware automating embryology labs, data driven decision making platforms for stimulation protocols and embryo creation / selection, life sciences companies developing in vitro gametogenesis, advanced genetic testing solutions, and technology that can treat specific root causes of fertility challenges upstream.
Q: Are there any technology trends you are seeing particularly concerning male fertility? How do these trends influence your investment decisions in this space?
Some of the more interesting things I’m seeing within the male fertility space include in vitro spermatogenesis, enhanced sperm testing, fertility preservation (sperm freezing), and male contraception. For example, Paterna Biosciences is developing technology to solve male infertility with in vitro spermatogenesis, by creating healthy sperm from a man’s testicle stem cells in a lab. Consider a couple having to repeat multiple stimulation cycles due to a male factor infertility issue, as today’s commercial technology does not support testing of an individual sperm before fertilizing an egg. The ability to ensure the sperm being used to fertilize an egg is “healthy” could drastically reduce the average number of eggs retrieved per live birth.
Although I spend a lot of my time supporting companies that make it easier to start a family, I also strongly believe in every person’s right to choose when they would like to do so. There have historically been very few options for men looking for contraception, but that is now changing. Contraline and Next Life Sciences are two companies developing long-lasting, non-hormonal, reversible birth control for men that can be administered via a single injection. I expect there will be a robust market for this type of product in the post-Roe era.
Q:What do you consider the biggest challenges and risks associated with investing in the male fertility market, and how do you mitigate these risks?
There are four primary risk factors I consider when investing in the male fertility market:
The first would be preclinical risk as there’s always a chance a given diagnostic or therapeutic does not work when you conduct a clinical trial in humans. However, I personally tend to hold off on investing until there’s some body of research that strongly indicates the contrary.
The second major risk I evaluate is the regulatory framework, especially when you consider the current political environment in the United States. Roe v. Wade being overturned has created notable uncertainty within the reproductive health space, especially considering Alabama’s ruling on IVF treatments, and there are widespread concerns about what’s next. That said, I’m optimistic about the longer term trajectory of reproductive health regulations, even if there are some near-term headwinds.
The remaining risks I assess are go-to-market and adoption risk, which can be a bit higher within male fertility than for reproductive health businesses targeting women or couples trying to conceive. The adoption of some existing and emerging technology options, like proactive sperm freezing for example, requires a cultural mindset shift and education on the benefits of fertility preservation (for which the body of supporting evidence is growing rapidly).
That said, most of the risks one would consider prior to investing in a male fertility business, would also be relevant for a startup in the women’s reproductive health space. Ultimately, one has to believe that there will be progress over the long term, and you can reasonably adjust your portfolio construction to incorporate the risk of elongated timelines to market or temporary regulatory hurdles by also investing in other business models that are more likely to generate returns within a shorter time horizon.
The Future of Male Fertility Tech
As more startups emerge in the male fertility space and existing companies expand their offerings, we can anticipate a wave of innovative solutions focused on improving male reproductive health. Kteily envisions a future where “every man freezes his sperm while young and healthy, just as women are increasingly freezing their eggs between ages 25 and 30.” He predicts it will become common for couples in their mid-thirties to have already secured fertility options, removing gender from the conversation altogether. Legacy is also scaling its business-to-business operations, particularly within the military. Kteily emphasizes the importance of this focus: “If you’re at risk of harm or death, you should have your sperm frozen. Veterans are twice as likely to experience fertility issues due to chemical exposure and combat stress.” In line with this mission, Legacy recently signed two major contracts with the Veterans Affairs to offer sperm testing and preservation services for veterans, ensuring that military personnel have the chance to safeguard their fertility.
Kteily concluded by discussing the broader industry, highlighting his belief that developed nations will soon require policies to address declining birth rates. “Governments will need to enhance access to fertility testing, sperm preservation, IVF, and childcare—whatever it takes to reverse the trend,” he said. With growing investor interest and a market ready for expansion, the future of male fertility care looks bright.
