Before IVF: the emerging market for a shorter path to pregnancy

From at-home diagnostics and wearables to fertility optimisation and lower-intervention treatments, a new layer of fertility care is emerging before IVF.

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Two years ago, I wrote about a small but growing group of companies trying to change the fertility pathway.

Instead of focusing on improving IVF, they were each asking a different question: could more people be helped before they ever reached it?

I’ve been thinking about that piece again recently, because the need for better answers to that question hasn’t gone away:

IVF use continues to grow, with more than 3 million assisted reproductive technology cycles reported each year worldwide and estimates now putting total ART-conceived births at more than 10 million, likely 13 million or more.

At the same time, innovation and capital continue to pour into the IVF industry. Since January 2025, FutureFemHealth has tracked more than $170m in funding for IVF-focused companies, spanning new financing models and lab automation to AI-powered egg and embryo selection and technologies designed to improve treatment outcomes.

All of that innovation matters. IVF is still one of medicine’s most important advances and an essential route to parenthood for millions of people - including me and my family.

But I’ve seen comparatively little attention on the pathway that determines who reaches IVF in the first place - a pathway I wish had existed before I went through it myself.

And that’s especially surprising when you consider that unexplained infertility still accounts for up to 30% of cases.

For a sizeable group of people struggling to conceive, the starting point is still that we don’t really know why - and yet many proceed through to IVF anyway.

There are signs that’s starting to change.

Today, Sunfish - a company best known for helping patients navigate and finance treatments including IVF - launched a new programme that moves it much earlier in the journey, combining baseline fertility testing with preconception and financial guidance before someone necessarily knows whether they will need treatment.

And last month, Maven published new research showing how fertility benefit design can influence whether appropriate patients start with IUI or move directly to IVF - and potentially cut the average cost to pregnancy nearly in half.

These are different approaches and focused examples, but they point towards the same opportunity: getting better at determining what should happen before someone reaches IVF.

Here’s where the opportunity is opening up: