Future of Fertility_Paxton Maeder-York: Audio automatically transcribed by Sonix

Future of Fertility_Paxton Maeder-York: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Abby Mercado:
Hi. I'm Abby Mercado, an IVF mom, former VC investor, and CEO of Rescripted. Welcome to The Future of Fertility, a podcast dedicated to shining a light on the entrepreneurs and innovators who are changing the face of family building. With billions in funding over the past few years, we'll introduce you to the people, the ideas, and the businesses that are changing the fertility industry and in turn, millions of people's lives. The future of fertility is bright. Now let's get into it!

Abby Mercado:
Paxton Maeder-York is the CEO and founder of Alife Health. Alife Health uses artificial intelligence to improve the equity and efficacy of IVF. Paxton and Team have built one of the largest and most diverse IVF data collections made up of millions of patient cycles and sourced from the top fertility clinics around the world. Alife's AI Software analyzes this data to identify what treatment plans have produced the best outcomes for past similar IVF patients. Paxton and I met through a fellow entrepreneur in the reproductive health space a while back, and I've really enjoyed following Alife's growth story since then, as they've gone on to raise tens of millions from VC to help more patients receive the right treatment. Thank you so much for joining us today, Paxton, welcome to the podcast!

Paxton Maeder-York:
Thank you very much, Abby. It's great to be here.

Abby Mercado:
Awesome. Well, very good. I'm so excited to hear about all the success that you guys have had at Alife and a little bit about the founders story. But first, I would love to just learn all about you and just tell us all of the things. Who are you? Where did you come from? And maybe most importantly, what's one fun fact that few people know about you?

Paxton Maeder-York:
Sounds good. Happy to give you a little bit of background about myself. So I'm actually originally from Cambridge, Massachusetts, born and raised, spent a large portion of my life really fascinated by medical technology, surgical robotics. And specifically, I was doing a lot of robotics camps at MIT when I was younger and watching a lot of surgery, heart surgery, cardio surgery at MGH and Brigham. And so I ended up going to Harvard undergrad studying biomedical engineering. After that, I worked out in the surgical robotics sector in San Francisco at a company called Auris Health. We were building lung cancer systems, and I lost several grandparents to lung cancer, so it was a really important mission to me. That company ended up getting bought by Johnson & Johnson, for just shy of three and a half billion dollars. And I went back and did my master's in data science as well as my MBA at Harvard as well. And it was during this period that I became really excited around opportunities for artificial intelligence to help across medicine, and then very specifically within the IVF sector, as we see more and more people starting families later, LGBTQ+ community requiring this type of technology, and this growing global rise in infertility rates, as I'm sure you've discussed on your show previously. So that's a little bit about my context and how I ended up here. One fun fact that not many people know about is that my little brother is actually an IVF baby himself, and it's been super fun because I get to work with Boston IVF, they're one of our core partners, and that's where my brother was conceived, so it's really been full circle.

Abby Mercado:
That is an amazing fun fact. And obviously, the personal story is something that, that makes a lot of people really passionate about this space, so thank you for sharing that with us. So I want to dig in a little bit more. So were, was your family an influence on robotics, or were you just that like sciency kid? Like who was Paxton when he was little?

Paxton Maeder-York:
It's a good question. So I definitely always knew I wanted to be an engineer, that was from very early age. My, my dad was an engineer before he moved over into, into finance. And I think part of it is just being in Massachusetts, where the hospital systems are such a big part of life, they're the, the largest employers in the state. And it's just known for this kind of really deep kind of biomedical research infrastructure there. And so, you know, I think it was partly that, I'm not going to lie, watching Grey's Anatomy in high school also got me really excited about doing things in surgery. I thought I wanted to be a doctor for a hot second, but I remember doing some napkin math about how many lives I could impact as a doctor and realizing that my, probably my best avenue to helping as many people as possible would be through medical technology. But as a kid, always avid kind of engineer player, loved Legos, is always playing around with things. I used to build a lot in my basement, I used to build custom skis in my basement, skateboards, all sorts of things, I can weld. I kind of just loved picking up anything and creating stuff, it was my outlet growing up, and I think that probably parlayed into my current career path.

Abby Mercado:
That's a lot of building skis, I'm a big skier, so we'll have to take that offline, and I need to understand that a little bit better. That's, that's, that's really cool. So on the, and another thing that you said that just kind of piqued my interest, I feel like this podcast is really, we started this because there are so many unique stories behind fertility founders in particular and so many guests on this podcast have wanted at first to be doctors and have kind of come to the same conclusion as you, like I, what I want to do is impact lives, how best can I, as a human do that? So I love that you, that you said that so.

Paxton Maeder-York:
Yeah. You know, it's interesting because my little brother is, in August about to head into med school and I'm going to his white coat ceremony, I'm really excited about it. And I think it's, you know, it's not that one is impacting more than the other, I think that they're just different. And, you know, we need more doctors, and I'm sure we'll get into this, but we're losing more reproductive endocrinologists to retirement every year than we're minting through our 40 odd fellowships we have in the United States. And so there's a massive need for people that are, one, smart enough to be clinicians, and two, are excited to kind of do that work and work directly with patients, snd they can have such an important impact directly on the lives of those that they touch, which is obviously enormously rewarding. And you see that in talking to all the amazing doctors that we get to work with in our jobs, you know, just the sheer passion they have for what they get to do and the joy fulfillment they find from it. But I think for someone with my kind of historical excitement around building things, and this was definitely the trajectory that I felt like I could make the largest contribution, and it felt like the best fit for me.

Abby Mercado:
I love it. So biomedical engineering, what was your favorite class?

Paxton Maeder-York:
Oh, that's a great question.

Abby Mercado:
My, my husband was also, he also majored in biomedical engineering, and when he tells me about some of his coursework, I'm like mind-blown emoji.

Paxton Maeder-York:
So yeah, I think, yeah, so I'd say a couple of courses. First off, I love Solid Mechanics. I thought it was incredibly intuitive and really easy to do. Thermodynamics was very difficult, but I enjoyed it a lot. And then Fluid Dynamics, I found very frustrating because this is getting very technical, so sorry about that.

Abby Mercado:
No, I love it! I asked!

Paxton Maeder-York:
Fluid dynamics really bugged me because the core computational or at least mathematical models we have are not particularly good. And you really need to go through and basically do what's called finite element analysis and go all the way down to these very small units of the fluid and measure all the forces on it. And so you end up using computational methods in order to predict how a fluid is going to react. But we're just not that good at it. And the computers and the model and simulation software we used back then also wasn't particularly accurate. And so I found it very frustrating that we didn't have a better way of understanding how fluid dynamics worked, whether that's air or water or otherwise. So that was frustrating, and I think the class that I really love the most was a medical device design class that I took with Professor Connor Walsh. And it was really basically how do you build medical technology one on one, and what is all the process of design, discovery, and requirements, documentation and, you know, iterating on a prototype and all the way through looking at regulatory and trying to get people to use it the whole gamut. And that was really when it clicked that this was something that I wanted to do for my career.

Abby Mercado:
Yeah, that sounds like, in that moment you're like, oh, like I should actually tack on business school too, like, this is, this is interesting. We'll go. Well, thank you for letting me dive into that. I always, that's, to me is some of the most interesting part of the conversation is understanding that human being is. So let's dive into Alife, like where did the idea come from? Like obviously your brother's an IVF baby, like why fertility? How did you discover fertility? How did you discover the problems that, all the things.

Paxton Maeder-York:
Yeah. So I mean, I would obviously start with my brother. I mean, obviously that had a huge impact on me of having a little brother. And whenever I was thinking about what I wanted to work on next, and lung cancer was super important to me because it's a crazy, crazy, complicated and also unfortunately impact so many lives, I wanted to find something that really was a meaningful area of medicine, and I think fertility is often lumped into kind of the more superficial fields of like plastic surgery or dentistry or other things. But what's wild about reproductive care is that if it doesn't work, a whole person doesn't exist. Like my life would be totally different if my little brother had never been born in. My parents couldn't conceive a second child and I was an only child, right? So I think it's it's such an impactful area of medicine, and then you kind of marry that with the macro trends that we're seeing, which are kind of quite frightening to be, to be honest. You know, honestly, there's, you know, obviously there's a lot of good reasons why reproductive rates are declining around the world, you know, female education and contraception and things like that. But you also have some really bad reasons, you know, and we don't really know why what it is about our environment or our lifestyles that's reducing sperm count by 50% and 50 years, endometriosis, PCOS, and miscarriage growing year over year by a percent. So I think it's just kind of this macro viewpoint that made it a really interesting problem and a really important problem to try to go put some weight, weight behind. I was at GoogleX for a summer and that was really rewarding, and it really forced me to think very large picture about what is a humanity-level problem that I can go and contribute to? And obviously global warming and climate change is a big one there, and there are a few others, but I can't think of too many things that are more central than making sure that we continue to be able to have kids and reproduce as a, as a species so ....

Abby Mercado:
And I think that, just to, just kind of tack on to that, you know, I love this and just kind of these big human problems. But another thing about, of course, there's, there's startling statistics about all the things and in particular, sperm count and quality, like that's the one that freaks me out the most. But I know that, I know that you're a fan of David Sample just like I am, he's amazing, advisor, friend, all the things, but he's, he's the one who's always publishing in Forbes like the use of IVF to eradicate some diseases, like that to me is just such a, that's such a critical one and such a key one.

Paxton Maeder-York:
Yeah.

Abby Mercado:
That a lot of founders talk about. And I know that, that that's probably on your mind as well so.

Paxton Maeder-York:
Yeah, you know, I'm totally a supporter of that mentality. I think the moral and ethical line there needs to be really carefully considered. And I think there are some companies that are, have crossed that line and are trying to cross that line in terms of predicting things like IQ and height, and.

Paxton Maeder-York:
Totally, yeah.

Paxton Maeder-York:
The hard thing with those things is like.

Abby Mercado:
I'm talking like Huntington's disease, like let's get rid of Huntington's disease. Like let's start, like low-hanging fruit here.

Paxton Maeder-York:
100%. Like what's more preventative than going from an embryo, right? But I don't know. It's going to be interesting how that other stuff plays out, because not only do I have reservations about it from an ethical perspective, talking about that area of prediction, but it's also impossible to prove. So you're really at some level like kind of selling snake oil because there's no way to prove that in a randomized controlled trial that patients that went through a certain prediction process had a higher IQ or a higher height than they would have chosen the other embryo. You'd have to, it's impossible, there are too many confounding factors, so those things are measured, you know, 20 years into the future, there's all sorts of other things in there so. But I totally agree that an amniocentesis is actually an incredible piece of technology, and I think the same is going to be true in the future, I think at some point IVF will be utilized by a much larger portion of the population than it is today.

Abby Mercado:
Yeah. Back to your life, sorry. So you were like big human problem, I'm going to solve it.

Paxton Maeder-York:
Yeah, well, I don't know if I can solve it, but I want to contribute to it.

Abby Mercado:
Yeah.

Paxton Maeder-York:
That's certainly where I would start there. So that was definitely a big piece. And I know that you have two little ones. Whenever you're, if you have the opportunity to really think about what you want to do next in your career, it's, one of the questions I asked is like, what do I feel comfortable leaving my family every day to go and do what's important enough that that's worth it to me? And so I wanted to pick something that had a macro kind of implication. I wanted something that I had a personal relationship to, this would be my little brother. And then there were some things that made this a really interesting dataset, data science problem, which is cool. So one of the problems we see across AI in healthcare is that labeling data is really hard. If you want to build an algorithm that predicts or finds cancer, for example, and just CTs, look at lung cancer, you have to go out and hire a bunch of doctors or a bunch of med school students to circle tumors. And by the way, that adds a ton of human subjectivity in there, and now you're training on how good those doctors were at finding the tumor. And it costs a lot of money to do that, and it's inefficient. And one of the amazing things about IVF as a, as a data science problem, putting my data scientist hat on, is that there's no objective ground truth here. Either, a baby was, was able to be produced and have a live birth or they weren't. And so we have this super clean measurement of outcome at the end of the day, and we can use that as, as a ground truth to then train these algorithms to try to predict that objective endpoint. And I know I'm using some data science jargon here, I apologize, but it's.

Abby Mercado:
No, it's like, it actually, like makes, makes a ton of sense. Like you have an outcome, it's a baby.

Paxton Maeder-York:
... problem, you know, the baby's there or it isn't, right? And so that, that means you don't have to label any of your data, you can just take historical cycles, which is what we've done. We've built all these amazing partnerships, and I'm so grateful that the medical community has decided to work with us and partnered with us and accepted us into this area of medicine to the extent that they have. But we can take these huge, diverse datasets and we can utilize them to pull out correlations and insights that are really valuable and, you know, the really cool thing about this long rambling on issue is that the, the all of historical medicine and modern medicine, right, is all about like evidence-based decision-making and doing these clinical studies, we're looking at 200 patients and seeing what information you can pull out of them and what modern data science is, it's all it is, is computer-enhanced pattern recognition. And we can now, instead of taking a few hundred patients, we can look at 300,000 historical patients and pull out interesting insights. And so it's really just kind of supercharging the rate of innovation of how we figure out how best to treat people. And then also operating, of course, precision medicine and personalized care.

Abby Mercado:
Love it. So what was it like taking that, that first wave like walk us through the first three months, because that to me, if I'm if I'm like putting myself in Paxton's shoes, I'm like, okay, well, I'm very educated, like, I know what I'm talking about. I probably have like a couple of team members who also know what they're talking about. Now, like, I have this idea and I have to get at least one clinic to do, to help me gather data. And actually after that, I need like, what, 20 more clinics? Like, the more, the more the data, the more data you have, the better the company does, like, the better jumping off point you have. So enough of my guesses as to what happens.

Paxton Maeder-York:
Yeah, I mean, you pretty much nailed it on the head. It was definitely difficult and stressful, but that's what being a startup founders like. I think, I'd say a couple of things about here. I mean, first, you talked a little bit about, about the team, and I think that's a really important thing to talk about quickly. When I, I had basically just ran into this idea when I was doing my data science masters and there were some people thinking about just the embryo problem. And of course, what Alife does now is we build this entire integrated operating system for IVF that helps patients all the way through their journey, health clinicians, embryologists, all optimized with AI. So it's a very broad integrated vision, which I think is really important because that's how we're going to really, really be able to improve things across the board and partner with with the clinicians in the way that we need to. But it all starts with the team and I was super lucky that I was able to get introduced first to Kevin Lokey, who is an incredible data scientist, PhD from Stanford, one of the co-founders of Oxygen, had been in the fertility sector, he is just humble, kind, thoughtful and incredibly talented. And so I started really with him kicking around ideas well before I had any data science, data in hand, and then about two weeks after I kind of got him signed up, I was able to convince two amazing people from my last company, from the surgical robotics company to join us. One was Melissa Tran, who is the most talented product person and just generally probably the most talented person I know.

Abby Mercado:
Shout out, shout out to Melissa. She's amazing. I met her at a MRSA, the best.

Paxton Maeder-York:
She's the best, I know. And I don't know how we would do any of this without her. And so she's really the brains behind a lot of what we build, and she's just spectacular. And then Mark Lown, who is a very, very talented data software engineer, he was running a 70-person software organization at Auris and all these crazy robotic systems. And he, he's just really, really talented as well. So the four of us really were the founding team of the business at the get go. And I think that's really been vital to the whole company, like everything has stemmed from, from that core team. The second piece you asked about is the partnerships and that that was hard, it was basically just luck and raw hustle, I was able to get in contact through a friend's uncle, the head of one of the big clinics, you know.

Abby Mercado:
Classic startup story. You're like my dog's brother's.

Paxton Maeder-York:
Exactly.

Abby Mercado:
Dad's sister.

Paxton Maeder-York:
It was just like, how can I work through this network and try to figure this out? I had cold emailed everyone, I tried a bunch of clinics that I knew and was continuing to do so and, you know, really just pure scrappiness, and I got very lucky. And that person, you know, Mike Olivia at Shady Grove was, was willing to help me out. And he put me in touch with a bunch of other amazing doctors, and it kind of grew from there. Once you have a few people that are on board and a few clinics that are willing to provide data, and you kind of work your way through the process and build more and more relationships. And it's crazy because like, I've never worked in this industry, I don't, I didn't know any of the doctors when I showed up. I hadn't even been through IVF myself before I started the company. And so you just never know how it's going to go. And thankfully this has been a really welcoming community and they're very thoughtful, very kind and ah, I think they're, I will say, genuinely excited that there's another group of kind of young people that are really excited about this area of medicine that are trying to contribute to it. I think there's definitely, I guess the sense is a little bit of a passing of the torch here. And I'll be the first to acknowledge we're, we're a young, hungry team. We're just trying to do what we can to help help out patients and help clinicians in their job. So hopefully, as long as we're kind and thoughtful the way we approach the community, they'll continue to be receptive to what we're trying to do.

Abby Mercado:
Yeah. Yeah. And it's, I feel like your, your mission and vision as I was kind of refreshing myself on, Alife before the podcast, I was just kind of reminded it's kind of a, like this type of company in the IVF space. Like this is something everyone can get behind, you know, like the more the more data, the better, the better for all patients. And, you know, I'm like, based on your recent fundraising numbers, it doesn't seem like you guys are having any trouble kind of making those sales and generating traction and all of the things. But, you know, it's, it's almost like you'll be able to paint the picture that somebody who does not adopt Alife Health is at a distinct disadvantage when it comes to things like site reporting, which is really important and required by the CDC, right? So anyway, that's just kind of my observation about you guys.

Paxton Maeder-York:
Yeah. You know, so Melissa being incredible has recently created this new term or coined this new term of collective intelligence. And I think it really does a great job of describing what we're trying to do here. People all over the world who are leveraging IVF services to start families or grow their families or for whatever reason, you know, our, the treatment practices are very distinct all over the place and different clinicians have different approaches. And it's really cool because, you know, this industry is so new and it's such a crazy idea. If you really think about what's happening here, that you're going to create a baby in a petri dish and then put it back, it's like, it's wild that this exists, you know, 40 years later.

Abby Mercado:
So stick a little sperm in there with a needle or something.

Paxton Maeder-York:
I know! It's like how does this lasersome, you know, stem cells off and genetically test them and the baby comes out normal, like, how does that work?

Abby Mercado:
Yeah, I know.

Paxton Maeder-York:
So we're, we're still in such the early, early days of this industry. And, you know, I think one of the things that we are really genuinely trying to do is unite all of the clinicians around the world and create this collective intelligence that can help continue to push the standard of care forward and into the future in a positive way. And I think, you know, data science and data aggregation and everything that we're doing is really the best way to do that. And it's foundational and it's of course, we're trying to deliver this back and easy to use workflow software so people can adopt it in the clinics, and we create all this infrastructure for patients so they can navigate their experience, and we care a lot about the patient experience, but it's, at its foundation, I think Melissa nailed it when it's really we're trying to build collective intelligence as a globe, you know, as to how best to help people get pregnant when they suffer from infertility or for whatever motivation they need these services.

Abby Mercado:
So, you guys got all these clinics on board, you launched, you started collecting data. So how long did it take to kind of perfect, and I know like an algorithm is always being perfected with the addition of data, but like how long did it take for you all to kind of roll out your first MVP? I know you have a variety of products and I'm excited to get into them, but tell us about that first MVP.

Paxton Maeder-York:
Yeah. So we're because we're trying to build so much, we're doing it kind of in parallel. And also as we finish up products, especially the ones that may require large clinical studies, which clinical research is super at the core of what we do, we do a lot of peer reviewed research, we're publishing all the time with our co-authors and partners, but the first MVP of really what we built was really around the embryology piece of it, and it was an algorithm and a workflow software that allows clinicians and embryologists to snap images of embryos and save them in a really thoughtful way and also generate patient reports and do this all this cool functionality with on top of that, an analysis of the embryo quality and that tool we finished back in November and are now, it's now in clinical trials right now in the United States. And it's you know, it happened really fast. It took us probably about nine months from when we really brought in the technical team and had the technical talent on hand to go and build the whole thing all the way through all the regulatory stuff of documentation and everything. And so I think it's a testament that the team has done this a lot, built really complicated robotic surgery platforms. And so there's a lot of expertise, but, but that product was fast. And then the second product that ran the simulation optimization, which is we talk a lot about our on our website and is actually now going into clinics commercially and we've done 40 patients, ee had this incredible feedback, and we actually beat our expectations in terms of algorithm prediction accuracy, that product we built in like four months, it was really fast and it was, you know, the team continues to be really thoughtful about how they architect everything, but it's also that we focus maniacally on operations and process and how people are working together. And I think it's allowed us to stay very lean while also trying to build a huge scope of a project.

Abby Mercado:
Yeah, you know I have a soft spot in my heart for that, that product because I, I miscarried because I overdosed on .... It's like everything about the way that we are educating patients about stem meds and just all sorts of IVF meds in general, the way it's so repetitive, the way that sometimes it goes wrong and it shouldn't. Like this is an area of, I think things that go on, in the embryology space like that is so obvious, you know, like we all know, like we just need to get better at what goes on in the lab. But for you guys to just so quickly uncover this other other product and make it good and work for people to make patients lives easier and to make doctors lives easier. You know, I know that it can be repetitive, even for physicians. Anything that's repetitive should be bolstered by AI, duh. Like, come on, IVF, so I love it.

Paxton Maeder-York:
Yeah, it's been a super cool, cool piece of technology to build and it's incredibly impactful. You know, our early results from our research papers that are being published right now is that we can, we can, in many cases, get 30% more mature eggs to be retrieved out of the mother and also save them over 700 IUs of FSH. And what we see is that in the United States, clinicians do tend to dose a lot higher, and our our data suggests that that in many cases you don't need to dose higher in a lot of patients aren't benefiting from that additional hormone injection. But, you know, it's been a super impactful and exciting tool because we're really, with embryo predict and that piece of software, we're able to assess the quality of genetic material that's available at that time. But we're not really changing like the embryos are still the embryos, whereas with ovarian stimulation, we can actually improve the top of the funnel of the amount of eggs that are being retrieved from the mother, which is obviously the constraint given how much male genetic material there is out there that's not necessarily the one that we're constrained by, so super cool tool. And it was actually originally a year ago an intern project, we had a brainstorm, we heard about this might be something interesting to work on, one of our advisors is Eduardo Harrington at UCSF, he had done some work on it and we had this undergraduate intern who ended up who's just an incredible asset and incredible person work on it. And it's turned into the first product that's going to be commercially available this summer, so you never know where great ideas are going to come from.

Abby Mercado:
Yeah, that makes me so happy. I'm not sure if you know this, we share Eduardo as an advisor, so he's a formal advisor to Rescripted and we love him, we think he is just so smart and he's just so helpful, and just such a, such a force in this industry. So, yay, yay, Eduardo!

Paxton Maeder-York:
Yeah, he's awesome.

Abby Mercado:
So tell us, I think the only the only product that I saw on your website that we haven't discussed yet is the patient app. Tell us a little bit about the patient app.

Paxton Maeder-York:
Yeah. So we've talked to hundreds of patients and interviewed them across all our products, but there are some themes that just kept coming up over and over again. One, is that there's just so much information to absorb when you go to the clinic and they're giving you all these resources and talking to you about your care, it's just difficult to keep all that information collated and safe in one place, and then two, all the appointments and reminders and stimulations and all these things were really complicated. So, you know, we have a whole sector of ambition on the patient side of our business and really helping to streamline education, building community, you know, cost of IVF and how people pay for it, like there's all sorts of things we ultimately want to do over there, but we're really starting with a very simple app that just helps any patient navigate the process and save all the information and organize it and understand when all their appointments and things are, and from there we're going to grow it. I think one of the really powerful things about building out a patient portal here is that we can connect this to all of our other products, so the ovarian stimulation piece, like we can read that directly out, we can give them predictions to their to their iPhone on their patient portal, the embryo assessment piece. If the clinicians feel comfortable doing so, we can auto generate a beautiful report and get all the images back to the patient, so we hear all these patients are just getting printouts or a lot of them are just getting printouts of their embryos. And you're like, this is like a really amazing thing that you can have this photo and, you know, of your future child, like you should save it and have it. And also like ...

Abby Mercado:
Put it on your fridge!

Paxton Maeder-York:
Put it on your fridge, that you should own a digital copy of that. And also just like we kept sharing the challenges around transparency through the process and that's really something we want to fix is how can we make super smart tools for clinicians that make improving transparency and communicating with their patients is way easier so that patients have all the contacts they can see the embryos, their quality, why a selection decision was being made and and really feel more empowered about their care as they as they progress through the journey.

Abby Mercado:
Such a noble mission, it really is all about the patient, for sure. We obviously see eye to eye on that as well, given those similarities to our two businesses though. So obviously I can imagine what your sales pitch is to clinics like we're going to see, we're going to save your time, we're going to make you look better in the START report like we're going to help your patients make fewer mistakes, all the things, so kind of in your, in that like one sentence description of Alife like that is efficiency. Like those are the things that you sell to the clinics, great, to patients, great. Tell us a little bit more about efficacy and this is such a leading question. I'm sorry, not efficacy, equity. So this is such a leading question, and you kind of touch on it with the fact that there are only 40 fellows and all the things. So tell us, tell us a little bit more about equity and how Alife can hopefully get more people into the system, into receiving the reproductive health that they, healthcare that they need.

Paxton Maeder-York:
Yeah, 100%. So when I think about health equity and this is super core to Alife as a business and we really strive we're incredibly diverse internally at the company, our board, our CAT table, it's something we really focus on. We've developed this huge data set through our partnerships, and it's really one of a kind that we have massive amounts of data on all these different types of ancestries and patients from all over the country, and it's representative of the US population, which is astounding, it doesn't often happen in medicine and unfortunately historically in IVF or in medicine abroad, across the board, it's the, the representation of minority groups and research has been lacking. And so when we think about health equity, we really break it down into three categories. So first is cost, second is efficacy, and third is access. So first costs, like we know that the typical IVF patient is upper socioeconomic quadrant. Whenever you're, unfortunately, we're really just tipping, hitting the tip of the iceberg in most cases of who can access this care. And it makes sense, right? If you think about IVF, which is primarily over 70% out-of-pocket pay today and it cost $20,000 per cycle in an average of three cycles, that's a lot of money, right, in order to have a successful outcome. So the first thing we would focus on is how can we reduce cost to patients and obviously efficiencies in the lab and at the clinic, you know, that plays a big, big role in that. The second is in efficacy, right? So unfortunately, we know that people of minority backgrounds have worse outcomes in IVF than their counterparts. And there are a lot of hypotheses for why that is. And I think there's, there's a lot of more research and we're doing a lot of research on that issue to figure out how we can solve that problem. You know, obviously, if you improve the efficacy of the treatment, that means you're going to need fewer cycles and that's also going to impact your cost, but more than that, people obviously desire to take home a baby at the end of the day here, and that's really important. And so leveraging our huge and diverse data set, we can find these important correlations specific to people of different ancestries and deliver these precision medicine insights that hopefully will improve their chances of success and improve their overall care. And then the last thing is access. And I think access is really two buckets for me. One is just general education and awareness, which is something we do a lot on, we've got a full team that's building out education resources on our website. You can go to health and go to our Learn Hub there and look at our blog, and we do a ton of research we publish there as well on these types of topics. But the second thing is, as you mentioned, we are losing doctors and we don't have enough doctors. And so one of the things that the Alife suite is really built to help with is to enable improved efficiency of the line, however, many reproductive endocrinologist we do have manage a larger group of alternative providers delivering care. And the challenge there is how do you enable a nurse practitioner or a physician assistant or whoever to deliver care at the same quality as the best clinicians? And that's really where the magic is. And to do that, you really need two things, which is what we're building. You, one, need software infrastructure so that the reproductive endocrinologist can have oversight over all those alternative providers. And two, you need AI software that helps make recommendations to help guide those more junior clinicians or NPs and PAs who don't have the luxury of 35 years of experience stemming patients and know what the right answer is, right? So and that hopefully over the long run will enable us to have a broader provider base and allow this access to be more affordable and have people across the health equity spectrum get access to IVF care.

Abby Mercado:
I love it and thank you for breaking that down into three very separate and distinct buckets. I, when I was working in DC immediately prior to starting Rescripted, we were, the firm that I was with, we were invested in an AI company and it was, it was so challenging and I was in the energy space and it was so challenging watching this company sell to, I mean, these large oil and gas companies who are like, wait a second, this, the computers are just taking over our jobs like these AI machines, I don't know what these like, what is this? What does this mean? But here it is so different because there is so much data that suggests that there are just not enough doctors anymore. And the thing that is really, really hopeful is I think Fertility IQ put out a report a couple of months ago that said coverage is increasing 18%, increase 18%. So more people are getting access, which is awesome. But, you know, at the same time, like we have eight-week long wait lists for every single doctor in the country, if not north of that. So yeah, it's that, it all makes just a ton of sense. I feel like I always do this on this podcast. I like really just fangirl over your company. So anyway, I love Alife. So a couple just quick, quick questions that I want to get into before we conclude. So how much, how much money have you raised?

Paxton Maeder-York:
We raised $32 million dollars so far across our rounds.

Abby Mercado:
That's a lot of money, so congratulations. I know as a founder who's also raised money, that is always very challenging. So tell me, Alife is a lot more than a software company, Alife is a data science company. So break it down for the listener, why does it take so much human capital to have a data science company versus just any other software company you see on in Silicon Valley?

Paxton Maeder-York:
You know, I think, I think really it's about not just the data science piece, but it's also about what we're trying to build and the complexity of building medical technology, which is really what we are right, you know? There's traditional tech and consumer tech which you can make an app and that's pretty fast or you can make a dashboard online and that's pretty easy. But when you're starting to talk about things like medicine and helping, and clinical decision support software and helping clinicians make good treatment recommendations, you know, these are, these are medical instruments, these are medical devices. And so there's a lot more that goes into how carefully we design these systems, how much we document, how much we test. We are incredibly rigorous about how the quality of what we build because it has to be, you know, this is, it's closer to building spaceships than it is to building traditional apps. And so that requires really smart, really experienced people who know how to do it. And so, that's who we've brought around the table here at Alife is, is really the best that Silicon Valley has to offer. I'm really fortunate I get to work with a lot of people that are a lot smarter than me to build this technology, and so that's one piece of it. I think the other piece of it is, on the back end when you're bringing this type of technology to market, rightly so, the medical community is going to require time to build clinical conviction around what you're, what you're telling them and what you're building. You need to do studies, you need to show research, you need to publish papers, you have pilots and have people try it out and see that they like it, and that's how it should be, right? Like this is, this is we're talking about people, people's bodies and having them help create new life. So it's always going to be a longer process and a more complicated process in building these types of technologies. And that, of course, means more capital in and in order to get these people around the table and be able to do this. But ultimately, this is a really impactful technology, it's one that if we're successful, will be able to put into market and put into clinics and have people use for a long time. And really what we're offering today that people know about today is really just the beginning. And I'd say that's really the piece that is important to recognize. Is that, it was a lesson I learned at Auris and again at GoogleX and throughout my life, which is, you know, the products are amazing, but the company is really the product, the organization, the people, the how people work together, the processes, the, the know-how, all of that of how you bring a collective group of people of incredible and diverse backgrounds to work together to build these things over and over again and expand what our offering is, that's the magic, that's the real product that you're building over time. It's not whatever the software comes out the other end of the process, and that's what we're focused on building, is building a team that can build amazing technology over and over again, continue to expand and deliver really valuable insights and AI to this field of medicine.

Abby Mercado:
Awesome. It's super clear that you're an amazing leader. So thank you, thank you on behalf of your team for talking about your team in that way. So team, team is everything. So very last question. I asked this at the end of every episode as a fertility founder, what is one thing that you would rescript about the fertility industry?

Paxton Maeder-York:
Is rescript just one thing that I can change over ...?

Abby Mercado:
Yeah, yeah. It's a word I made up. And then I started.

Paxton Maeder-York:
I love it.

Abby Mercado:
A company and we called it that. So yes, rescript, reframe, you know, change the narrative, all of the, things like that.

Paxton Maeder-York:
Yeah. I mean I'll, I'll give you a cop out answer, which is that I just wish that everybody who needed fertility services could access those fertility services. I think that's just, you know, this is such an important area of medicine and it's only going to become more important over time. And it's one that desperately needs a lot of innovation and support and just broader awareness around, I think, I think is really important. I think if there was a more specific thing that, that I would like to change, it would be the idea of doing more preventative reproductive health. I think people, when they're younger, should be educated about this. I think the part of the freshman of college year, orientation curriculum should be let's talk about your reproductive health and how that's going to look just as much as they talk about people not trying to get each other pregnant, it's let's talk about what is what is this actually going to take when you do want to have kids? How can you take steps now to to make sure that you're going to have that opportunity later on regardless of your career, career track? I think that education piece is something that I would love to change, and I think there's a financial component to that, of how can we give people preventative insurance, if you will, or something that allows you to pay for it down the road if you do need this this type of care and to it's just, hey, what treatment? Is it egg freezing? Is it even, just how, you're healthy and or just being, like, aware that this is something that will probably come down the pike at you when you're 28 or even older or younger? I think that would be an important thing, but I would love to rescript.

Abby Mercado:
Awesome. Yeah, we talk, we talk a lot over at Rescripted as to just how broken sex ed is in America. It's just so broken. And the latest stat, one in five people have infertility that is defined as it taking a year or longer to conceive a child. So big problem. Thank you for, for wanting to rescript it.

Paxton Maeder-York:
We didn't really touch on obviously the recent Supreme Court case with Roe v Wade and its implications obviously across that specific area, but also in the IVF case as well. I mean, we're going to see, unfortunately, people having to do more medical tourism to getting IVF care. The clinics that are already have eight week lead times are going to be swamped with even more patients from more conservative states. You know, same sex couples or anyone that needs surrogacy is going to be, in a way, a tougher time finding, a way tougher time finding those types of services, because people aren't going to be willing to risk their bodies if they can't perform a medically required abortion down the line. So it's, it's going to be really tricky to see how this pans out for for the industry. You know, a lot of that stuff, the things that we hope that we can bring value and help alleviate some of those stresses, especially around cost of when you add in tourism and travel, trying to get this done in two cycles versus three and also helping clinics operate more efficiently and scale up their operations to meet the growing demand. But that is another piece that I think is, is very sad to see and important to recognize in this field now.

Abby Mercado:
I don't know what else to say, besides it is just a shitstorm. So I agree with, with all the things, we've definitely got a problem, but Alife is part of the answer, so.

Paxton Maeder-York:
Very small piece, but we're hoping, hoping to help a little bit in the ways we can.

Abby Mercado:
Well, thank you so much for joining us today, Paxton. This was an absolute joy and I learned so much. And thanks for letting me ask you all, all the hard questions and really letting me dig in. So where can people find you?

Paxton Maeder-York:
Online at AlifeHealth.com you can find us on LinkedIn and you can also find us on Instagram at AlifeIVF. So please follow us and we look forward to keeping you informed to our progress and where you can get an Alife software, an AI supercycle somewhere near you.

Abby Mercado:
Awesome. Well, thanks again, Paxton, and we will talk soon.

Paxton Maeder-York:
Awesome. Thanks, Abby!

Abby Mercado:
Thank you for tuning in to the Future Of Fertility. We hope you live here feeling empowered about all of the exciting innovations taking place in the fertility space. If you like today's episode and want to stay up to date on our podcast, don't forget to click subscribe. To find this episode, show notes, resources, and more, head to Rescripted.com, and be sure to join our free fertility support community while you're there.

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