Four years ago, San Francisco newlyweds Deborah and Jake Anderson-Bialis booked an appointment at a fertility clinic.
Deborah was just 26 and Jake 32 at the time, and neither was quite ready for parenthood. Deborah had some health issues as a teenager that threatened her ability to conceive, so they decided to get a jump on things and investigate fertility-preservation options, such as egg freezing.
The Journey Begins
“We went in thinking this was a smart move,” Deborah recalls. By being proactive, “we’ll have no fertility worries” in the future, she believed.
Instead, the experience was disastrous. Unsure of how to find a clinic, they went to one recommended by a friend. After a medical workup at the facility, Deborah was first erroneously told that she was approaching menopause—which is shocking news for a 26-year-old woman.
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Then, in a subsequent visit, a $20,000 egg-retrieval procedure involving painful hormone shots yielded no viable eggs—because the doctor wrongly advised Deborah to continue using her IUD.
They had an even worse experience at a second clinic where a staffer misread Deborah’s chart and gave her the wrong drug instructions. She got home to find a voicemail from the clinic ordering her to go to the ER because the instructions put her life in danger.
Many months and thousands of dollars later, the couple was left feeling extremely frustrated by their ongoing attempts to navigate the murky world of fertility treatments.
“There was a lot of mismanaged medical advice,” Deborah says. “Errors at the clinical level kept happening, and I didn’t have a voice to be able to give feedback in a way that I thought would improve the system.”
The couple realized they weren't alone in their frustrations as Deborah began fielding more and more phone calls from friends of friends who had heard about her experiences and wanted to know where they should go.
“I told them, I’m not the best resource to be giving you advice, but I would love to build a website that can answer all your questions,” Deborah says.
With that, a promising business venture was born.
Getting Things Off The Ground
Determined to help others avoid the problems they endured, Deborah and Jake kicked around the idea of creating a website that would post crowd-sourced reviews of doctors and clinics—so patients could share their experiences, good or bad. The site would also be a source of up-to-date information on fertility treatments and breakthroughs.
The timing was perfect. A few months before coming up with the website idea, Jake had quit his job at a venture capital firm, and Deborah had left the nutrition app where she worked. Both wanted to pursue business projects they were passionate about that would make a difference in the world.
“We wanted to do something that was impactful and that we really cared about,” Deborah explains. “When we landed on this idea, it felt right.”
The couple knew that they wanted real reviews from fertility patients detailing every aspect of their clinic experience. While several health websites offered these kinds of crowd-sourced reviews, there was no site offering unbiased assessments from patients about their experiences with fertility doctors and clinics. To read firsthand accounts, patients could either troll fertility message boards, where the content tended to be very emotional, or peruse CDC data on success rates, which isn’t an accurate gauge.
“We found out that clinics manipulate their numbers by taking on some cases and not others or by shuttling certain patients into specific treatment types,” Deborah says. Also, a clinic might not accept a couple if either partner has a health issue that they feel might hurt their success rates.
After nearly a year of hard work, their website, FertilityIQ, debuted in February 2016. "We are a site that helps fertility patients, from egg freezers to IVF patients, find the quality care that they deserve,” she says. “We think of ourselves as Bloomberg for fertility,” she added, referring to the financial media giant.
“Our data comes from a community of fertility patients, the majority of which are verified, and since we take no money from clinics, patients know our data is 100% unbiased," notes Deborah.
How They Made It Happen
The goal is for FertilityIQ to become the go-to resource for men and women trying to feel their way through the world of assisted reproductive technology. It's been dubbed kind of a Yelp for fertility treatments.
But as rewarding as their journey from patients to entrepreneurs has been, getting FertilityIQ off the ground wasn’t without its challenges. Below, the couple outline their business plan and strategy—plus what the future holds.
Preliminary Research: Before anything else, Deborah and Jake spent months interviewing roughly 50 couples who had visited clinics across the country. “We were trying to identify key patient populations and things they wish they’d known to look out for,” Deborah remembers. “What would have made their journey easier? What types of resources do they wish they’d had?”
They also gathered information from fertility physicians themselves and other specialists in the field: clinicians, therapists and acupuncturists. “They gave us a good sense of what the pain points are in the process and things that tend to go wrong frequently,” she says.
In addition, she adds, “we wanted to make sure that clinicians thought the way we collected data was responsible and medically sound, in the hopes that they would be inclined to incorporate the feedback into their practice.”
Based on those conversations, they built the assessment form for users to fill out once the site went live. The form, which they ran by data scientists, has 80 questions, to encourage readers to give lots of detail. The more information available, the more useful it would be to patients.
Funding the Business: Rather than seek capital from outside investors, the couple decided early on to self-fund FertilityIQ. “We felt this would give the product the best chance of lasering in on what matters to us, which is the patients,” Deborah explains.
To have enough funding to work with, they made sure their financial health was in order and went into savings mode leading up to the launch. “We resisted upgrading our lifestyle when either of us got a raise or a bonus," she says. "We still drive cars that are 10 to 15 years old.”
Building and Launching the Site: As part of her role as CEO, Deborah served as a product manager (her former role at the nutrition app where she previously worked). She oversaw a team of engineers and began a soft launch in summer 2015.
“We wondered whether people were going to give us this information, because it’s very personal and time-consuming,” Deborah says. Yet within an hour, they began getting responses from friends and acquaintances and then users who happened upon the site. As data came in, the site grew. To date, FertilityIQ has thousands of reviews covering 90% of the fertility clinics and 80% of the fertility specialists in the nation, they estimate.
Without a budget for an extensive PR strategy, they publicized FertilityIQ themselves on fertility chat boards and through support groups and therapists. Their tactic seemed to work. To date, the couple believes the site attracts 10 to 20% of all U.S. patients considering fertility treatment in any given month. The site is growing 30 to 40% per month.
Facing Down Roadblocks: Though pleased with the initial responses and success, “it’s still a lot of effort to get the word out and keep the data coming in,” Deborah says. “For each assessment you see on the site, there is a puddle of sweat on the ground, because we’ve worked so hard for each and every one.”
The difficulty in getting patients to craft thoughtful answers on the assessment form lies in the personal nature of the questions. Patients are typically very sensitive about going to a clinic or physician, and they are selective about who they trust with the details, she says.
Money has been another source of stress. They hadn’t anticipated how complicated the data-processing tools the site requires would be to implement, which means paying extra for engineers to perfect the search mechanism.
The rewards of scrimping and saving to run a business together, however, have been enormous. “We have the freedom to wake up every day and work on something we truly care about,” says Deborah. “Plus, we now get to spend all of our time together—when we had different jobs, we had just 90 minutes with each other every day. It’s been great for our relationship and our quality of life.”
Thanks to a network of friends in the San Francisco area who are also entrepreneurs, the couple lucked out with a strong support network who offered their help gratis.
“Some were enthusiastic about seeing us take on a mission-driven project to solve a problem; others had experienced infertility themselves or knew someone who had and wanted to contribute,” Deborah says. For example, earlier this year they received an email from a scientist struggling with infertility who offered to help them with analytics because she wants to make it easier for patients to find the right doctor.
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Their Future Plans
These days, the couple is concentrating on gathering enough data so that when people turn to the site to search for an MD, they can find feedback from patients who fit their exact demographic profile, in terms of history, income and location. Down the line, they’d like to incorporate information about other areas of fertility, like reviews of sperm banks and surrogate agencies.
At some point, they hope to put the site behind a paywall. But for now, FertilityIQ is free for viewers and contributors. Once the site grows bigger and they have a better sense of how people use the data posted, they’ll try to figure out if and what to charge, Deborah says.
And on a more personal fertility front, the couple has just welcomed a baby of their own. They found a doctor they loved based on some of their early FertilityIQ research and, just before beginning a round of IVF, Deborah discovered she was expecting. Their son, Lazer, arrived on April 30.