As a part of my interview series with leaders in healthcare, I had the pleasure to interview Anne Hogarty. Anne is chief executive officer at Extend Fertility, the first fertility company built from the ground up for women who want to preserve their fertility for the future. As CEO, Anne is leading the rapid growth and expansion of Extend Fertility to fulfill its mission of creating more fertility options for all people. Prior to joining Extend Fertility, Anne was chief business officer of Prelude Fertility and president of MyEggBank; from 2013 to 2017, she worked at BuzzFeed and oversaw their revenue-generating strategy and operations in 9 countries outside of the U.S., doubling BuzzFeed’s international revenue within two years.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
I joined Extend Fertility for both personal and professional reasons. On a professional level, I am drawn to working with emerging companies that are challenging the status quo in staid industries. BuzzFeed did that for the media and Extend Fertility is doing that for fertility care. Extend Fertility was founded as the first fertility company looking to meet the needs of women seeking to preserve their fertility and we have become one of the largest providers of egg freezing in the country, completing over 1,000 cycles in 2018.
I also believe passionately in Extend’s mission: To help people build families when they’re ready. I think modern life has gotten very complicated and unfortunately a woman’s peak reproductive years coincide with the years when many women are still trying to find the right partner and working hard to advance their careers. So, if everything hasn’t fallen into place for you to have a family by your mid-30s, we can help take some of the pressure off of adhering to the “typical” timeline.
I first became aware of this market a few years ago when some of my good friends started to freeze their eggs. Now, many of my best girlfriends who were not ready to start families during their peak reproductive years have frozen their eggs. I am so grateful that they could leverage this amazing technology, vitrification, to increase the chance that they will be mothers. I can’t wait to meet their amazing children some day!
Can you share the most interesting story that happened to you since you began leading your company?
Watching life literally being created in our state-of-the-art embryology lab will never get old for me. In one of my first weeks on the job, I spent a morning putting on scrubs and shadowing our lead embryologist, Dr. Leslie Ramirez. I used to think my job was challenging, but seeing the precision with which the embryologists handle the microscopic oocytes, identify the mature eggs that have been retrieved, and freeze them using liquid nitrogen makes being a CEO seem like child’s play!
Of all the amazing things I’ve seen in our lab, nothing tops watching our senior embryologists perform Intra Cytoplasmic Insemination (ICSI), where they inject a sperm into an egg to make an embryo and actually create life in a petri dish. While Extend began with a focus on egg freezing, our lab has also been doing in vitro fertilization (IVF) since the company’s inception. (After all, our egg freezing patients will likely return to use their oocytes to make babies someday.) So my favorite days include getting to be a fly on the wall in the lab — even if I look terrible in scrubs and a hair net.
Can you tell our readers a bit about why you are an authority in the healthcare field?
I am an authority in the healthcare field only as much as any woman who is seeking to navigate her life and health is. At Extend Fertility, we see women every day who are making the brave decision to learn more about their fertility health and figure out how to increase their chances of having children — if that’s what they want. In overseeing the company that did more egg freezing cycles in 2018 than any practice in the U.S., I have a unique perspective in understanding how technology is helping the field of women’s health rapidly evolve.
What makes your company stand out? Can you share a story?
In the fertility industry there are currently three kinds of companies: long-standing academic medical institutions, brand-new entrants that have turned the marketing spigot on while establishing operations and Extend Fertility.
The fertility industry has been doing things the same way for decades, led by long-standing academic institutions that are focused on treating couples struggling with infertility. Egg freezing is a side-business for them and many of them are not motivated to keep up with the latest technological advances. Then, there are new entrants into fertility, many of whom are really fertility marketers. They’ve seized onto egg freezing as a self-care, wellness trend and are aligning it with things like juice bars, pop-up shops and spa treatments.
Extend really stands alone in this space because we launched as egg freezing specialists, with three things that set us apart: clinical excellence, a hospitality-based approach and accessibility. We feel that women who want to preserve their fertility should have access to clinically excellent care in a comfortable and supportive setting. We built a state-of-the-art lab on-site and have hired reproductive endocrinologists from the best institutions. We are also committed to accessibility. This means we’re transparent about our pricing, which is significantly lower than the national average. We’re also deeply committed to education, offering opportunities to learn about fertility and egg freezing monthly at information sessions and via a phone call with a fertility advisor.
Extend Fertility stands out because we go above and beyond for our patients. One example of this is that we provide discounts to patients seeking to freeze their eggs due to medical diagnoses, particularly cancer. For cancer patients, chemotherapy and radiation can have a high probability of destroying their fertility. A few months ago, we had the family of young girl suffering from a severe brain cancer petition to have her sister freeze her eggs for her. She had first contracted the disease as a toddler and gone through several rounds of chemotherapy, making it unlikely she would ever be able to conceive with her own eggs. Of course, our answer was a resounding yes and made me feel so thankful to be part of a company that cares so much about helping others.
Can you share with our readers about the innovations that you are bringing to and/or see in the healthcare industry? How do you envision that this might disrupt the status quo? Which “pain point” is this trying to address?
Extend Fertility was founded in 2016 as the first fertility company built from the ground up for women who want to proactively preserve their fertility for the future. For the first time ever, women in their 30s are having more children than those in their 20s according the CDC. However, this social shift has not yet had an impact on the biological “clock” that impacts fertility; that is where Extend Fertility can help provide women with more options. By providing egg freezing as a proactive option, Extend Fertility can help reduce the prevalence of later fertility problems amongst reproductive-age women — over 1 in 10 of whom struggle with fertility, according the CDC.
The status quo within the medical industry has continuously underserved women when it comes to fertility, with many women not learning about fertility until they are trying to conceive — often today well into their 30s, when the possibility of fertility problems are already high. This is why Extend Fertility focuses on providing in-depth education to women, from the very first contact, about fertility, the biological clock, and the potential benefit of egg freezing to extend a woman’s timeline for having children. We address this lack of information while continuing to uphold clinical excellence in an industry that is modernizing quickly and leaning into wellness trends. This allows women to make informed, smart decisions about their fertility and provides them with the best chance for success with egg freezing.
Are you working on any exciting new projects now? How do you think that will help people?
We want to see Extend Fertility not only at the forefront in creating options and choice in family planning, but also as advocates and standard bearers for truth and transparency in the fertility process. To start, we’re expanding our services to the West Coast and building out our infertility services like IVF and IUI to create better experiences for those dealing with infertility. We’ve also created a research center of excellence to address the gap in fertility research and to help the industry leverage accurate data to better serve the needs of those who want to have children. We’ll continue to test and iterate over the next few years and apply our learnings to our overarching purpose.
What are your “5 Things I Wish Someone Told Me Before I Started” and why. (Please share a story or example for each.)
- Healthcare is different. While I have been in the fertility industry for a few years now, my background is in the finance and media businesses. I think it’s important to recognize that healthcare is a more deeply personal service with higher stakes. I am reminded of that every time I speak to one of our patients about her experience, which is something I try to do as much as I can.
- Healthcare isn’t different. Thankfully, consumers are starting to demand that healthcare services evolve just as every other consumer-facing sector has evolved today. While healthcare should be approached more carefully by disruptors, longtime providers should not get a pass for poor customer experience or lack of transparency in the 21st century.
- It’s all about the people. Every business gets its heartbeat from the people who work there. Extend’s workforce is over 80% women, but we come from all walks of life and approach problems from many different angles. That diversity of background and thought can lead to intense debates, but ultimately makes us better at what we do.
- Embrace the skepticism. There are still many people who are skeptical about egg freezing — and perhaps frightened by the freedom it can give women to live their lives on their own terms. Seeing the amazing work our clinicians do with patients every day can make me feel very angry when our motives are questioned. But I’ve learned that I should embrace conversations with skeptics, because that’s the only way I can get them to change their minds!
- Bagel Mondays go a long way. At BuzzFeed, where I previously worked, we had loads of perks that I felt most of us took for granted. However, when I hired a former coworker to join us at Extend, he suggested Bagel Mondays and oooh what an impact a little food at the office can make. Any personal sense of Sunday Scaries is definitely decreased by knowing there’s a bagel and coffee, and perhaps an unexpected conversation with a coworker, waiting for me when I get to the office Monday morning.
Let’s jump to the main focus of our interview. According to this studycited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?
We spend more per capita on healthcare than any other nation and yet we have more maternal deaths during childbirth than almost any other developed country. Why haven’t we focused on nailing the one medical event that literally every person goes through, by either giving birth or being born?
Sticking to our free market roots, the U.S. doesn’t have a nationalized medical system, and yet consumers in the U.S. — who are paying for their own healthcare! — get very little transparency around the prices they are asked to pay for everything from labor and delivery to knee replacements.
The U.S. healthcare industry is dominated by large incumbents, from the health insurers to pharmacy benefit managers to large hospital chains. Innovation and improvement is driven by startups, like Extend Fertility, that can challenge the status quo in an industry and give consumers a different, better option. We need to decrease the barriers against healthcare startups shaking things up.
While women have gained so many rights and freedoms in the U.S. over the past century, our bodies are still often ascribed symbolic value — political, religious, biological — causing any advances in fertility science and care to take on outsized meaning and controversy. Upon telling one friend I was going into the fertility industry, he said “how sci-fi.” Actually, women deserve to benefit from medical advances, and to receive all of the options that modern medicine can provide, just as men do.
You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
- More transparency in healthcare pricing. Some in the medical establishment like to posture that cost shouldn’t matter. Well, unfortunately, for most Americans it does. According to NHIS, nearly three-quarters of Americans between ages 20 and 65 said they were insured but could not pay their medical bills. At Extend Fertility, we believe in explaining exactly what everything costs, and what is included, because we respect our patients’ desire to make decisions about what is best for them based on the facts, including cost.
- Better use of technology in healthcare. Fewer long, opaque paper statements sent to sit in your unchecked mailbox and more real-time communication with patients via the communication platforms they’re on all day long.
- Fertility benefits for all. How and when Americans decide to build families has fundamentally changed. There are more same-sex couples and more couples in their late 30s and 40s who want children and need fertility treatment to help them achieve their goals. Companies, and perhaps the government, should contribute to reduce the cost of assisted reproductive technology to give all people the chance to be parents.
- Paid maternal, and secondary caregiver, leave for all. There are more dual career households than ever before in the U.S. and reproductive and career timelines now converge in a stressful way. Paid leave can give women the chance to recover and return to work healthy; give secondary caregivers and men adequate time to bond with their babies; and help families establish healthy relationships that will benefit children throughout their lives. It’s a no-brainer.
- The continued rise of “femtech” companies. Women are eagerly seeking better solutions to their healthcare and startups are finally supplying new answers, from organic tampons to ovulation calculators to egg freezing. Investors should continue to support, and fund!, femtech companies.
Thank you! It’s great to suggest changes, but what specific steps would need to be taken to implement your ideas? What can individuals, corporations, communities and leaders do to help?
Individuals should demand good care and always seek to understand their health options. For women, that means not being embarrassed to ask basic questions about their fertility and fertility preservation. There’s a reason reproductive endocrinologists, who provide fertility care, are some of the most highly trained doctors in the country — fertility can be complicated!
Leaders should put the health and wellbeing of their constituents and employees first. And they should recognize that a woman’s health is often the key to a family’s success, given that women in the U.S. are still primarily responsible for childcare and domestic chores. So consider that in your maternity leave policy and what fertility benefits you provide.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
When I (very occasionally) get out for a run, it flies by if I listen to the podcast, A Healthy Dose. The business geek in me enjoys the way the hosts dissect business models and I always learn something new about our healthcare system.
For books, I love Atul Guwande’s Being Mortal, Paul Kalanithi’s When Breath Becomes Air and my fellow college newspaper editor Daniella Lamas’s You Can Stop Humming Now. All three authors are physicians and capture the intricacies of medicine as a science and also the vulnerability and humanity that we all have or will experience being a patient.
How can our readers follow you on social media?
Follow us @ExtendFertility on Instagram, Twitter, Facebook and LinkedIn or connect with me on LinkedIn!
Thank you so much for these insights! This was so inspiring!