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Delaying the menopause to increase women’s healthspan:

Reproductive longevity

Author

Daragh Campbell

Scientific Editor (Former)
Longevity.Technology Market Intelligence Unit
  • Reproductive longevity is important for two key reasons: firstly, menopause is associated with a health decline in females which means women can spend a significant proportion of their lifespans in poor health and, secondly, reproductive longevity is associated with a pressure on females to reproduce before they reach the average age of infertility
  • There are few companies that are targeting reproductive longevity using geroscience methods, but the companies that are already in the game present an exciting opportunity for investors
  • Companies in this space need the proper investment to generate efficacy data to enable them to succeed given fierce competition in multiple markets
  • Where’s it all headed? We expect this segment of the longevity industry to grow as the industry itself continues to accelerate and gain prominence, and women’s health and fertility markets boom as a consequence

Longevity isn’t just about living longer and having more days in your twilight years; rather, it is about drawing out your life while maximising the number of healthy days and delaying age-related decline for as long as possible. This includes fertility, as for women, an extended life currently means a narrower fertile window relative to lifespan.

Delayed childbearing has an impact on fertility, as both the number of eggs and their quality declines, but lifestyle and economic factors often mean that more women are opting to have children later in life. As the ovary ages, and women enter the perimenopausal and menopausal stages of life, a significant proportion of females also have a decline in their quality of life.

Ova can be frozen to artificially extend fertility, and hormones can be replaced to help with menopause, but geroscience approaches could consign both of these processes to history.

Traditionally the female fertility industry has been dominated by large clinics offering similar treatments at similar price points. There are a number of bottlenecks in fertility services including access, cost of treatment and lack of digitisation and automation within the most basic procedures. Lengthy, expensive, and sometimes distressingly ineffective experiences are the norm.

An intervention that could extend fertility, delay menopause, and extend longevity therefore has huge potential from an investment perspective

This one is interesting. Reproductive longevity goes beyond what it might mean for a woman. It could potentially impact on every individual on the planet.

The ovary is the first organ to age. And its aging is premature – it is literally termed ‘geriatric’ by the time a woman is 35. It will take this woman another 30 years to catch up with her geriatric ovaries.

Studying the reasons why ovaries age prematurely could have direct implications for understanding aging in other organs and interventions that could prevent it.

For many women, having children is still a key priority, but as career opportunities and choices have improved for women, particularly in the developed world, more are choosing to wait longer before having children. This is creating a huge, and growing market of women looking for fertility aids and the global infertility treatment market is estimated to reach $2.1 billion by 2026[1].

In addition, reproductive longevity could help delay menopause or make it more manageable. Perimenopausal and menopausal woman are arguably the most untapped market on earth. There are 48 potential symptoms associated with menopause, of which only three are openly discussed, and all are often not taken seriously or ignored. However, this is changing, and women are becoming more vocal about their needs in these turbulent stages of life. The estimated global economic cost of menopause is also staggering – the burden on the economy due to productivity losses alone costs $150bn[2].

The science community has noted that reproductive longevity is not keeping pace with anti-aging progress; indeed a $6 million gift from a Silicon Valley-connected, tech-focused lawyer, entrepreneur and philanthropist was recently given to the Buck Institute for Aging Research to specifically redress this issue.

Companies founded each year as percentage of total. Analysis by Longevity.Technology, according to Pitchbook data as of 23 June 2022, based on 6 companies.”

Consequently, there are only a few companies that are targeting reproductive longevity using geroscience methods, but those companies already in the game present an exciting opportunity for investors; almost $100m of venture capital was invested in these companies over the period 2015 to date.

Reproductive longevity venture capital investment ($M. Analysis by Longevity.Technology, according to Pitchbook data funding data as of 23 June 2022, based on 6 companies.
Reproductive Longevity Companies yearly deal count.  Analysis by Longevity.Technology, according to Pitchbook data funding data as of 23 June 2022., based on 39 companies.”

Investment by location

Number of Reproductive Longevity Companies by region.  Analysis by Longevity.Technology, according to Pitchbook data funding data as of 23 June 2022, based on  6 companies.”

As previously stated, targeting reproductive longevity using geroscience techniques is still a relatively young field. The US is leading the race in terms of company formations. Asia has also taken an interest perhaps driven by notoriously low fertility rates in this region, which will threaten economic growth, presenting big opportunities for reproductive longevity companies.

Reproductive longevity methods

The number of Reproductive Longevity companies by category. Analysis by Longevity.Technology, according to Pitchbook data funding data as of 23 June 2022, based on  6 companies.”

Companies that have sprung up in the reproductive longevity field are using different targets and methods to tackle reproductive aging. Each has its strengths and weaknesses in terms of route to market, potential efficacy and investment required.

Technical Risk

At present, infertility and menopause are usually treated as two separate issues. There have been two key areas of focus in terms of dealing with these issues – improving fertility through assisted reproductive technologies (e.g. high cost and low success rate IVF programmes) and ameliorating the effects of the menopause, through hormone replacement therapy.

Both are multi-billion-dollar markets but treat consequences instead of focusing on prevention. A technique that extends reproductive longevity will impact on both industries and could also impact the life and healthspan of women, accessing the longevity market on top.

Companies in the space need the proper investment to generate efficacy data to enable them to compete aggressively in all three markets.

Market risk

Little is known by the general public about the impact of reproductive longevity on women’s health. Companies in the space need the runway to drive their therapeutics programmes but also must engage with scientists, clinicians, policy makers and the public to elevate the conversation around women’s health to explain how targeting reproductive longevity using geroscience approaches should be more fruitful than current interventions.

Market adoption

At Longevity.Technology, we conducted a survey of 1000 females in the UK population and analysed the results of those between the ages of 18-44 (457 respondents). When questioned whether they would take an intervention to delay menopause and extend fertility, 32% said yes (intervention methods included: take a supplement; take a prescribed drug; freeze my eggs; remove an ovary; undergo HRT). This percentage, when extrapolated, corresponds to 3.6 million women in the UK population and 20 million in the US (between the ages of 18-44). We predict these numbers to grow even higher as females begin to understand the impact of menopause on the aging process and how they could manage and improve their own fertility in a safe and effective manner.

“% of British women that would take an intervention to delay menopause and extend fertility. Results from YouGov poll, conducted by Longevity.Technology, asking women aged 18-44 if they would take an intervention to delay menopause and extend their fertility”

Clearly, there is a large and growing potential market, and a longevity company that can produce clinically sound data to prove its intervention can delay the reproductive longevity process offers huge potential.

There are several companies already in the field of reproductive longevity, but we expect this to grow as the longevity industry continues to accelerate, and women’s health and fertility markets become more prominent and potentially boom.

To invest in the university spin-out, IP-rich tech companies in this space requires patient capital and extended time horizons, and investing in a field as specific and emotive as fertility will in addition require domain expertise to understand the science in this field. However, we at Longevity.Technology believe this is an exciting opportunity to watch out for.

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