Hey Apple, Let’s Build An IVF Clinic Together

A million babies a month and half a trillion dollars in yearly revenue

To: Board of Directors, Apple Inc.

From: David Sable, MD

Re: Collaboration with Apple Inc. in reproductive health

Dear Apple,

From the days of my first G3 titanium powerbook to today, typing on my M2 MacBook Air (8/512/space grey), I have confidently turned to Apple as my technology partner. Your hardware and software have been the tools in transforming my and my colleagues’ ideas into tangible reality.

I wish to return the favor.

You may have heard of in vitro fertilization. In fact, based on demographics it’s likely that every member of the board of directors of Apple, and most of your employees, is either an IVF parent, an IVF baby, or is one degree of separation away from one or the other. IVF is a safe and effective procedure, and one that has resulted in almost eleven million babies in a little over forty years, currently about 600,000 worldwide per year.

It is not an exaggeration, however, to state that IVF is just getting started. 600,000 babies in a year seems like a lot. But the reality is that in addition to the 130 million babies born worldwide each year, there are another twenty million plus families who cannot conceive a child without help. There are millions more for whom IVF could help prevent a fatal childhood disease, and millions more of our LGBTQ friends, family and neighbors who could not become parents with it. An adequately scaled IVF ecosystem could preserve the fertility of the million or so men and women who develop cancer before they have families, young people whose life-saving treatments often render them infertile.

The problem is not the IVF procedure itself. The problem is scaling IVF to meet the needs of the tens of those who currently lack access to it. IVF now is like computing in the 1970’s: concentrated around mainframe hardware, with layer after layer of people standing between the magic created in the microchip (or in this case, the embryology lab) and those whose lives will be improved, restored or jump-started by that magic.

Now here’s the best part. I get that Apple is a public company and is tasked to produce profitable growth. And damn — you’re good at it. But IVF may not have penetrated your radar, so let me convince you that adding IVF to everything else you do really can move the needle, even for a 2.8 trillion dollar company.

Our current great science / mediocre engineering IVF world generates about 20 billion or dollars or so of revenue. These are profitable businesses; private equity firms have been paying 10–15 times cash flow for them. Less than a million people are treated per year worldwide, and efficiency has never been much of a priority. Globally, we have somewhere around 7,000 IVF labs, each one an artisanal kitchen with its own vocabulary, standards and practices, often passed down in “it’s the way we’ve always done it” fashion. Importantly, little effort has been made to collect, analyze and benefit from the tremendous amount of data that each cycle creates.

Now insert an IVF version of: an App Store / iCloud / ivfOS / and some sophisticated hardware — most of the hardware having prototypes in use in other areas of cell biology or just being developed now for IVF, converging into a number of alternative delivery models which combined provide the twenty million plus people on the sidelines an entry into the marketplace. Our ambitious entrepreneurs have tools to rocket launch their drive to pick off one inefficient piece of the IVF process after another, fix it and scale it, enabling new delivery methods and a parallel IVF industry, build alongside the one that exists today. But bigger.

How much bigger? Approaching half a trillion dollars versus our current 20 billion. $15,000 a baby from a process optimized IVF (versus the current $60–75,000 for the artisanal version) times 25 million sets of parents to be, plus sufficient capacity for fertility preservation after cancer, proactive management of age-related infertility by egg freezing, LGBTQ parenthood — a half trillion dollar marketplace for the democratization of creating a family.

Apple Inc. should be hitting $400 billion in yearly revenue pretty soon. Where’s the next $400 billion going to come from? (I think we might be able do this at a better gross margin than your current business too.)

Anyway, that’s my modest suggestion. Happy to talk anytime.

Best,

David Sable

PS — if you’re a pass, do you have the contact info for your counterparts at Samsung, Google or Microsoft? Thanks.