The 800 Million Baby Deficit: Policy, IVF And ART Solutions Wanted

David Sable
2 min readApr 11, 2021

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Working on an IVF investment thesis and wanted yet another data point to support the size of the as-yet unmet market. This question is usually approached (appropriately) by patient metrics: infertility prevalence, recurrent preg loss, oncofertility, LGBTQ eg. Wanting to add another layer to the data, I looked for policy / macroeconomic factors that would lend support to my assumption that reproductive medicine will be one of the fastest, if not the fastest growing area in healthcare in the coming decades. Evidence of negative economic impact of, for example, declining fertility rates, would suggest that expansion of reproductive medicine access as a policy goal. So I set out to define the size of that impact.

So I looked at the largest “population deficits” in the world ie the amount of the population that the current fertility rate is not adequately replacing. This is a simple calculation multiplying the number of women in the country * the TFR, or total fertility rate (reference: Population Reference Bureau). An equilibrium replacement rate is ~2.1, slightly over one baby per parent, with an adjustment for early childhood mortality.

Data suggest a favorable policy environment for this narrow area in the future. #ivf #femtech #healthcarepolicy #infertility

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David Sable

bio fund manager, Columbia prof, ex-reproductive endocrinologist, roadie for @PriyaMayadas. I post first drafts.