Possible Fertility Revolution Born in Jewish Atlanta

Possible Fertility Revolution Born in Jewish Atlanta

Michael Jacobs

Atlanta Jewish Times Editor Michael Jacobs is on his second stint leading the AJT's editorial operations. He previously served as managing editor from 2005 to 2008.

Time is the enemy of female fertility. Wait to try to get pregnant for the first time until you’re 35 and your likelihood of success begins to decline. Wait until you’re 40 and you’re unlikely to succeed without the help of a fertility specialist.

By 44, as a result of aging eggs and the decline of unused body processes, your chances for a first pregnancy are just about over, said Daniel Shapiro, a leading reproductive endocrinologist with Sandy Springs-based Reproductive Biology Associates.

It’s a growing problem in modern society as women, Jewish and non-Jewish, wait later to marry and to start families.

In 1961, the average age when an American woman had her first pregnancy was 21, Shapiro said. Now in Massachusetts, as an example, the age is 31.

Martin Varsavsky, who lives in New York, said he doesn’t expect a set schedule for his trips to the Prelude headquarters in Sandy Springs, but he does anticipate frequent visits.
Martin Varsavsky, who lives in New York, said he doesn’t expect a set schedule for his trips to the Prelude headquarters in Sandy Springs, but he does anticipate frequent visits.

Shapiro has tried to help through involvement with the Wo/Men’s Infertility Support Havurah (now Wo/Men Infertility Support & Help) and the Jewish Fertility Foundation, but he acknowledged in a recent interview that reproductive medicine has been a reactive specialty.

But with the help of Shapiro and his partners, Jewish entrepreneur Martin Varsavsky is offering a proactive approach that aims to turn infertility medicine into fertility medicine.

Varsavsky, a native of Argentina who has made his fortune by launching tech and health care businesses, announced the launch of fertility company Prelude on Oct. 17 to provide women something money usually can’t buy: time.

“My wife, Nina, and I had a hard time getting pregnant,” Varsavsky said in an email interview. They succeeded by using in vitro fertilization and freezing her eggs and his sperm, but “I felt there had to be a better option than emotionally and physically draining infertility treatments. We had to undergo those treatments given the current state of this industry, but I wanted to find a better choice for those seeking to have kids in the future.”

That better choice, now known as the Prelude Method, is to persuade people to plan for families and act during their peak fertility years, which continue into the early 30s. The chances of miscarriage and chromosomal abnormalities rise as fertility declines in the late 30s and early 40s

Varsavsky decided that educating people and applying the best medical technology “would increase their chances of having a healthy baby when they’re ready via fertility preservation, embryo creation, genetic testing and single embryo transfer.”

His wife is having their third child together, and his seventh overall, in January. That will be the first Prelude baby.

Others could follow soon. Varsavsky said the Prelude Method — the whole process of extracting, freezing and preserving eggs, then later fertilizing and implanting one at a time — will be available starting early next year at Reproductive Biology Associates. “We’re proud to be launching in Atlanta first at the nation’s largest frozen donor egg bank, My Egg Bank, and with some of the nation’s leading experts in reproductive medicine.”

Shapiro said he’s a good doctor, but what drew Varsavsky to RBA was the frozen egg operation, My Egg Bank, the nation’s largest. And Shapiro attributes its success to RBA’s lab director, Zsolt Peter Nagy, whom Shapiro called a genius.

Unlike sperm banking, a routine process that is also offered as part of Prelude’s service, egg freezing is a relatively new technology. The large size and small number of eggs compared with sperm are complicating factors, but the main issue has been the tendency of the water in the eggs to form ice crystals that ruin them.

The solution is vitrification, which adds nontoxic materials to the eggs to lower the freezing point of the liquid so that instead of crystallizing, the egg becomes glasslike.

Nagy didn’t invent the process but has refined it. Shapiro said My Egg Bank not only has a high success rate with the eggs, but it has reduced complications in harvesting eggs — a process that uses hormone treatments (whose cost will decrease dramatically through Prelude’s bulk buying) to boost production — to a negligible level.

The harvesting and freezing results should be good for women ages 21 to 34, Shapiro said, although he expects most of the demand for Prelude’s services to begin when women are 28 to 32. Once the eggs are frozen, a woman can wait as late as 55 for successful implantation, he said.

While IVF can cost $15,000 now, Shapiro said the Prelude method, including initial egg storage and genetic testing, will cost about $8,000.

Shapiro and his new CEO said they expect the business to grow by partnering with established clinics across the nation. By starting with the purchase of RBA and adding other successful clinics in the future, Prelude has a positive cash flow from the start. It also has a $200 million commitment from Lee Equity Partners to use in acquisitions within what’s now a $2 billion industry.

“It’s by no means an easy task to shift culture, but who would have thought 30 years ago we would have phones in our pockets with access to all the information in the world? Same goes for fertility preservation,” Varsavsky said. “What once seemed like science fiction is now an easily accessible reality. As millennials are quick to adopt new technology when it helps improve their lives, we believe they will do the same to seek out the technology of the Prelude Method.”

Success, he said, involved the creation of “a culture that celebrates and preserves fertility vs. one that waits to treat the issue until it becomes infertility. That’s a macro view. … It’s supported by a system that reaches millennials with a message that helps them realize their options and starts with their choice to freeze their eggs and sperm.”

The marketing plan and team selling that message were crucial to RBA’s decision to be part of Prelude, Shapiro said.

“It starts with education. Millennials may not be thinking about their fertility right now, but they should be,” Varsavsky said. “It’s a matter of being proactive so that people can focus on those other goals as well as increase their chances of having a healthy baby when they’re ready.”

Although Prelude is lowering the cost of fertility medicine, it’s still not cheap. Shapiro can envision would-be Jewish grandparents giving the service to their children.

The grandparent market isn’t the initial focus, Varsavsky said, but he’d welcome early adopters. “Many parents help their children with buying a car or a home. We believe that spending towards their children’s future parenting dreams is just as important of an investment.”


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