Much of the capital flowing into fertility to date has gone to care delivery, diagnostics and platform infrastructure, largely driven by PE roll-ups of clinics into larger provider groups. Meanwhile, there remains a significant gap on the scientific and R&D front, with limited funding for translational research and the development of new targets and therapeutics.51 Most fertility drugs still rely on hormonal protocols developed decades ago, albeit with incremental improvements to drug delivery and oral formulations now in development.52,53,54,55 Though early-stage innovation is emerging – including induced pluripotent stem cells (iPSCs)- derived ovarian cells56 and oral embryo implantation enhancers57 – these remain the exception. A recent pipeline review called the fertility therapeutics space “sparse”,58 pointing to significant room for greater investment in discovery-stage innovation.1.2 Where the investment flowed, and where gaps remain While reimbursement has fuelled growth, increasing access remains a critical frontier. Use remains concentrated among higher-income, privately insured and disproportionately white populations.59 Only 24% of infertile couples have access to the full range of care.60 Globally, ART access is even more constrained. In low- and middle-income countries (LMICs), availability is limited to urban, private centres – often at significant out-of-pocket cost.61 Expanding access and coverage represents an untapped lever for long-term market growth.1.3 Access as a limiter of full market reach IVF provides a valuable roadmap for how scientific reliability, increased demand and regulatory and reimbursement traction can turn a niche market into a multibillion-dollar global industry. Investors played a defining role – not just by funding growth, but by shaping the ecosystem. They standardized delivery models, consolidated networks and proved that profitable growth and improved access can reinforce each other.1.4 Lessons for investors Women’s Health Investment Outlook 9

Womens Health Investment Outlook 2026