Exclusive: Turtle Health seeds $5M to bring fertility testing home

Turtle Health is attempting to go where no fertility startup has gone before: Replicating a full-scale fertility evaluation in the home.

Why it's the BFD: The company raised $5.4 million in seed funding for its largest clinical trial with the Mayo Clinic, CEO Amy Zwanziger tells Erin exclusively.

Details: Switch Ventures, Blue Seed Collective, NextGen Venture Partners, Mayo Clinic Ventures, and US Fertility, the parent company of IVF clinic Shady Grove, participated in the seed round.

• Turtle plans to raise its Series A sometime in 2023.

What's happening: The trial, now enrolling patients, will help determine whether Turtle's approach — which includes an at-home transvaginal ultrasound (TVS) — can spot abnormalities that could interfere with conceiving.

How it works: Turtle's approach costs $300-$500 and includes a health questionnaire, its at-home ultrasound (which is still investigational as it is being actively studied), bloodwork, semen analysis, report and optional virtual counseling.

Of note: Turtle's approach is not meant to replace the standard of care, but rather to serve as an adjunct intended to help improve access.

• "Traditional reproductive endocrinology practices are the closest analogy to what we do, but they’re just not able to serve enough patients," Zwanziger says.

Catch up quick: Zwanziger faced significant skepticism from providers and prospective investors who said women wouldn't want to use an invasive device on themselves.

• "People thought we were nuts," Zwanziger says, recalling providers saying learning to properly perform a TVS takes years.

Between the lines: Investors and providers got on board after positive results from Turtle's core study of 56 women, which it funded and published in April in the journal Obstetrics and Gynecology.

• The trial concluded its technology was as good as an in-clinic TVS when it came to clinical-quality images and estimating a woman's supply of eggs.
• Participants rated the virtual experience at 47, which is 58 points higher than the in-clinic score of negative 12.

State of play: A cadre of tech-forward startups have emerged, with offerings ranging from diagnostic testing to IVF — but few provide all the components of an in-person fertility consult virtually. Other virtual-first companies in the reproductive ring include:

• Maven Clinic, a virtual maternal and family health unicorn, in November raised $90 million in Series E funds.
• Nodal in September debuted as a kind of "Bumble for surrogacy" with $4.7 million in seed capital.
• Legacy, a sperm testing and storage company, in May banked $25 million in Series B funding at a valuation of $150 million.

• Future Family, a startup combining fertility financing and care support, in April collected $25 million in Series B funding at an $80 million dollar valuation.

What they're saying: Alessandra Ainsworth, a Mayo Clinic OB-GYN involved in Turtle's current clinical trial, commends the company's thoughtful and far-reaching approach, as does Turtle investor and Switch Ventures partner Paul Arnold.

• "I think their efforts, which are tremendous, to do this in a data-driven way while still designing a product that’s beautiful and comprehensive...the level of thoughtfulness has a lot of potential," Ainsworth says.

Yes, but: Provider buy-in will be the company's next challenge.

• "Doctors are slow movers," says Arnold.
• "There's a perception from some fertility providers that patients either don’t want to or can’t do this," adds Ainsworth.
• Turtle's first trial, she adds, shows patients want this offering and are willing to take it on.

The backstory: Zwanziger, who previously led digital clinical trials for pharmaceutical giant Sanofi, underwent her own complex fertility journey, and was frustrated by the lack of quality at-home tests and the expense of in-person appointments.

• "I wanted to take all the building blocks of that fertility process and make it possible to do all of it at home," Zwanziger says.

🐢 One fun thing: To lay their eggs, loggerhead turtles undertake epic migrations guided by magnetic fields to return to the beaches where they were born.