%% **Request for startups inspiration:** - https://www.ycombinator.com/rfs/ - https://medium.com/breakdowns/request-for-startups-may-2019-76729c71214a - https://medium.com/@sariazout/request-for-startups-63184b1677fc - https://bubble.io/blog/request-for-startup-ideas/ - https://www.producthunt.com/posts/requests-for-startups - http://www.requestsforstartups.com/ - https://joshuaschoenaker.com/discover-startup-ideas-investors-would-like-to-fund-aka-requests-for-startups/ - https://quip.com/rcLXASq4IbIj - 2015. Cheeky. $1-a-day for an idea-a-day in your inbox. A brainstorming and startup idea discussion community. - https://medium.com/cheeky-ideas - Old title: Request for Startups 0001 - Commercial Surrogacy %% %% [Formatted Version](https://preview.mailerlite.com/o2s8k2) ### **Topic:** - Commercial Surrogacy: creepy sci fi future or modern family empowerment? %% ### **OPPORTUNITY:** - Build a vertical managed marketplace for the surrogacy journey - Potential name: Surro ### **Problem:** - Increasing global infertility rates (~[1 in 8 couples struggles to conceive](https://www.cdc.gov/reproductivehealth/features/what-is-infertility/index.html)), non-traditional family creation, and demanding work responsibilities are fueling a quiet revolution... the surrogate baby boom. - Despite the money in the market and the seeming inevitability of this future, the process of having a baby born via surrogate is largely manual, complex, stressful, expensive, and fraught with challenges. %% Scraps - A quiet revolution has been taking place during the past three decades. The way that children enter families has changed radically among upper middle class families. In the 1980s infertility increasing became defined as a medical problem that could be solved with assisted reproductive technologies (ART) rather than through adoption. Asexual or ‘assisted conception’ involving medical technologies such as in vitro fertilization and embryo transfers began to replace sexual reproduction for infertile couples. Third parties, referred to as surrogates are hired to assist individuals and/or couples who wish to conceive and child with whom they share a genetic tie. This has resulted in a ‘surrogate baby boom.’ - Infertility rates around the world are increasing. (link) non-traditional families are increasing. - "A quiet revolution has been taking place... the surrogate baby boom" and it's here to stay. It's driven in part by i - "If you think about how much money's at stake here, the fact that [the industry is] unregulated, it breeds a lot of unethical behavior," said Twine. "Even if you're against surrogacy, this industry is not going away. So how can we create an international consensus to make it more ethical?" - Must be done in a thoughtful and sensitive way in partnership with regulators. %% ### **Market:** - The surrogacy market is projected [to exceed $27.5B by 2025](https://www.globenewswire.com/news-release/2019/12/16/1960684/0/en/Surrogacy-Market-revenue-to-cross-27-5-billion-by-2025-Global-Market-Insights-Inc.html). A single surrogacy birth can cost up to $200k. The willingness to pay is extremely high. [Resilient market](https://www.vice.com/en/article/exq7nz/how-commercial-surrogacy-became-a-massive-international-business). Painkiller, not a vitamin. - Potential to unlock latent demand through affordability and convenience. TAM expansion. Nascent market potential. - Tailwinds around regulatory reform (e.g. New York just passed [The Child-Parent Security Act](https://www.law.com/newyorklawjournal/2020/04/27/the-child-parent-security-act-is-a-game-changer-heres-what-you-need-to-know/?slreturn=20201023182530) legalizing commercial surrogacy) - Companies are increasingly providing fertility benefits (e.g. [Google and Facebook offer generous surrogacy subsidies](https://www.economist.com/1843/2019/04/30/surrogacy-is-surging-in-the-tech-community)) - Recent technological advancements in assisted reproductive technologies, rising awareness regarding infertility treatment, a growing number of fertility providers, softening cultural attitudes WRT family creation, and a trend of having children later are all powering this market. %% Scraps - This is existential painkiller for many people (not a vitamin). - Intended parents are driven. - Passed in NY https://www.law.com/newyorklawjournal/2020/04/27/the-child-parent-security-act-is-a-game-changer-heres-what-you-need-to-know/?slreturn=20201023182530 - The market is persistently resilient, despite challenges. Unlock latent demand if becomes more convenient and prices lowered. Market will grow if more jurisdictions legalize it. tailwinds around regulatory reform. - __Why now? What's changed?__ - "There's a global demand," said France Winddance Twine, author of Outsourcing the Womb: Race, Class, and Gestational Surrogacy in a Global Market. "More than 160 million European citizens want these services, but aren't able to access them in their own country. If people can't get this service in India, or in Thailand, they'll find another place." - Technological advancements in assisted reproductive technologies, rising awareness regarding infertility treatment and growing number of fertility clinics will drive the surrogacy industry growth over the forecast period. - Surrogacy Market revenue to cross $27.5 billion by 2025: Global Market Insights, Inc. Surrogacy Market value is projected to secure over 24% CAGR up to 2025, propelled by increasing number of infertility cases across the world along with growing demand for assisted reproductive technologies. - Surrogacy is not a new phenomenon. For thousands of years, women have nominated others to give birth on their behalf. However, technological advances such as IVF, softening of cultural attitudes and the trend for having children later have fuelled a recent boom in surrogacy. In the past two decades, it has become a global phenomenon. There are no precise figures on how many children are involved but as far back as 2012 the industry around surrogacy was worth an estimated $6bn (£4.7bn) a year. - In 2012, after India passed legislation banning single parents and same-sex couples from seeking surrogates, there was virtually zero effect on the the industry—globally, but also within India. For many would-be parents (like this Israeli couple), surrogacy agencies continued to use Indian surrogates, who they would move to neighboring Nepal in time to give birth. In Mexico, even though surrogacy was legal only in the state of Tabasco before it was ultimately banned countrywide last year, but many fertility agencies operated out of Cancún, then relocated their surrogates to Tabasco to give birth, to skirt the law.This kind of global whack-a-mole makes international surrogacy difficult to police. Where one market closes, another one opens, to keep up with the demand. %% ### **Potential Solution:** - An end-to-end platform for commercial surrogacy enabling: - Future parents to access family creation - Surrogates to give the gift of parenthood & access life-changing economic opportunity - Babies to receive the gift of life - All done in a safe, ethical, and thoughtful way. - This trusted, managed marketplace for the surrogacy journey could include: thoughtful protection for all stakeholders wrapped in a high-quality experience, case management, matching services, medical expensing and reimbursement, regulatory compliance, coordination of services, education, counseling and support services, fair and transparent pricing, financing plans and insurance, audited success rates, access to community, standardized legal contracts, medical and psychological evaluations, background checks, referrals and discounts for related services. %% Scraps: - A trusted, managed marketplace for the entire surrogacy journey. Profit comes from the "take rate" of a managed marketplace. Service includes: vetting, protection, and risk reduction for all parties involved (babies, surrogates, clients, etc.), compliance with local, state, and federal laws and regulations, insurance and payment support, access to psychological counseling, positive experience for all stakeholders, opportunity to lower prices, fair and transparent pricing, financing plans, audited success rates, support throughout the journey, access to local IVF clinics, exclusive community of others going through same journey, medical expensing/reimbursement, standardized legal contracts, coordination of services, counseling and support services, case management, access to counseling education and support, matching services, medical and psychological evaluations, background checks, Fully vet clients/intended parents and surrogates, customer experience, reducing friction, education, support during the journey, legal contracts, access to related services, can even provide referrals to baby products and services after the child is born. %% ### **Competitive Landscape:** - Whitespace available in a rapidly growing and fragmented industry. Potential for category creation. - Dominated by local surrogacy agencies and fertility clinics. - [Circle Surrogacy](https://www.circlesurrogacy.com/) - [Orm Fertility ](https://ormfertility.com/) - [Hope Surrogacy](https://hopesurrogacy.com/about-hope-surrogacy/) - [Same Love Surrogacy](https://www.samelovesurrogacy.com/about/) - Other fertility categories - [Carrot](https://www.get-carrot.com/) - insurance - [Modern Fertility](https://modernfertility.com/?utm_source=google&utm_medium=cpc&utm_campaign=&matchtype=e&keyword%5B0%5D=modern%20fertility&keyword%5B1%5D=modern%20fertility&device=c&network=g&creative263953604104=&placement=&campaignid=1352549414&adgroupid=57921301607&adid=263953604104) - predicting future fertility - [Extend Fertility](https://extendfertility.com/) - egg freezing - [Ava](https://www.avawomen.com/) - pregnancy planning - [Fertility IQ](https://www.fertilityiq.com/) - education and community - [Kindbody](https://kindbody.com/) - closed loop care %% Scraps - overlooked by many because of its political challenges, fragmented, incumbents aren't tech saavy (just agencies), potential for category creation - Surrogacy Agencies - helps navigating the journey, like a broker (generally a couple decades old, built for a cottage industry not a rapidly rising demand?) - https://hopesurrogacy.com/about-hope-surrogacy/ - https://www.samelovesurrogacy.com/about/ - https://www.circlesurrogacy.com/ - Fertility Clinics - provides fertility services and helps navigating the journey (Surro can be lead gen for clinics) - https://ormfertility.com/ - Agency, clinic, and donor search directory - https://www.gostork.com/ - https://www.wellandgood.com/fertility-startups-technology/ %% ### **Challenges:** - High regulatory & legal risk - Polarizing public relations - Requires a special founder - one deeply interested in the intersection of medicine, technology, ethics, law, business, politics, and culture, who has the thoughtfulness to engage with sensitive situations and edge cases. %% Scraps - This massive market opportunity is fraught with ethical questions, legal and cross-boarder regulatory challenges, and socioeconomic considerations. It requires a special founder - one deeply interested in the intersection of medicine, technology, ethics, law, business, politics, and culture, who has a willingness to engage with sensitive situations and edge cases. - However, high cost related to the procedure along with stringent regulations pertaining to surrogacy in several countries will restrict the growth of market over the coming years. - Fraught with socioeconomic considerations, legal and regulatory challenges, - high regulatory risk - public relations challenge - no technology risk %% ### **Business Model:** - Generate profit from the "take rate" of a [managed marketplace](https://a16z.com/2019/08/28/where-the-opportunities-are-in-regulated-marketplaces-managed-marketplaces/). High transaction price = potential for strong profit margin. - Existing product-market fit, already validated existing behavior. - Numerous upsell and cross-sell opportunities available. - Defensibility of a managed marketplace: network effects, data moat, brand. - Leverages high-value, idle supply. - Desirable CAC to LTV ratio - Low-cost PR marketing (due to polarizing nature of surrogacy) - Classic human desire + New tech + Experience = Winning combo - Timeless market need (to build a family) - New technology (assisted reproduction) - High-quality experience (trust, risk mitigation, delightful experience) - Long term: begin developing artificial womb technology %% Scraps - aka credible adjacencies, proxy markets, nascent market potential, - services throughout the 9 month pregnancy journey. - network effects to drive more stakeholder value, raise entry barriers, and increase switching costs? - Potential distribution channels? fertility clinics, gynecological associations, LGBTQ and women's organizations. - __GTM, Distribution/growth Channels? Business Plan? Validation? Lessons? Monetization?__ - https://a16z.com/2019/08/28/where-the-opportunities-are-in-regulated-marketplaces-managed-marketplaces/ - https://techcrunch.com/2017/05/25/anatomy-of-a-managed-marketplace/?guccounter=1 - democratizes access to family creation? - 10x existing solutions - repeat customers (for 2nd or 3rd child), high LTV given transaction high price. low CAC to LTV ratio. - polarizing (hate it or love it) so driving public awareness should be relatively easy - an existing behavior that's only growing. Strong product-market fit %% ### **Ethics:** - Human rights must be upheld at all times - Opportunity to reduce existing exploitation of surrogates, with strong company oversight, plus [wage and safety standards](https://link.springer.com/article/10.1007/s11019-020-09976-x) - Edge cases must be addressed: pregnancy complications, child health issues, abortions, divorce of intended parents before birth, multiple babies born in one pregnancy, etc. %% Scraps - Potential for exploitation of surrogates, - Various arguments against commercial surrogacy are explored, such as exploitation and commodification of surrogates, reproductive capacities, and the child. We argue that, although commodification and exploitation can occur, these problems are not specific to surrogacy but should be understood in the broader context of an unequal world. Moreover, at least some of these arguments are based on symbolic rhetoric or they lack knowledge of real-world experiences. In line with this critique we argue that commercial surrogacy can be justified, but how and under what circumstances depends on the context. Surrogates should be paid a sufficient amount and regulations should be in order. In this article, the Netherlands and India (where commercial surrogacy was legal until 2015) are case examples of contexts that differ in many respects. In both contexts, surrogacy can be seen as a legitimate form of work, which requires the same wage and safety standards as other forms of labor. Payments for surrogacy need to be high enough to avoid exploitation by underpayment, which can be established by the mechanisms of either minimum wage (in high income countries such as the Netherlands), or Fair-Trade guidelines (in lower-middle income countries such as India). An international treaty governing commercial surrogacy should be in place, and local professional bodies to protect the interests of surrogates should be required. Commercial surrogacy should be permitted across the globe, which would also reduce the need for intended parents to seek surrogacy services abroad. - Financially and socially vulnerable women can be targets for surrogacy recruitment, attracted by the sums of money on offer. A surrogate in Ukraine, for example, can earn up to $20,000 (£15,507) - more than eight times the average yearly income. - "The impetus for legalizing commercial surrogacy [in 2002] was so that women would actually be able to get payment for it," she explained. Before then, "richer families could coerce their maids or poorer relatives to have babies from them and say, 'Look, we're taking care of you financially.' Commercial surrogacy was really the way by which to see that women actually got a fair wage for these services." - Rudrappa's research also shows that, while hardly a glamorous job, many women specifically seek out surrogacy for its economic opportunity. %% ### **Links:** - https://www.bbc.com/worklife/article/20190906-the-workplaces-that-will-pay-for-surrogacy - https://www.economist.com/1843/2019/04/30/surrogacy-is-surging-in-the-tech-community %% **Parting Thought:** - __Wisdom from dead people / Ancient Wisdom / sayings, phrases, humanities, parting thought__ %% ### **Thank You:** - [Ariana Thacker](https://conscience.vc/) (Conscience Fund) %% Surrogacy farm. Surro. Inevitable future, just who and when. Someone who can navigate politics. Sensitive situations. Miscarriages. Self-harm. Abortion. Willingness to pay is so high. Cross-boarder regulatory. Immensely challenging. %% <br>