Lior Geft - Founder, CEO at The Fertility Concierge

Welcome to another CEO Is on Pod. We have Lior Geft with us today. Lior is a CEO and founder at The Fertility Concierge, previously at an agency called Mabley, and prior to that, a lawyer of all things, if my memory is good, in M&A. So Lior, welcome to the pod. Tell us a bit more about yourself and what you're up to.

Thanks, Charles. Good to see you, man. More important, how's your baby doing? Let's start off on the right foot.

Right, right. Yeah, it's all about family, right? So baby is fine, uh, fine and screaming. He's got hella lungs. Um, what about your kids? You have like 4, no?

Yeah, yeah, crazy.

You went from like 0 or not, not being able to conceive to 4. Isn't that the best success story?

It's the best, man. I'm so lucky, so lucky. They might make an appearance, who knows? There's a chance they might just pop in. Um, they're great, man. All right, so you're doing it right though, one at a time. It's okay, start with one, see how it goes, see how you guys do, and then, and then go from there. But, uh, no, they're great, man. Everything's thankfully fantastic.

So describe your struggle, I guess. Let's start with that, right? Um, How did the company saw the light of day? You know, and I mean, I've been through it as well. Like I told you, right? Like a year before, we weren't sure. We're trying different things, right?

Yeah.

My we're almost the same age. Like me and my wife, thirty-two and thirty-three, right? So, but I still think we can conceive. I still think the machine's open for a while. So I'm not too stressed about like conceiving another plus. Like you said, like let's. start with one, right? It's pretty chaotic initially because you need to develop system. But yeah, I didn't have that anxiety of not knowing, right? Like, you also had that on your side.

Yeah, I think that the anxiety of not knowing, the doubt, right? The doubt, the fear, the uncertainty— that's often the scariest part. Meaning this is something that you don't necessarily know if you're gonna have trouble with, if you're gonna struggle with.

People—

most, most people aren't thinking about this until they want to have a kid, right? It's not like they're planning or, you know, years in advance. We're trying to get ahead of that now. You know, a lot of the industry is pushing towards think about freezing your eggs, think about how you can, you know, increase your fertility, etc., before you're actually trying. But no one thinks about it typically. So it was similar. I mean, it was similar for us, right? We didn't think about it. We assumed, listen, our parents were fine, our siblings were fine, like, we'll be fine. You just don't know. Um, and then, you know, for us it came through just a routine blood test. So there are different things that you can do as you get older that test, or at least give you an assessment or an idea of your ovarian reserve, or how many eggs you have, or your sperm count for fertility. There are all these things you could do. Uh, but sometimes you only learn when there's an issue, right? So that's what happened with us. We only learned when there was an issue, and then we said, all right, I guess we have to— I guess we have to deal with it. So yeah, you do get kind of hoisted into it, you know, which is a little bit trickier.

Okay, and how did that lead to a company?

So the short story is that it set us down this path. Bless you. Um, it set us down this path of, uh, fertility treatments and going through them and doing what IUI is— it's called IVF. Um, we saw firsthand that the patient experience is broken. The patient experience is awful. Uh, so much of the experience is outside the clinic. So you could go to the clinic, they diagnose you, right? They tell you to go home. They simply give you a couple YouTube links. And they say, you're gonna get boxes of medication in the mail, come back for blood work and ultrasound. And, um, uh, then you're out, you're left to your own devices. So we saw that, that experience at home, doing this by yourself, figuring it out, is, uh, is very difficult. It's very, very difficult. So just by going through it ourselves, we realized, God, there's got to be a better way. There's got to be a way that we can improve this experience and change the patient experience across the board. And that's how it led to starting the company.

Okay, um, but starting in that niche is pretty crazy, right? Like, prior to that, you managed an agency, you were a lawyer. It's a tough niche, right? Obviously it's trending up, but it's still direct-to-consumer, right? Like, uh, in any DTC business, it's pretty damn hard. So yeah, I gave you the craziness. I get to get it started and keep on investing your time into it.

That's a great question. Um, I think the, the reason why we did it, the reason it was, uh, it grew is because we weren't trying to make it something big. We weren't thinking about it as a business, uh, truly, meaning we just wanted to help people going through it. That's it, plain and simple. So my wife is a nurse and she would go out and give people injections, like friends and family, right? People that we knew were going through it and wanted the help. So we said, God, I'm sure there are other people who would want this, but But, um, that was it. It was just trying to help out, right? There was nothing more to it than that. So we had the benefit of just diving in, not worrying about the perfect setup or the perfect name or the perfect branding or voice and tone or logo or strategy or go-to-market. Like, we didn't worry about that stuff. We just said, if anybody's here And wants help, great. We'll help them out. So that's how it started. I think that was probably part of the easier reasons, or one of the reasons why we were able to get started is because we weren't trying to make it perfect. We were just trying to help. Oh, I think you're sorry.

And I think you've been like what eight years into that ten years into that company.

Yeah.

So what's been the growth like through this decade?

Yeah, so the growth has been significant because it's been on both our nurses' side, our team side, and on the patient side. So it started in 2017, so we're in our 10th year now. And when I say it started, I mean it was me and my wife. That was it. So she was the only one going out. She was the only nurse. So she was— you had one nurse, it was her. She was going out in Chicago and giving injections to people. who needed help, uh, with their fertility treatments at home. And then it just started growing through word of mouth. So you talk about like how we got it going, the market spoke, right? The demand in the market just spoke for itself. And people would reach out and just through friends and, and referrals and clinics talking about us, um, it started growing. So we went from one nurse, which is my wife, to 2 and 3 and 4. Now we have about 1,900 nurses across the country, and we've done— we're approaching about 15,000 visits completed to date. And this is the first time— I mean, only about a year ago is when we started actively marketing and reaching out to clinics and trying to get the word out there. So until then, it was, it was very much organic, like completely organic growth.

And did you— did your agency experience have an impact on how to grow that one? Why do you attribute that the company is still well and alive at this stage?

Yeah, it's a great question. I mean, I think, you know, when I— when we started this, I was at the law firm, um, and I think my legal training helps every day. I do. I loved law school. I'm a huge fan. If anybody's interested, if anybody has the, the the opportunity and the, the pleasure of going to University of Chicago for law school. Like, I thought it was amazing. I loved it. Uh, not because I always wanted to be a lawyer or I always thought I would be, just because I think it's a special place where they teach you how to think, how to think differently. Um, so I use that every day, right? I tell people all the time, I'm not at a law firm, not practicing law, but I use legal training every day. And then at the agency, there are multiple things that I've learned from, and one of them is working with brilliant people. So we were a full-service boutique agencies. We had 5 studios, so working with amazing designers, developers, strategists, data analysts, creatives— like, they were just incredible people. I was able to learn from them, so that was definitely helpful. And then also just learning how to understand people and be a better leader, and, you know, be a better, uh, servant leader to everyone. I think you just need to experience. So yeah, without question. And when we sat down, you know, a year ago to get this going, to get this rolled out. There's no question having done almost a decade at Mavely doing rebrands or launching brands or building product, running campaigns, just being around that was extremely helpful. No question about that. What do you invest in nowadays?

Do you invest in influencer marketing to get more clients? How do you get the word out?

That's a great question. We're still in the learning phase so much, right? I think so much of the being a novice and being early on as a startup is figuring out what actually works and what doesn't work, right? People that have done it for a while, like my mentor who's always saying that people have done it for a while, they just have the benefit of knowing what doesn't work, where you're wasting your time. So, so much of our, you know, so much of our, marketing now is just experimentation and trying and getting very diversified. So yes, we've done influencer marketing, we've done paid SEO, blog posting, white papers, etc., things of that sort, paid social. Um, we just were on a first TV segment, so we, uh, it went a lot. Actually, the episode broadcasted just a week ago. I don't know when this is gonna air. but it broadcast on the 25th of September and it was across the country, across the nation. So we'll see, right? Maybe just getting the word out there on TV with millions of viewers, that'll let people know that the help is available. So influencer marketing for sure, but I think honestly, if I had to guess based on what we're looking at now, I would say AEO and like, yeah, AEO would be our biggest investment.

Interesting. And do you also like partner up? Like, what's, uh, what's cooking on the partnership side of things?

Yeah, man, you read my mind. Um, I find that there's— it's a very small industry, the fertility space. It's a very small, tight-knit industry. Um, and I do believe in doing good work with good people, meaning I want to grow and I want to grow with people. I don't think we need to grow by ourselves. We shouldn't grow by ourselves. So that's through a joint venture, through a partnership, whatever it may be. We're happy to do that. So we have one, uh, active partnership right now. It's with this fantastic company called EngagedMD. So EngagedMD is a great company. We're aligned in our values and our ethics and our morals. They're just great people there. They have built a software that is a— it is basically a patient journey management software. So you become a patient at a clinic, this software will help manage you through that journey. What do you need to do next? What forms you have to sign, consents? What comes next, videos to teach you about the process, about the injections, etc. So it helps keep the patients on track, uh, and the clinics love it. So we have, we have an active partnership with them where any clinic who's using their software, they could add our, add our information to let all their patients know that our service is available, which is the biggest barrier right now.

Got it.

So there are a couple other ones cooking. They're great people in the industry. We're looking at partnerships with some with some clinic networks across the country, with pharmacies, with pharmaceutical companies that provide the medication, right, the fertility medication. Because at the end of the day, what we've found is everybody understands the problem. Like, no one disagrees that the patient experience is pretty awful and broken, right? No one's disagreeing with that. Everyone agrees and they want it to improve. So they're happy to, they're happy to figure out how we can get the service to everyone.

Got it. And the process is basically I book a meeting on the website, right? It's $200, and then you pair. So that meeting is online, I would guess. And then there's a short visit if it applies to us, right? Like if, if there is need for like physical treatment, is that how it works?

So the way we— yeah, so the way it works is it— we have a proprietary tech. It's, it's a, it's a native app and it's a web app. And the easiest way to think about it is it works very similar to Uber. You request a visit, same way you request a ride. It notifies all of our nurses in the area, and then they can pick it up and come to you. So we do have a virtual platform, but we— but that's not what we lead with. We don't think that's what patients want. At the end of the day, They want a human being there to support them at their house. Listen, the medication is really important, but it's not the heart and soul of everything. They want someone there with them telling them it's all going to be fine. I got this. I'm a professional. You just keep watching TV. You relax. Don't worry about it. Right. It's the peace of mind that is most important. So if, if they don't want that or for whatever reason, let's say they're in a remote location. Yes, we have a virtual platform that we can use, but the request to visit, nurse picks it up, says, hey, I got it, gives you a call. Charles, I'll be there for your wife, no problem. I'll come 7:30, you know, October 5th. I got you. And then she comes to your house, or if you're traveling, to your hotel or wherever you may be, and administers the injections for you.

That's pretty cool. I love it.

Um, thanks. Hopefully you don't need it. I say hopefully you and your wife don't need it, man. That's the secret. The secret is I, I hope nobody ever needs us, right? I, I don't wish it— I don't wish it on anybody, right?

Why do you think humans are less fertile nowadays? Have you investigated that?

Um, we have. There's a lot of— there's a lot of literature on it, but I think in the end, first of all, I'm not an expert on it, right? We're focused on addressing the, the need, the existing need, not necessarily not asking why the need exists. Um, but from what I've understood and what I've gathered, it's a combination. On one hand, yes, you think the, the fertile or the infertility rates have gone up, and people point to many different things such as the food we eat, the hormones in the food, to cell phones and radiation, etc. At the same time, I also think we have to acknowledge the fact that intervention is so much more available, it's so much more readily available now that people can raise their hand and seek treatment or be deemed or diagnosed as infertile, when many years ago that didn't exist. So for example, if you speak to your parents, but more likely your grandparents, other generations, they'll tell you that sometimes they just had a hard time conceiving and it took years They didn't go to a doctor. They didn't necessarily know what to do, so they just kept trying because it's also statistical, right? Like every month, if you produce one egg, you have a shot at fertilizing that egg. It doesn't work, you try the next month. So you'll hear stories of, you know, my grandparents would say, yeah, there's a huge age gap between some of our kids because we just— it didn't work, right? Where these days If it's not working for a year, for example, if you have unprotected sex and you're trying to conceive for a year and it does— it's not happening, then you would be diagnosed as infertile. So, um, they go right away, they go to the doctor, right? So the rates are much higher. That's also because people are seeking treatment. People are actively trying to, to, you know, to, uh, receive intervention. And treatment as opposed to before, it would be lower because just fewer people raise their hands.

Yeah, and they panic, right? Like, they need— it's like we live in the age of quick fixes. Everyone wants a quick fix. Also, it's not just mental, it's also life, right? Like, a lot of women are professional and then they need to plan time off, right? And yeah, everything is like more scheduled, right? Like, uh, that, that's the age we live in.

Yeah, it's all scheduled. It's also that people want to have control. I think that might be the hardest part, right? I want to have control. You want to have control. We want to control the temperature in our homes remotely from our phone so it's exactly what it is when we get home, right? We want to control every aspect of our day in our lives. This is something that it's taken out of our hands, and next thing you know, you feel very helpless because of that. And the truth is, we don't have control. We all have to realize that as much as we think we do, we have no control. So it's a very humbling realization, I would say.

So you have 10,000-person visits in patients' homes. That's crazy, right? Uh, that's a lot. Uh, how much shots does one person need and how frequently, uh, are these visits?

Yeah, it's a great question. The average cycle If someone's going through, let's say, IVF, um, the statistics vary, but it's about between 15 and 50. There are some statistics like CNY Fertility will say it's between 30 and 90. Um, it varies tremendously, but let's just say if you're doing a stimulation cycle or a stim to freeze your eggs, the first part you're doing around 10 to 15. injections. And then afterwards, if you, if you're doing IVF and then you have to do progesterone and oil injections, you can do up to, uh, you know, weeks more. So call it 30 to 50 injections, right? That being said, our patients sometimes call us for one if they just need help with one of them, if their partner's out of town. So the amount of injections in the, in the US, the amount of visits Significant, right? Uh, let's say around 4,500. Um, yeah, actually scratch that, we don't have to get into the math right now. Let's just suffice to say, if each— if each cycle, as we're talking about, 15 to 50 injections, um, you usually have about one per visit. Sometimes there are more per visit, but usually one. And, uh, we're there for all of it, any of it and all of it.

Got it. You facilitate the experience to make it nice, but is it like painful in the end, like a shot? Like, are you thinking about a better experience, a better product, or is someone thinking about like a better way to, uh, make people pregnant?

They are, they are. So what we always say is we can't make everything perfect. We can't, right? We can't take it all away. That's just the reality. We can make the process a lot better. Um, there is a group, uh, there is a group called HRC. It's a clinic, it's a fertility clinic network in Southern California that, um, are trying out this needleless IVF where they basically put in like a port and they do it once. And this way you can, you can administer that medication through the port. Uh, it is still very early on, but there are people trying to do different things. Now I would say Is it still painful? It's still an injection, right? The large intramuscular ones, you, you could still bruise. That's just the reality of it. Now, what we've found is the physical, the physical aspects of the physical pain and the physical discomfort often pales in comparison to the mental and emotional and psychological struggle. So if you deal with the latter, Then the former typically is a lot easier. So if someone's in a good mental place and they know they're being taken care of by a professional, it's done well, then the trust is there. So even if it might physically rank the same on the pain scale, right, let's say this shot stings, uh, a 2 out of 10. If I'm doing it for my wife and it stings a 2 out of 10, it might feel like a 7. But if a nurse is doing it and it stings a 2 out of 10, it might feel like a 1. So it does, you know, a shot is a shot. I think that's also why people realize that it's not virtual. That's why virtual visits aren't, you know, our, our first line of defense. Um, but the other aspects to it make it so much more, uh, so much, so much more, uh, I'd say, um, feasible and, and digestible.

What's the next step for you as a CEO? What are your goals for this year?

Uh, you know, my goal is to make sure that every patient going through this treatment knows the help's available. That's my goal. It's an awareness play. People don't know the help's available. So I— what I hate is when I hear someone say, oh my God, that's amazing, I wish I knew about you 6 months ago, or I wish my sister knew about you 3 months ago or a year ago. Uh, we We have an active collaboration with a clinic network called CCRM across the country. And when we were talking to their, their heads, they said, oh my God, how did I not know about this? I wish I knew about it earlier to tell all of our patients. So that's really the goal. It's awareness. Now, we don't sell anything. We don't push anything. We don't convince anybody of anything. Know that we're available. Know that we're there. If you want the help, we're here to help. If you don't need it, no problem. That's why I make— I say it's similar to Uber. If you have a car, you should still have the Uber app because you just don't know. You don't know when the car would break. You don't know if you might lend the car to somebody else. You don't know what it might be. You should just have that backup. So, so that's the goal. And what we're doing now is we're working with clinics and also EngagedMD to make sure that all of their patients, everyone across the country, knows the support's available. You're not alone. If you want it, it's there. If you don't, no problem. But at least everyone should know that we are available.

Well, Jor, thanks for being on the podcast. Where can people find out more about you?

So they can find more about us at our website. It's thefertilityconcierge.com. So thefertilityconcierge, one word, dot com. Um, they can find us on Instagram, on TikTok and on LinkedIn, uh, and they can always reach— I don't know why anybody would want to reach me, but if they do, I'm just lior@thefertilityconcierge.com.

Interesting. That was, uh, Leo.