This week, Griffin hosts Drs. Gurjeet Singh and Sahil Gupta, founders of Oma Fertility and Oma Robotics, to discuss their plans for utilizing $37.5 M in venture capital. Who will have access to the tech? How much automation can they bring to the industry? Tune in to the latest episode of Inside Reproductive Health, as Griffin Jones presses these entrepreneurs on their plans to scale their company.
Tune in to hear:
How Oma Fertility and Oma Robotics came to be, how they raised so much capital, and what role debt plays in their plans to scale their organization.
What Drs. Sahil Gupta and Gurjeet Singh have to say about the role of AI in increasing productivity and reliability in the labs.
Griffin ask about their growth, especially the pros and cons of purchasing clinics vs. beginning de novo, and where their footprint is expanding.
Gurjeet’s information:
CEO and Co-founder at Oma Fertility
LinkedIn: https://www.linkedin.com/in/gurjeetsingh/
Website: https://omafertility.com/
Sahil’s information:
Chief Commercial Officer & Co-Founder at Oma Robotics
LinkedIn: https://www.linkedin.com/in/sahilgup/
Website: https://www.omarobotics.com/
Transcript
Griffin Jones 00:00
So let's talk about the debt side for a second, because maybe I'm making an assumption. But my assumption is that many people aren't leveraging debt in that way, like directly from the financier that they're often they're either selling to private equity and then they might be leveraging some debt or, or they're selling equity to a venture capital firm. But it seems like people forget that you don't necessarily have to sell part of your company. If you want to get more money to invest in expansion. You can do it the old you can do it the old fashioned way. One way of getting your technology adapted in the field of reproductive health to advance assisted reproductive technology is to build clinics yourself and put it in those clinics. That's where Oma Fertility is. I have their co-founders Sahil Gupta, Gurjeet Singh on and they are the co-founders of Omar fertility and Omar robotics, they just raised 37 and a half million dollars, both in equity through venture capital. And in debt. We talk about the pros and cons of those two tools. We talk about how debt is often underused, and why they were able to get access to more debt than many people can often get from banks, we talk about their strategy of opening new centers as a means of advancing the technology that they're aiming to improve on the lab side trying to automate the lab trying to use artificial intelligence to dramatically increase the the productivity and reliability of embryologist. We talked about how they are buying clinics in order to be able to do that, how they're starting clinics de novo, the pros and cons of doing each of those things. So this is an interesting model guys, I think of all of the AI companies that are coming in and they might have excellent value to add, but they're kind of struggling to get adopted. This is one way of doing it and a lot of people are talking about some of the newer private equity backed fertility networks. I think you might be interested in this. I hope you enjoy this episode with Sahil Gupta and Gurjeet Singh. Mr. or Dr. Gupta Mr. or Dr. Saying Sahil Gurjeet Welcome to Inside reproductive health.
Gurjeet Singh 02:45
Thanks so much for having us.
Griffin Jones 02:47
So the that little joke for the audience was that Singh, he was a he was trained as a physician and Gurjeet has a PhD in mathematics. They both said they don't normally go by doctor but guess what on inside reproductive health you do you get the full honor of your previous degrees in training. And the reason why I think it was my team that reached out to you all to talk was that as we started to cover more of just what's happening in the field, like more of the current events, the name OMA fertility popped up. And the name Alma robotics is associated with that. But I want to stick on OMA Fertility for a second, because I think it wasn't really familiar with the group outside of your location, Southern California and then saw Oh, they're in St. Louis now. And so us deciding where to start this conversation is interesting enough, but let's start there. Where did OMA Fertility come from? And then what's the expansion that's happening? Is it fair to start there?
Gurjeet Singh 03:57
Yeah, that sounds great. I can give you a little backstory on OMA Fertility, and then I can tell you where we are and where we plan to go. Great. So we, you know, I had a friend of my wife's, I believe, of my wife, who was going through IVF. They went through six cycles of IVF treatments, didn't succeed, paid about $45,000 per cycle and ended up having to file for bankruptcy. You know, it completely destroyed their life. And very coincidentally, as all of this was going on, my wife was helping them think through how to put their life back together. cyl was visiting us as a family friend, both cyl and I had grown up in Delhi in India. And you know, Sahil as a physician, he had built a chain of IVF clinics in India where they see 15,000 patients a year and do 6000 cycles a year. And so my wife and I were venting at him about this whole thing. And he said, Why don't you come visit a lab? You know, just so you can see how it works, you know, you can get a sense for perspective. So I went to India and saw an IVF lab, and I was just completely blown away. You know, my I didn't know anything At the time, I'm a mathematician, as you mentioned, my expectation was that, you know, there will be some science fiction stuff going on behind the scenes, you know, but it turns out it was like a high school biology lab right at the same microscopes, incubators, the same kind of equipment that I had seen in a high school biology setting.
Griffin Jones 05:18
You were disappointed at the lack of sci-fi? Yeah, I was
Gurjeet Singh 05:21
like I was expecting there would be some science fiction stuff going on. They'd be like, some sequences of some sort. I'm gonna be naive. I didn't know it was so disappointing. I came back to the US, I visited a bunch of labs here, because I just couldn't believe it. And you know, I will say, perhaps they were slightly cleaner in the US the labs, but they had the same exact equipment, the same media, the same manufacturers, the same procedures. And I think there's something wrong, and then science had, you know, he had been going to fertility conferences for a decade, and he was like, they just don't change. That's just it's the same people show up every year, the same equipment, it just doesn't evolve. So tell
Griffin Jones 06:01
me what was wrong other than the aesthetics other than okay, that it looks so tell me what's wrong about it?
Gurjeet Singh 06:06
Yeah. So first of all, nothing is wrong, right. Like the labs are obviously doing well, you know, people who are struggling with infertility, babies are getting created, you know, so, so nothing is objectively wrong. It's just that it felt super manual, right. So when I, when I looked at the embryologist looking under a microscope, they are literally hunched over, right, looking at a petri dish, moving cells around manually with manipulators. It just felt super subjective. Right? What if somebody was having a bad day? What if they were tired? What if it was late in the evening, and they've been working since seven in the morning? So like, a lot of the decisions that they were making, with all of their great experience, felt so subjective, that anything could go wrong? Like not even the intent would always be great. But you could always make, you know, a mistake. And so I want it to be more automated. Sorry,
Sahil Gupta 07:03
yeah. I just wanted to add that one of the conversations, early conversations we had with between us was Gurjeet is asking, Where do embryologist train? Where are training schools? And, you know, I literally had no answer because the embryologist actually trained inside the labs. And you know, they are probably the most important part of the IVF process and the lab and, and then having to make subjective calls was really surprising to him at the time. Like how could such important decisions be made, you know, subjectively and cannot like, are not consistent. So I think that's probably where it started, where we decided that our focus, you know, as a company would be to make tools for embryologists to make it more consistent in order to give them tools to make it more consistent, and the results being more consistent.
Griffin Jones 07:58
Who and what are the tools that they needed in your view?
Gurjeet Singh 08:02
So I'm gonna go ahead.
Sahil Gupta 08:07
No, I was trying to break down the IVF process into two parts. The first being, you know, where the embryos are created. And once the embryos, embryos are created, the second half is about grading and biopsy. So I think we as a company started to focus on the starting part of the process, on creation of embryos, where embryologists have to sort of make this subjective call on which sperm to decide on when they pick it for ICSI and then ICSI iitself, you know, different embryologists trained differently. Some are better than others while doing xe, I think these are the steps we thought were the most objective. And we we decided to go after them first. But I think we can talk about more details on the technology. But sponsor elections and Ixy are the first thing that we are going after. But our Northstar as a company is to is to automate the entire thing. And just have a human in the loop. You know who can oversee the process? Good. Yeah.
Griffin Jones 09:17
What would you add? Well, where does where does the math background come in?
Gurjeet Singh 09:22
Yeah, so the math background is right, basically, let's do some math. So for sperm selection, as I was just describing, you know, in a typical IVF cycle, you're dealing with a handful of eggs, that's 20 eggs. And you know, the eggs are extremely precious. Right eggs become embryos, they are physically challenging for the patient. They are all with the egg retrievals which are obviously financially expensive and emotionally challenging. So eggs are you know, very, very precious, and you kind of get what you get right so the physician works with the patient, you get the eggs that you get, and you have to use all the exotic and get your hands on in a cycle. Right. On the other hand, on the male side, in a typical healthy male sperm sample, there are 100 million sperm cells also vary typically 4% normal morphology is considered good, which means that only 4% of those 100 million cells have normal morphology. Today, an embryologist looks at 20 cells, maybe 30 cells order of 20 to 30 cells out of 100 million for about 10 seconds before they pick one sperm cell to fertilize an egg. And if you again do the math, right, the probability that 20 cells seen out of 100 million would even contain one of the 4 million normal sperm cells is so abysmally small, that it's, uh, you know, it basically speaks volumes about the robustness of biology that it still works. So that's kind of where the math comes in. And using machine learning and AI to help embryologist make the determination would fit sperm cells to pink.
Griffin Jones 10:58
So, so the lab side is making sense, the AI side is making sense, how the heck does this end you up with a clinic in Southern California and in St. Louis?
Gurjeet Singh 11:11
Yeah. So then I think the main question is, what is the best way of building the tech? Right? Okay, you got up, the tech is important to build. And so how do you best build it? And what we, you know, I have I have done business in healthcare before I've sold into healthcare before. You know, there's a lot of potential benefits that AI brings to healthcare, which I've seen firsthand in my previous company. And so when we started building Omar, basically, we had a cold start problem, right? When you start to build this device, you need data to machine to, you know, for machine learning to train the systems. And so we decided that the most efficient way of getting this data would be actually to start a clinic, capture the data, because it needed, we needed some special hardware that we have developed to do this. So to the beginning, install the hardware, capture the data, build machine learning systems, and then deploy it in the in the lab can sort of see results in real time and then tweak it. So that's kind of how we initially decided on building the clinics. But then as we started building, we also noticed that patients or families who had gone through IVF, in the past, you know, we did user interviews, we spoke to them, even people who had been successful, you know, felt like there were a number in the system. They felt like they were just there to enrich the clinic, they did not feel empowered or educated. You know, they felt like they had lost power in sort of going into this whole situation. And so we then decide that we're going to double down and we're going to build a chain of fertility clinics. Where, you know, we will bring our technology to bear in in helping embryologist work consistently as well as serving patients in a in a consumer first customer first mindset.
Griffin Jones 13:02
Such an interesting, it's an interesting concept, because the challenge. Well, I've been selling to Fertility Centers for eight years, and I know how difficult it is I've gotten pretty good at it. But we're just a little client services firm. There are so many tech companies that are that, you know, there weren't like how are we going to get this into use? And you just said, eff it will buy it will buy one and we'll do it ourselves. So, so Did it start? So it started with one clinic, the clinic in Santa Barbara?
Gurjeet Singh 13:34
Yeah, yeah. It started with a clinic in Santa Barbara. And we've just started a clinic in St. Louis. We are actually we are about to announce an acquisition next week. We have acquired a clinic that's based out of Long Island. We are building one in Atlanta. We are building one in New York. And then we are hoping to launch two more clinics next year in LA. Yeah.
Griffin Jones 13:57
So who is this where you're coming in? So you've done this in in India before it was a via the group that you? You have seriously?
Sahil Gupta 14:07
Yeah, I started awareness in 2015 with one clinic. And affordability was kind of like the core of that clinic as well and accessibility. And by the time I sold it in 2019. It was a network of eight clinics in India and Nepal. And as Gurjeet mentioned, you know, we started with Santa Barbara and by the end of March 2023, will have seven, seven operations.
Griffin Jones 14:34
And so I help people chart the timeline. When did when did Santa Barbara take its inception?
Sahil Gupta 14:39
So Santa Barbara started somewhere in January of 2021. And I think this year, we are launching three clinics by the end of this year. So Atlanta, St. Louis and New York. Go live by the end of this year. As Gucci mentioned we have acquired a clinic in Long Island in New York, this, you know, hopefully in the next week or so it will be live. And then we are building the two clinics in LA, which will go live in March 2023.
Griffin Jones 15:15
Was Santa Barbara, was that an acquisition?
Sahil Gupta 15:18
No, no. So apart from Long Island, all the other six clinics are served in all those, we are building it from the ground up.
Griffin Jones 15:27
Why did you decide to go that route?
Sahil Gupta 15:33
So I think there are multiple reasons why we decided to do that. First of all, I think it's always easier to sign up, sort of bring about the change that we want to in terms of experience, when we are building things ground up, there's not only we also wanted to make the physical space, you know, change the digital and both digital and physical space that we were building, I think in terms of in terms of just the build, you know, I had experience building these clinics in India. So I knew what it takes the systems that are required. And then we found great physicians to partner with, with whom we could, you know, launch these clinics from from ground up.
Griffin Jones 16:26
Oh, why do you say this? I'm asking you to speculate about other folks. But most of the people coming into the unless they're already an established group, most of them are going acquisition, why do you think more people haven't tried the VC, venture capital de novo route?
Gurjeet Singh 16:48
So I think from a venture capital perspective, right the to do the de novo route, your venture capitalist model requires some tech innovation, it requires some step change that you can foresee in the future. And so I think if you're just going to start fertility clinics, without any tech innovation, inside it, that can lead to a step change in the, you know, along some metric, you know, it's not a venture scale business otherwise.
Griffin Jones 17:19
So what about us if you've done this before? Is it? Is this a model that could be that we're going to see more replicate? Like, are we going to see companies like Cooper, for example, or whoever the new AI companies, whoever IBM might spin off of a healthcare division, are they gonna start going this route of a build of, okay, we want to get our technology adapted, and we want to have a full tech stack, we're going to build, we're going to build the clinics ourselves.
Sahil Gupta 17:55
So again, you know, as you had mentioned, there's been a lot of private equity, you know, activity in this space over the last three, four years. And I think when, when there is private equity, there's a lot of roll up acquisitions, as you had mentioned, a lot of groups trying that. I think as good as you'd mentioned, with venture capitalists, there has to be some underlying tech that fundamentally changes or disrupts the industry, which we believe we are doing. And I think if other groups come up with, you know, similar other ideas there, there might be, you know, similar companies in the future. But I think we have the right mix. As a company, as you know, with with the team, we are, we have been able to put together over the last couple of years that we see ourselves growing with both the novel and acquisitions over the next couple of years.
Griffin Jones 18:53
How are you going to interact with those Fertility Centers, I will Oma Robotics sell to service Fertility Centers that are not a part of the OMA Fertility partnership.
Gurjeet Singh 19:08
So our plan is that our technology and devices are for exclusive use of Oma clinics, we're not selling our technology or devices into any other clinics, and don't plan to either. But there are several clinical practices across the US. You know, where the practice is great, but we do but they don't have their own lab, or they want to use a third party lab. So we definitely want to approach clinical practices, you know, that don't have their own lab or want to switch labs or want to use our technology to come use our labs. So that we are okay with but we are not, we are not selling technology into any other clinic.
Griffin Jones 19:47
Tell me about that decision.
Sahil Gupta 19:50
I think part of it. Part of what we are building and we have seen in different clinics in larger chains, is that if you go to let's say an A We see clinic on the East Coast versus, like the same ABC clinic on the West Coast, their results are different, just because they have the same name, but results are different from in all their clinics is because of the embryologist or could be any number of reasons. We believe that we are building a network, it doesn't matter if you go to St. Louis, or Santa Barbara, or New York, you're going to get the same consistent results and same consistent OMA experience. And that's going to be our differentiator, as we continue to build our own clinics and acquire clinics that have similar mindset or clinics that align with our mission and vision.
Griffin Jones 20:45
You don't see any application within the device other than the entire lab itself. But we could license this technology to these other surely you must have had that discussion with each other, hey, let's break off this piece. Let's license it. What was that conversation like when you decided against that
Sahil Gupta 21:04
our North Star as a company with in terms of building tech is full automation. And I think it was that time we reach there this this isn't a conversation that, you know, we want to have it next we want to make sure that we are able to build all these steps along the way. And I think we're at full automation, then the conversation to be had with other clinics or clinics outside the US where we might be willing to, you know, probably sell it to other clinics outside or inside the US.
Griffin Jones 21:40
You talked about it a little bit before but I think I need a clearer picture of what you mean when you say full automation?
Gurjeet Singh 21:50
Yeah, I think that's all we can say on that at this point, as we see a future in which we sort of build much, much more automated devices that do more than just bomb selection or just to automatic See, we want to sort of build more of the automation, the embryology process, to help embryologist basically get consistent results, even outside of just the fertilization and sperm selection where we are focused today.
Griffin Jones 22:18
So this is on the lab side. What about on the clinic side?
Gurjeet Singh 22:23
Yeah, I think thus far, I think AI has a role to play on the clinic side. And what we are planning to do is we are planning on mining data from the clinic to help physicians with better protocols, or to kind of have a better standard of care that we deliver to our patients. But at this stage, our focus is squarely on on the lab side.
Griffin Jones 22:48
So if you're not selling to clinics, and you're not, like you said for those clinics that don't have labs, or they want to switch labs that, that that's an opportunity. But if you're not going to be sending to clinics, how much of other companies will be up using in your labs?
Gurjeet Singh 23:07
Yeah, so for example, if you look at our Omar lab, today, it looks it basically I'm a little horrified to say it looks the same as any other lab, except that our devices are kind of, you know, built inside the microscopes and so on. So we, we buy equipment off the shelf, and then we install our hardware inside that equipment. So it from from the external viewpoint, it looks exactly the same, but kind of all the magic is inside.
Griffin Jones 23:34
Oh, are you working with? So like embryoscope? TMRW? Are those companies that are using the tomorrow tank? Or are those things that you all are using?
Gurjeet Singh 23:43
Not yet, we want to and so we are in discussions with TMRW? And you know, we are we are optimistic we can get to an agreement.
Griffin Jones 23:52
The discussion is the discussion about how does our stuff, talk to your stuff? And vice versa?
Gurjeet Singh 23:58
Yeah, how does that stuff work to your staff? And and just the business terms? Right.
Griffin Jones 24:04
So go ahead. So are you
Sahil Gupta 24:08
saying, you know, a lot of our value proposition for our patients is about accessibility and affordability? So that's the other thing we have to think about while we form these partnerships, if we are able to, you know, pass on savings to our customers and to our patients as well.
Griffin Jones 24:31
Are you focused on the United States right now? Are you also working on opening places in India and elsewhere?
Gurjeet Singh 24:39
Yeah, we are focused in the US. But we have done partnerships with some third party agencies that are international.
Griffin Jones 24:47
What about things that are not involved with the lab tech stack because you're doing this for your own clinics as well? What about EMR Do you have your own EMR? Are you using one of the others?
Gurjeet Singh 25:05
No, we don't have our own EMR. As of now. And we don't plan to build an EMR system.
Griffin Jones 25:16
How about things on the financial side? Like, like patient financing or the guarantee backings or employer benefits? Is that in your future scope?
Gurjeet Singh 25:31
We do. We are partnered with a company in LA called capeX Md. And we offer financing to organs or, you know, families that work with us to capex MD. And on the benefit side, we currently don't have any plans on going on the benefit side.
Griffin Jones 25:47
So for you all, it's it really has to do with this this lab focus and then the patient experience in the clinic. How are you getting Doc's? Everybody's fighting for doctors right now? And in your three years old as a company, how are you? How are you getting docs for these new clinics that you're opening?
Gurjeet Singh 26:06
We are two years old..
Sahil Gupta 26:13
So I think everybody in the industry knew that this is there's, you know, there's disruption coming. Everybody has been excited about it, you know, and I think whenever I talk to doctors, 100% of them actually get intrigued by what we are building. But when they see our devices working in our labs, that's when really, you know, there, you can see their eyes open up, right. There's like so much enthusiasm in them willing to talk and wanting to, you know, start the discussion of joining the network. And in general, I think we are trying to do things differently. I truly believe that Omar clinics are different considering, like, I've seen a lot of clinics in India, I've seen a lot of clinics in the US. And I think when we present our vision to our doctors, they get really excited and thus far, you know, the doctors that are working with us are super happy with what they're seeing and what we are building. And I think we are getting a lot of referrals from our existing doctors. So three of the doctors that we have hired are referrals from our existing doctors. And I think generally there's enthusiasm to join a company that is disruptive. And I think many of our Doc's are also aligning on the mission of accessibility. I think it's important work, you know, access in the US is a problem. Only 2.1% of the births happen via IVF compared to, let's say 10%. But in Denmark, where IVF is free. So I think it's important for a lot of people to solve the access issue as well.
Griffin Jones 28:04
Let's talk about the access issue, because a lot of people say that they want to solve that issue. And then some people say you're not solving for it at all, there's still the bottleneck. And there's at least two bottlenecks. One is the bottleneck of areas, there's only 1100 in the United States. And so we've had that discussion about top about what you can train, OBGYN and advanced providers to do. And then there's also the, the bottleneck in the lab, and mean the shortage of embryologist and I will tell you guys how blown away I am by how many young embryologists want to get the heck out of the lab. They're applying to jobs at my firm and marketing jobs. And I'm like, why are you everybody trying to hire an embryologist? Why are you applying here and some version of we don't want to stand in a box all day. We don't, we just don't want to stand here all day. So there. So there's, you already have a shortage of embryologists and then you have young embryologists wanting to get out of the lab. And as Dr. Carroll Curchoe pointed out on the show. So many of these labs are run by five lab directors that oversee multiple labs. And they're going to be retiring in the next half decade. And so let's talk about the lab bottleneck first, how is the AI going to solve for are you going to be able to do more cases? How are you going to solve for the lab bottleneck?
Gurjeet Singh 29:38
Yeah, on the lab part, the main way of scaling the embryology lab is by building more AI robotics and more automation. And that's kind of what we are working on. So we sort of foresee a future in which you know, most of what happens in an IVF lab is automated. And you know you basically build systems that bring out the best in Human embryologist, but then also since you automate the physical tasks that you require fewer of them and maybe they can even be remote. That's kind of what our vision for the future of the embryology lab is. It's massively automated.
Griffin Jones 30:18
And so then though, you would, you would still hit the other bottleneck if let's and that and the clinic bottleneck happened first, by the way, the lab bottleneck really didn't happen until late 2020, early 2021, in my view, that for the most part, there were there were many clinics that were they were, they were okay at capacity for new patients, but they still felt like they could have converted more to treatment. And then by the end of 2020, early 2021, is when people said, we can't even vert, even if we converted more to treatment, we don't have the lab space, or the lab staff to be able to fulfill all those cycles. And so what if most of your tech stack is focused? On the lab side, you solve this lab bottleneck? How will you improve access to care?
Sahil Gupta 31:17
You know, just just adding one more thing to the lab pod? I think there is enough. You know, there can be enough embryologists, I think the problem is, with all the apprenticeship that happens to make them skillful. So we are also making a lot of tools that, you know, Junior embryologist could use and still get the similar or consistent results that, you know, top five percentile embryologist would get. Talking about the clinic, I think one of the things that I was surprised or almost shocked to know when I moved from India is that the average number of cases that Rei does is about 150 to 200. So that was very, that sounded very low. So we actually spend a lot of time with Rei is with physicians and really like what we did was to map their time out what you know, most of their time look like and most of the time, actually went into tasks that were not related to clinical practice. So I think what we've done in our online clinics, is to actually take a lot of the tasks from the clinics, to our central or to our head office, remotely. And for example, we are not doing a lot of like billing HR, or, you know, a lot of our chart reviews are offline. You know, even, you know, some some of the stuff that was traditionally done inside Atlanta, is now done remotely by our, you know, central team. And I think what it has done is that it's made the physicians do things that they love doing, which is to see patients. So our physicians basically focus on three things, just to see patients and do the procedures. And just, for example, in Santa Barbara, our throughput for the physician right now is roughly about 400 cycles a year. And it doesn't feel to him that, you know, he's working longer hours, just the same amount of time. We are just running this more efficiently and taking a lot of this in house to in in our central office.
Griffin Jones 33:36
What are your views on using advanced providers in this mechanism?
Gurjeet Singh 33:47
Or do we
Griffin Jones 33:49
decide by advanced practice provider, I mean, nurse practitioners and physician assistants.
Sahil Gupta 33:56
So I think that's one of the things that we are using a lot in our clinics. For example, in our clinics, we've also hired ultrasound techs, that would do all the monitoring. You know, the physician doesn't, we feel like there's important touch points in which the physician has to be there for the patient and only those important touch points or milestones the physician would meet, meet the patient, and the rest of the time, either the ultrasound tech or nurse practitioners that will deliver the care to the patient. I think one more thing that I wanted to talk about why we are unique is that we have two points of contact for our patients. One in our remote team, what we call the care advocate, and there's a point of contact in the clinic. So each time a patient goes to the clinic they only meet this person who sort of project manages their cycle or their treatment inside the clinic. Similarly, when they are not in the clinic, they are only dealing with one person outside of the clinic. Home Project manages their treatment and gets them all the answers that they need. So from the patient experience side, it doesn't feel like you know, they're just a number and we make sure that all their questions are answered and they are, you know, taken care of throughout the process.
Griffin Jones 35:25
I should have asked Sahil and Gurjeet if they use EngagedMD in the so if the OMA fertility people are listening right now, this is my question to you. If you're using EngagedMD, and I was thinking after we're recording, then I'll then I'll ask them, and I forgot, because when I think of a group like this, it's that purports to improve the patient experience. It's become so clear from talking to clinic manager, practice director, Medical Director, nursing manager after the other one right after the other of how EngagedMD is no longer just a business plus, like it might have been if it were around 15 years ago, but it's now part of the standard of care that patients have so much on their plate, and they're so overwhelmed, and putting a stack of papers in front of them right now and trying to condense a whole course of information into a 3040 60 minute console. It's just so unfair, and then not giving them the opportunity to customize that to themselves. It's so hard on the patient that it's now part of the standard of care that EngagedMD is able to provide to patients. Most recently I've been talking about engagedMD’s benefits for nurses, staff providers, because those are the people that are texting me talking about how much they love the platform, how much time it saves them how much nursing time you can get back by using EngagedMD and provider time that you can get back and time clerical time from tray tracking down informed consents that, by the way, aren't as informed as they are, when they're through a module like EngagedMD, I've spent so much time talking about this, your staff side that I forget to talk about the patient benefits. And if you go online and look at EngagedMDin these reviews, from the patient side, it's overwhelming how in powered, engage them the makes them feel, and so you can get the benefits from your staff side, the benefits from the patient side. It's one of the quickest and biggest wins that you can do for your practice. If you're not already using EngagedMD, this goes for my friends at OMA fertility, but it goes for everybody listening, go on over to engagedmd.com/griffin They will give you a free workflow assessment, they're going to show you what it looks like that you're doing that other clinics are doing, that's free, whether you decide to move forward with EngagedMD or not after that, either one is going to be valuable, that you're going to get value out of it engaged md.com/griffin. Now back to the show.
What about training OBGYN means to be able to do retrievals and then you can have more doctors and then a board certified Rei oversees those cases that's been that people are often on one side of the fence or the other about that, and a lot more people are on the OBGYN side of the fence now than than there were five years ago. And there are people that are vehemently opposed that Dr. Anate Brauer was on the show and and she said that we How Why are we even talking about this? And so there are some people that feel like that's a big risk. Other people think that it's it's a very minimal risk, and it's necessary to expand the clinical side of care. And then Rei should be practicing at the top of their license. Where did you all fall on that?
Sahil Gupta 39:18
I think we are on this side of you know, having OBGYN to as much or train them. But I think as a company, we've decided not to do it as far. And I think it's a decision we have taken collectively along with our positions and we are open to changing that in the future. But for now we've decided to stick to our API's.
Griffin Jones 39:39
So you're so well that's a smart way of doing it. By the way Sahil is because people have said that they're categorically against it. And then they come up and when necessity merits it they they end up doing it. Did you go with that decision? Because so you think it's necessary to expand access to care but I just don't feel ready to do it at this point.
Sahil Gupta 40:04
I think for us, it's, we have to first ramp up all sort of be at a level where we are running full capacity. And we can test the elasticity of, you know, how many cycles, we can go with a single physician. And I think after that, you know, we are in that position where we have to expand even with a single physician, we might look at other options.
Gurjeet Singh 40:32
Also, I think from a training perspective, right, we are not in the training game, right? We are alike, in some sense, if there is, you know, there is a future in which, you know, there's an exceptional OB GYN who has learned to sort of do retrievers and transfers and are great at the craft at medicine, I think we would absolutely consider them having them in our network. But we are not in the game of training OB gyns to becoming REIs. So are
Sahil Gupta 41:02
doing procedures? I think it's, it's, as I said, we are open to it, but we're not doing it. I know.
Griffin Jones 41:08
Okay, yeah. So then tell me a bit about the fundraising that you've done. And that was what caught my attention. Because as inside reproductive health, we want to start becoming more of a news media outlet and just covering some of these things. And, and that's part of what made me reach out. And so you raised 37, and a half million dollars, some of it is in equity, and some of it is in debt. Our audience is mostly used to talking about private equity. And they've heard me hammer the definitions in their mind private equity, typically taking controlling stake of businesses, typically mature businesses, typically, in an exit plan of a couple years. Venture capital, usually not taking a controlling stake, usually, for something that's new, and, and aiming to scale. And so talk to us a little bit about the this mix. Why? Why this much in debt, because I don't know if people are, are not in so by debt financing, is that from one of the VC partners, or that's the old fashioned way from a bank.
Gurjeet Singh 42:26
It's from our bank, it's our banking partners, Silicon Valley Bank. And again, I've had a long relationship with them. They were our bankers, my previous company, as well. And so the debt that you've taken, it's not like a private equity model. It's like a very standard, you can think of it as a more flexible loan, if you will. Right. So it's, it essentially does not dilute us from an equity perspective. And to the sort of, you know, if we are able to get clinics up and running and scaled and profitable, you know, you can easily pay off their debt, and then continue building.
Griffin Jones 43:03
So let's talk about let's talk about the debt side for a second, because maybe I'm making an assumption, but my assumption is that many people aren't leveraging debt in that way, like directly from the financier that they're often they're either selling to private equity, and then they might be leveraging some debt or, or they're selling equity to a venture capital firm. But it seems like people forget that you don't necessarily have to sell part of your company, if you want to get more money to invest in expansion. You can do it the old, you can do it the old fashioned way, and just borrow some power, some good old money and pay some good old interest. So why aren't people doing that more?
Gurjeet Singh 43:51
I think it's difficult. So banks typically don't underwrite too much risk. So in fact, in our case, right, the reason why Silicon Valley Bank has been comfortable with this is because we've had relationships, our investors have relationships with them, I have relationships with them. But then be you know, at the same time, we also raised a bunch of money in equity capital. So you know, they were convinced that, you know, one way or another, they would get their money and their interest back. So I think if you did not if we did not have the equity raise done, we would not it would be very difficult to get this level of debt.
Griffin Jones 44:25
Did they happen concurrently? Or did the 29 million raise in equity happens first?
Gurjeet Singh 44:32
I mean, it technically happened first, but call it within two weeks of each other like it's pretty concurrent.
Griffin Jones 44:39
And why Silicon Valley? I mean, normally that question would be obvious, but you because you've had such experience, and you have relationships and partners in New Delhi, I assume that there's a again, I'm assuming so you might take me to church right now and I'm totally wrong, but that there is a burgeoning venture. Your capital ecosystem in New Delhi Am I wrong about that? If I'm not wrong about that, why Silicon Valley?
Gurjeet Singh 45:10
Why are we building the company in Silicon Valley? Or why did we?
Griffin Jones 45:13
Why raise the money there? Why not raise the money from the venture capital ecosystem in New Delhi?
Gurjeet Singh 45:21
Okay, so I think first of all this the venture capital ecosystem in Silicon Valley is beyond compare. There is no other place in the world, which is anywhere near still
Griffin Jones 45:32
still, even in 2022. Even in Singapore and Hong Kong, they're still nowhere. No one's touching them.
Gurjeet Singh 45:40
No, no, there are venture capital firms and you know, they, it's, they have VCs and they are growing and so on. But if you look at the deal volume, the investor experience, you know, the deal terms are standard, like there's a lot of muscle memory that we've built up in Silicon Valley, to actually get deals like this done easily and painlessly.
Sahil Gupta 46:01
And the other answer is that we live here. That's right. Next door, and we can do this. You both
Griffin Jones 46:09
live in the Bay Area. Yeah. Yeah. So why did you start in Santa Barbara, then why not start in? In Northern California?
Gurjeet Singh 46:18
Yeah, that's actually a great question. So when we first started out, I remember when we decided on starting our Santa Barbara clinic. We were like three guys and a dog. And we did not have the dog yet. Didn't have any resources IPI? So you know, we went out to look for physicians. We were very lucky. We found Dr. Rich lake in Santa Barbara. And, you know, he saw the vision with us. And he took some risks join us.
Griffin Jones 46:48
Did you get your dog?
Gurjeet Singh 46:51
I did. He's like, Yeah,
Sahil Gupta 46:53
I think one of the other reasons for choosing Santa Barbara was, you know, there's an interesting mix of diversity in population in Santa Barbara in surrounding areas. So it was an interesting experiment for us to learn where most of our customers would come from. And, you know, that was one of the other reasons
Griffin Jones 47:19
I want to get an education from you Gurjeet about what makes Silicon Valley so much more robust and developed than other venture capital ecosystem, because most of our audience, they're not used to us talking about VC, and I think this will be interesting to them as well, I would have thought that there's no way that that Silicon Valley or I know that there isn't a way, but I just would have thought that they likely wouldn't have had the same differential advantage that they would have had 20 years ago to the whatever this the VC ecosystem is in Hong Kong and Singapore and New Delhi and London and, and New York. And but it sounds like it's still very much the place and by a longshot, so what are the things that make it so much more developed and robust for entrepreneurs?
Gurjeet Singh 48:21
So I think the first thing is that a lot of Silicon Valley is still run by operators, right. So these are people who have operated companies in the past who have experience. And, you know, when they, when they sort of grew up, or, you know, maybe are not in an operational role anymore, you know, they're, they have a great home, in various venture capital firms to go start operating there. But then I think, second, they're just muscle memory, right. So there are, you know, if you're going to do a seed financing, or a series, a financing, a lot of the terms are pretty common. And people know that. While for example, I have a friend, you know, who's based out of Switzerland, as an example. And Zurich has a venture venture capital ecosystem. But you know, the deal terms that they get there are very, very different, right, the amount of dilution. You know, if in many European venture ecosystems, if you go for a financing meeting, typically the investor will ask you, how much are you putting in? Right? And in Silicon Valley, things are different, right, where, you know, if a company is great, and obviously, only the great companies get invested in, you know, then there's a fight. There's a fight about, you know, how much money can you put into the company to be on the cap table? So in like, in other words, right, risk capital is something that's sort of everywhere in Silicon Valley. It's what people you know, talk about, it's what they live and breathe. It's kind of like, if you're going to make movies, is there a better ecosystem to be, you know, down in LA, or if you want to be in finance, is there a better place to be compared to, let's say, New York or London? Maybe? There isn't right because that's what that's people are used to those to that ecos stem, they have muscle memory, they know how to get deals done. And there's a concentration. So like the number of investors who are available, you know, call it within a stone's throw in Silicon Valley is, you know, beyond compare.
Griffin Jones 50:13
So what was the fundraising process? Like, because you had previous relationships, but are you going to multiple firms? And you're pitching all over the place? What's that? Like?
Gurjeet Singh 50:22
Yeah, so again, it you know, it depends. In our case, we, we had relationships with root ventures, and, and jazz ventures and, you know, we met, you know, when you're raising money, since in Silicon Valley, finding people who know and want to do deals is certainly not that difficult. The main thing that you optimize for is that you want people who are with you on the journey, who pie the same vision that you have. And we'll support the build of the company and the growth of it. And you know, in route ventures and jazz ventures, we certainly found partners who are super like minded, see the same future that we do, and you and you don't want it to help us build the company.
Griffin Jones 51:10
So what are you going to do with this 37 and a half million dollars, so you're buying clinics? That's that's part of it, you're starting your buying clinic on Long Island, the other six years starting, you know, or have started yourselves? What else are you going to use the money for?
Gurjeet Singh 51:27
So a significant amount of the financing is basically earmarked for research and development. Right, we are building more devices. We went public about our sperm selection device that's already being used in our clinics. But we are building more devices to automate parts of embryology.
Griffin Jones 51:45
And that certain that sperm selection device is not going to be available to any other groups until the lab is fully automated. Is that my understanding that right?
Gurjeet Singh 51:58
We'll see. I think it's in the foreseeable future, we are not selling it.
Griffin Jones 52:03
So okay, so there's more r&d, is there more fundraising to be done in the near future?
Gurjeet Singh 52:09
There's always more fundraising. You know, every CEO is always raising money. So yeah, there will be more fundraising. If he
Griffin Jones 52:19
asks any CEO, would they say that in that IPO? Is the the end journey to is that is that on your Horizon?
Gurjeet Singh 52:29
Yeah. So I think an IPO is a tool, right? It's a tool to kind of raise a type of capital to, you know, basically go after a type of growth. And I think certainly, that's something that's on our radar, right? We want to grow the company and build a company. And at a certain scale, we see that we will need an amount of money that will be viable with an IPO. So it's a means to an end. It's not a destination in and of itself.
Griffin Jones 52:55
What about when you get big enough? Yeah, so now you all are in the game. And because you're making de novo clinics, you're full network yourself. So now there's OMA fertility, there's pinnacle, there's CCRM, which as we're speaking, I see just bought IRM S. In New Jersey, there's IV, there's us fertility, Inception, Prelude first fertility, who am I forget, I'm forgetting somebody, and they're going to be picked up Boston, IVF. And so they're not all just going to the, they're not all just going to remain independent fertility partners, they're not all going to remain independent networks, some of them are going to merge with each other. And maybe some of them will be cashless mergers. I suspect most of them will be acquisitions. But why is that in? In your essay, you said, you want to have full control of the lab, and you'll work with clinics if they're building a new lab, but would you acquire a group, and update all of their labs?
Gurjeet Singh 54:02
I mean, absolutely. It's a question of capital. Right? If we have the capital, then yeah, absolutely. That's a super attractive option. I
Sahil Gupta 54:11
you know, one thing is capital. And we also need to make sure that we are aligned on on what we are building, I think, again, like I'll pull back and say, you know, if the leadership of whoever we are merging with it's not aligned on access, so affordability, that's something that that might not be a good fit for us in terms of an acquisition or so we will continue to look for partners that believe in a lot of our core values. And we want to make sure that we partner with the right people. And one more thing that I wanted to add is I think we also want to make sure that you know, the physicians are aligned and we want to make sure that you know we create any ecosystem for them in which they thrive. I think I've heard this a lot from a lot of physicians that we've interviewed, that they've been burned by a lot of the interviews that are happening in the past couple of years. And I think we make sure that we create a system or an ecosystem in which they are also taken care of.
Griffin Jones 55:26
Tell me a bit about the brand. What's the significance behind Oma?
Gurjeet Singh 55:32
Yeah, so OMA is a is a special word, you know, in, in Sanskrit, it means “the giver of life”. In many languages, it means mother or grandmother. So we love the name, it's a very caring name. And we believe it sort of espouses our value of caring for our patients above everything else. And if you, you know, bear the name, OMA alongside our logo, you will notice our logo has built up dots, and then there is one dot that we have highlighted. And so that dot that sort of thought process behind that is that it's, it's a notion of going from many to one, which sort of significant, you know, it's a, it's a story of IVF read, you have to go from many eggs to one embryo from, you know, two people being sufficient to make a child to sort of be taking a team of people to make a child. And so I think it's sort of this notion of many to one is embedded in our logo. And we kind of knew that we wanted the logo to be scientific and precise. And so that's why we chose the name, which was, which, you know, emanated a sense of care, and empathy.
Griffin Jones 56:41
I want to let each of you conclude, knowing that our audience is mostly for utility doctors, execs in the field. At practice owners, that's mostly who listens to this show. And I've asked you so much today about venture capital about the advantage or disadvantage of using debt of your plans for the lab have the bottlenecks in the clinic and the lab as well. I probably didn't ask you for something that I could have. So I will let each of you conclude the way you'd like to
Gurjeet Singh 57:19
say your first.
Sahil Gupta 57:22
Okay. So, I think about let me talk about Omar, we started Omar with a mission to democratize IVF I think we believe in a world in which whoever wants to have a child and cannot get pregnant naturally gets access to high quality, consistent care, you know, through our clinics, leveraging our technology, I want to end it by calling out to like all your listeners, especially doctors, and, you know, physicians to come talk to us, we want to build a network will with all of you, and, you know, with people who align with our mission, and we are acquiring practice, especially smaller practices, and we would also love to chat about that as well. So it's a bit of a plug.
Gurjeet Singh 58:19
What I would say is, look, we you know, there are three kind of key things that we care about, we want to get our patients successful in as few cycles as possible. That's why we are building our tech, we want to provide empathetic care, Human Centered Care, where we educate our patients and we give them support all along their journey. And third, we want to make IVF accessible, right, these are the three things that we are after. So, to that end, similar to what I was saying anybody who you know, listens to your to the show and and is interested in, you know, working with us jamming with us talking to us in whatever capacity we are super interested in, in sort of connecting. Second, what I would say is that, you know, personally I believe, I, you know, I believe that we are kind of at the very beginning of the beginning that we are sort of looking at this process, as in particularly in the lab as something that people do today and we are building engineering to you know, help and make it more consistent. But we but we see a future in which sort of this notion of operating on single cells using robotic devices similar to what we are building is going to have many, many other applications. And we are excited for that any academics or scientists who are listening to the show who are interested in that you know, or need help. We are happy to connect.
Griffin Jones 59:47
I suspect a couple of them will so we'll we'll link to each of you your LinkedIn profiles in the in the show notes and maybe people will reach out or they can email me Griffin and fertility dot com and I'll make an email connection. Be happy to make an intro if, if some of you that I know would like to talk to our guests today. So Gupta, Gurjeet Singh. Thank you so much for coming on inside reproductive health.
Gurjeet Singh 1:00:12
Thanks for having us. We appreciate it. Thank you so much.
1:00:16
You've been listening to the inside reproductive health podcast with Griffin Jones. If you're ready to take action to make sure that your practice thrives beyond the revolutionary changes that are happening in our field and in society, visit fertility bridge.com To begin the first piece of the fertility marketing system, the goal and competitive diagnostic. Thank you for listening to inside reproductive health