Opinion. How the Fertility Industry Failed Its Greatest Advocate
BY LINDSAY BECK
Barb Collura was just let go as CEO of RESOLVE: The National Infertility Association.
Why? In part, it’s rumored, because she didn’t raise enough money.
Let’s be crystal clear: that’s not on Barb. That’s on us.
I say ‘us’ because, while I’m also a lifelong patient advocate, for the last few years I’ve been on the corporate side of the table deciding if, when, and how to support RESOLVE. And I’m embarrassed to say that as I juggled corporate priorities, I gave too little too.
Barb took the helm of RESOLVE in 2007. Back then, there were just over 132,000 IVF cycles a year in the U.S. and 9 states had varying mandates for fertility coverage. The industry was scrappy, still fighting for legitimacy. RESOLVE was operating on a shoestring, trying to get lawmakers to even listen when patients asked for help.
Today?
More than 389,000 IVF cycles are performed annually – nearly a 200% increase.
Millions more Americans have employer-sponsored IVF coverage.
The U.S. fertility industry is now worth over $35B and growing fast—and FemTech is even bigger.
Every inch of that progress has Barb Collura’s fingerprints on it.
She fought. For decades. On Capitol Hill. In statehouses. In employer boardrooms. In the media. She made it her life’s work to make sure that more people could build families. She’s the reason there was a patient voice at the table as the industry exploded.
When IVF shut down in Alabama last year—sending a chill through the field—Barb was a (the!) leading force to get us back in business in 7 days. And she continued to work tirelessly to prevent it from happening again elsewhere.
Under Barb’s strong, steady leadership, RESOLVE’s impact has been deep, far-reaching, transformative, and irrefutable. At the 2023 gala, Dr. David Sable captured this beautifully when he said: "Everyone [in the field] deserves credit for doing it, and no one deserves more credit for helping us do this than RESOLVE."
As the world changed around us, one thing didn’t: RESOLVE’s budget.
Despite the booming industry, RESOLVE’s funding has barely grown. While the number of IVF cycles skyrocketed, RESOLVE’s annual revenue has been stalled at approximately $2.5 million for years—an order of magnitude too small to meet the moment.
Let’s talk about what has grown:
Companies have gone public with multi-billion dollar valuations.
Networks have been sold for multi-billion dollar deals.
Clinics have been rolled up, sold, resold.
Doctors and clinic owners earn millions—every year.
Start-ups have raised hundreds of millions of dollars—expecting access to grow.
How many of those deals included even a 1% donation to RESOLVE?
None.
This isn’t normal. Consider this: Marc Benioff started the Pledge 1% to encourage founders, CEOs and companies to donate 1% of their revenue, equity, and/or product to causes they care about. More than 19,000 companies have signed on and donated billions—Salesforce, Slack, AirBnB, DocuSign, Canva to name a few.
A 1% donation from a $500M+ buyout or $1B+ IPO would be $5-10M+ respectively. Of course, a 1% commitment wouldn't have to be directed solely to RESOLVE—the Alliance for Fertility Preservation, Chick Mission and others are worthy recipients too. But when you consider the immense wealth generated through industry salaries, revenues, acquisitions, and IPOs, it's jarring to realize that RESOLVE’s largest individual donation is $100,000—and only one person has ever given that amount. And, the largest corporate donation is $500,000—again only one. In some cases, companies even give more to clinic-started foundations and network events than to RESOLVE.
Big gifts aside, if each of the 450+ fertility clinics in America simply gave $10,000 per year (roughly equivalent to the annual cryostorage fees of 10-20 patients), that’d be more than $4.5 million a year. Sliced another way, if each of the 1,250+ practicing REIs donated just $4,000 annually, RESOLVE’s budget would double, exceeding $5 million.
Industry revenue is in the billions annually, and the room everyone wants to be in to celebrate, awarding each other's accomplishments, is RESOLVE’s annual gala—where 600+ guests come together and donate less than $1 million total.
Earning a fraction of the peers she calls on, at last year’s event in honor of RESOLVE’s 50 year anniversary, one of two five-figure donation matches was pledged by none other than Barb herself.
Barb has spent two decades knocking on our doors, asking for support. For policy change. For access (market growth!). For patients. For our collective future. She’s asked again and again and again. We’ve made her beg, responding with small gifts, endless maybes and ‘what’s in it for me’ mentalities.
We failed her. We didn’t give enough.
Barb’s advocacy built the road that allowed all of us to scale—and we haven't reinvested in the organization that made so much of it possible.
To Barb: I’m sorry. You and RESOLVE deserved better.
To everyone in the industry: It’s time to adequately fund the independent advocacy group that supports and advocates for the patients we all serve.
We’ve taken too much and given too little.
The views expressed in this Opinion piece are exclusively those of the author.
Inside Reproductive Health published this article at its own discretion, without seeking comment from or consulting any parties that may have been named.
