The hundreds of thousands of people who undergo IVF each year put their faith in a high-stakes, hands-on process that requires extensive manual manipulation of fragile, microscopic sperm and eggs.

One small misstep by an embryologist could destroy someone’s chance at a future child.

A US startup is now trying to automate the IVF process using robots and artificial intelligence in Guadalajara, Mexico. The technology has the potential to improve the procedure’s success rate and lower costs, thereby expanding access to widely needed treatments that are out of reach for many.

“It’s very expensive and impossible to scale,” said Joshua Abram, co-founder and chairman of Conceivable Life Sciences. “And the kinds of errors that can happen, they’re all over the place.”

Conceivable is conducting its research in Mexico because another one of its founders is from Guadalajara, which is sometimes referred to as the Silicon Valley of Mexico. Backed by venture funding, the startup is among the most ambitious of the rush of tech companies looking for novel solutions to help the US$40bil fertility industry keep up with demand. It’s a confusing landscape, as Bloomberg explores in a new podcast series, Misconception.

The number of IVF treatments performed in the US has more than doubled in the past decade, according to the US Centers for Disease Control and Prevention. People are starting families later in life and more often finding it difficult to get pregnant on their own. As the industry has grown, investment dollars have poured into the space. In 2023 alone, fertility startups raised more than US$874mil , according to Pitchbook, more than double five years earlier.

As fertility treatments become more mainstream, the industry needs to evolve. Human errors, while rare, are increasingly in the spotlight. There aren’t enough embryologists or doctors to keep up with demand. Cost, too, is a problem, with the average patient spending close to US$50,000 on treatment that is often not covered by insurance.

“I have not seen a single innovation in our field that has made the cost of care cheaper,” said Pietro Bortoletto, the director of reproductive surgery at Boston IVF, a major clinic chain. “Everything has increased.”

Conceivable has raised US$20mil in seed funding from firms including ACME and Black Opal Ventures. Industry watchers say the startup is closest to automating nearly every step of the lab, with just one human embryologist, a lab technician and an engineer to oversee it. Its assembly line of robots can sort eggs from the cells around them, fertilise them with sperm selected with the assistance of AI, incubate them and then freeze them in liquid nitrogen before storing them.

So far Conceivable has only revealed the results of small studies, but it says its technology has led to 19 pregnancies. The findings would need to be confirmed in bigger tests and likely evaluated by the Food and Drug Administration before being rolled out in US clinics.

Nikica Zaninovic, director of the embryology lab at Weill Cornell Medicine in New York City, is skeptical that such technology could perform as well as top embryologists.

“Human input is still extremely important,” Zaninovic said. “I don’t think that at the moment the lab is ready to be completely automised.”

Some clinics have also begun experimenting with AI and robotics on a smaller scale, like Columbia University Fertility Center, which plans to soon debut a robot called APRIL that preps the dishes where embryos are grown. Columbia’s studies, as well as others, suggest that AI and robotic systems are at least as good at manual tasks as human embryologists, if not better.

Cristina Hickman, founder of a fertility clinic in the UK, is excited by Conceivable’s technology. She thinks robotics will eventually revolutionise the job of an embryologist, allowing them to help more patients.

“We’re each going to be responsible for more babies in the world.”

 - Bloomberg