Episode #338: Startup Series – Will Matthews, Fellow, “Semen Quality Is The Canary In The Coal Mine To Overall Health”

Episode #338: Startup Series – Will Matthews, Fellow, “Semen Quality Is The Canary In The Coal Mine To Overall Health”

 

Guest: William Matthews is the founder and CEO of Fellow, which offers the only lab-certified, mail-in semen analysis that exceeds all standards for FDA validated semen analysis methods.

Date Recorded: 7/15/2021     |     Run-Time: 49:21

Summary: In today’s episode, we’re covering the topic that men like to shy away from – sperm health! We start by discussing the decline in fertility rates in the West and the possible reasons why – stress, obesity, and chemical exposure. Then Will shares what it was like to create the first clinic grade direct-to-consumer semen analysis kit so you can avoid that awkward doctor’s visit.

As we wind down, Will shares his vision of creating a flywheel effect, using test data to conduct research and in turn use that research to fine-tune their test kits.

As a special offer for listeners of the show, visit www.meetfellow.com and use the code MEB to get $20 off your order.

Sponsor: AcreTrader – AcreTrader is an investment platform that makes it simple to own shares of farmland and earn passive income, and you can start investing in just minutes online. AcreTrader provides access, transparency, and liquidity to investors, while handling all aspects of administration and property management so that you can sit back and watch your investment grow.  If you’re interested in a deeper understanding, and for more information on how to become a farmland investor through their platform, please visit acretrader.com/meb.

 

Comments or suggestions? Email us Feedback@TheMebFaberShow.com or call us to leave a voicemail at 323 834 9159

Interested in sponsoring an episode? Email Justin at jb@cambriainvestments.com

Links from the Episode:

  • 0:39 – Sponsor – AcreTrader
  • 2:25 – Intro
  • 3:20 – Welcome to our guest, Will Matthews
  • 4:47 – The current landscape of fertility right now
  • 6:17 – Possible correlations between poor health and weakening semen quality
  • 8:04 – Episode #286: Jeremy Grantham, GMO
  • 9:09 – Fighting the stigma around men’s fertility
  • 12:04 – The initial inspiration to found the company
  • 20:03 – Marketing the company and growing over the last year
  • 24:06 – COVID’s impact on the company
  • 25:41 – Offering storage services as well as sample testing
  • 29:09 – Episode 105: Olivia Judson, Author
  • 30:02 – Milestones for Fellow over the coming years
  • 35:02 – Health tips for ensuring optimal fertility
  • 38:13 – The fundraising process
  • 39:59 – The biggest challenge of Fellow’s journey so far
  • 42:02 – Drawing inspiration from other DTC health startups
  • 43:57 – The importance of ending the stigma around proactive testing
  • 45:26 – Learn more about Will; meetfellow.com (use code MEB for $20 off); LinkedIn, Instagram, Twitter

 

Transcript of Episode 338:

Sponsor Message: Today’s episode is sponsored by AcreTrader. I’ve personally invested on AcreTrader and can say it is a very easy way to access one of my favorite investment asset classes, farmland. AcreTrader is an investment platform that makes it simple to own shares of farmland and earn passive income, and you can start investing in just minutes online. AcreTrader provides access, transparency, and liquidity to investors while handling all aspects of administration and property management so you can sit back and watch your investment grow. We recently had the founder of the company, Carter Malloy, back on the podcast for a second time in episode 312. Make sure you check out that great conversation. And if you’re interested in a deeper understanding and for more information on how to become a farmland investor through their platform, please visit acretrader.com/meb. And now, back to our great episode.

Welcome Message: Welcome to “The Meb Faber Show,” where the focus is on helping you grow and preserve your wealth. Join us as we discuss the craft of investing and uncover new and profitable ideas, all to help you grow wealthier and wiser. Better investing starts here.

Disclaimer: Meb Faber is the co-founder and chief investment officer at Cambria Investment Management. Due to industry regulations, he will not discuss any of Cambria’s funds on this podcast. All opinions expressed by podcast participants are solely their own opinions and do not reflect the opinion of Cambria Investment Management or its affiliates. For more information, visit cambriainvestments.com.

Meb: Welcome, podcast listeners. Today, we have another episode on our podcast Founder Series where we invite kickass entrepreneurs to chat about their experiences from the front lines of starting a company. We cover everything from newly minted startups still struggling to make it out of their garage all the way to the elusive unicorns that are either transforming traditional business sectors with innovative ideas or creating entirely new ones through cutting edge technologies. Either way, the result will be total catastrophic failure and bankruptcy or hundreds of millions of dollars of revenue and a valuation worth north of a billion dollars. Listen in to hear the tales of blood, sweat, and tears as these founders try to change the world. As a disclosure reminder, I’ve invested in most, if not all, of these startups, and will look to invest more as they continue their startup journey. Please enjoy the next episode on our Founder Series.

Meb: What’s up, friends? We got a model show for you today. Our guest is the founder of Fellow, a company that’s rethinking the future of men’s fertility and runs the largest semen analysis lab in the U.S. In today’s show, we’re covering the topic that men like to shy away from, reproductive health. We start by discussing the decline in fertility rates in the West, possible reasons why, stress, obesity, chemical exposure. Then our guest shares what it was like to create the first clinic grade direct-to-consumer semen analysis kit so you can avoid that awkward doctor’s visit. As we wind down, our guest shares his vision of creating a flywheel effect using test data to conduct pharmaceutical research and, in turn, use that data to improve the health and lives of men everywhere. As a special offer to listeners of the show, visit meetfellow.com and use the code MEB to get $20 off your order. Again, meetfellow.com and use the code MEB for $20 off your order. Please enjoy this episode with Fellow’s Will Matthews.

Meb: Will, welcome to the show.

Will: Thank you for having me. Really, really, appreciate it. Glad to be here.

Meb: Where do we find you today?

Will: I am in the Mission District of San Francisco.

Meb: I miss San Francisco. I need to get back up there. I used to live above the Broadway Tunnel in Chinatown, a little bit in North Beach next to the old Tower Records. I used to get up there about once a quarter. I’m due for a trip, so you’ll have to take me to your favorite burrito place. What is it? What’s your favorite burrito place in the Mission?

Will: Oh, it’s called Taqueria El Buen Sabor. I don’t know how I think about how that rolls up my tongue so well, but that has the best vegetarian burrito. Not that I’m vegetarian, but I just love their veggie burrito.

Meb: You don’t sound like you’re from the Mission. Where are you from originally?

Will: I’m from the UK, born and raised in this little village outside of London, about 40 minutes northwest, in between Oxford and London.

Meb: Are you guys allowed to get back there yet? When’s the last time you’ve been across the pond?

Will: March last year, I was there. TBD on when I can make it back. There’s this whole two-week quarantine period that I would need to do if I am coming back, so I’m trying to wait until that is released.

Meb: I miss it. We had some trips over there. Hopefully, fingers crossed, at some point soon. We’re big investors in the UK now. Their stock market is really cheap compared to over here. So we’re cheering for them to figure out Brexit and everything else, the virus. All right, let’s talk about something totally different, sperm and everything surrounded by it. You guys, when you came across my plate, may have been one of the most obvious and interesting startups I’ve seen in seven years. So disclosure, listeners, we’re an investor. But let’s start, take a step back before we get into what you guys do, let’s talk about what’s the situation with fertility in general. Is this like a prequel to “Children of Men,” that movie with, who was it, Clive Owen?

Will: Yeah, yeah.

Meb: Are we entering a dystopia? Give us the background.

Will: I mean, I think there’s a lot of press out there right now about how men are doomed, fertility is decreasing, we don’t know why, etc., etc. There was a very large study published a couple of years ago that introduced the fact that fertility rates amongst men in Western countries, specifically, have declined about 40% over the last 40 years. And to the way in which I phrase this is that young men today have 40% lower sperm count than their fathers did at the same age. Specifically around the science behind it and what is causing it, there’s a lot of discussion about what could be factoring in. I mean, plastics, BPA, phthalates, pesticides, like, endocrine disruptors. I mean, they’re not good. The jury is really out as to why this is the case, and that is certainly something that we hope to solve and glean insight into as we progress with the business.

Meb: I’ve heard you guys talk about this in general. Is this a coincident indicator? Is it something that, look, we have, obviously, in America, but in a lot of other countries as well? There’s epidemic of obesity, and overweight, and all sorts of similar things like diabetes. Is that something that’s coincident? It’s totally separate? How does it factor in?

Will: I mean, I believe that, and there’s a lot of research that goes into this, that semen quality is the canary in the coal mine to overall health. And so in looking at diabetes, in looking at cancer risk, in looking at heart disease risk, and things like that, there have been some studies that have demonstrated that, like, a subfertile semen quality is an indicator of heightened risk of diabetes, of heart disease, of cancer, unfortunately. And so they are related. I mean, I went to…in the very earliest days of this business, I was talking to many, many doctors about what we were trying to do and how we were trying to do it. And one doctor, in particular, based in San Francisco and L.A., he said, “Will, there’s one metric that I look at when trying to determine what could be causing a sample to be subfertile,” and he said, “And that is waist size.” And I mean, that seemed pretty interesting and has stuck with me since. And so, certainly, if men are eating poorly, if they are obese, if they are very stressed, if they’re not getting much sleep, that’s not going to do a man’s fertility any favors.

 

Meb: How much of this is a Western phenomenon? Is this going on elsewhere in the world? Is this happening in Asia, in Africa, in South America? It’s, like, a very frightening topic. We talked a little bit about this with the episode with Jeremy Grantham. Our listeners, if you didn’t hear that episode, it’s a really good one. Is it unique to the Western world, or is this happening everywhere?

Will: I mean, this study, in particular, surfaces this as something happening in the Western world. I’ve dived into the research, dived into some of the numbers, and it doesn’t seem to hold in Africa, in Asia, and non-Western areas. And so Europe, Australia, North America is where these trends have been seen. But, like, there could be a lot that’s factoring into why this is the case, including the fact that there could have been more research done in the Western world than there has been in the non-Western world. And so I’d take it with a grain of salt, but the study itself introduced this as something that’s happening in the Western world.

Meb: Yeah. And the weird part is it’s like a continual decline. It’s not, like, per decade it, like, went down and then flat lined, or…it’s just, like, a steady kind of horrifying linear exponential sort of decline. My first thought when I saw it was that I wondered if it’s just, like, bad data, but then you have every year, over the past 40 years, makes it a little more reasonable that it’s not an artifact. All right. So, you know, sexual health and then that topic, in general, my parent’s generation was probably one that was a little more taboo maybe, you know. What’s the sort of state of people talking about it? Is it becoming more mainstream? What’s your general thoughts there?

Will: Well, I think it’s becoming more mainstream they certainly talk about. But there’s still a long way to go. When I was first looking to build this business, I said that there are two reasons why this is so troubling today, and that is that, one, the convenience of men getting a fertility evaluation is very difficult. They got to go into a clinic, and we all know those stereotypes of going into those rooms, getting the magazines, providing a sample. So that convenience is really terrible. And then there’s also a stigma associated with it. And I believe that we are progressing very well in introducing this as a topic that is very relevant. Data is beginning to show that when couples are having a hard time conceiving, in equal proportion, men are at fault as women are. So it’s a problem that is equally shared, and we just need culture to catch up. And I believe that that is happening, and I believe that the media is certainly encouraging that in light of the stories that they’re painting about this previous article, in particular.

Meb: Let’s rewind. I want to hear the origin story of Fellow. As a glide path getting to that, let’s hear a little bit about your background. What were you doing before founding this company?

Will: So before founding Fellow, I joined a friend of mine to build a home improvement financing company. And very, very different space. We took that from his kitchen table to a 100-person company today, and the premise was to create the Expedia for homeowners to get financing for non-discretionary remodels, let’s say. When someone needs to fix a roof, they really need to fix their roof. And we wanted to help them get the financing they needed in order to do that. That’s what I was doing directly before. I was cutting my teeth, so to speak, going on how to build a business, how to get licenses, how to work with, like, federal agencies and state agencies to understand whether you need different…what licenses you need, which has certainly helped for Fellow, for sure. And then before that, I was working at Playboy Enterprises down in L.A. I was there for just under two years, helping with their positioning, how they were trying to orient themselves in this, like, digital media era, and where the business stood the strongest.

Meb: You ever make it in the Grotto?

Will: I did. I did.

Meb: What was the inspiration idea? I mean, Playboy, that’s a little close to home on this topic. What was the initial inspiration? Was there a personal experience? Was it something that you had some friends in the industry? How did you get this part?

Will: Yeah, that’s a great question, Meb. It’s funny, when people hear Playboy, like, “Wait a second, Playboy, male fertility company. What is the origination there?” So when…I mean, born and raised in the UK, I was familiar with the NHS and the health care system out here. When I came out here, I wanted to see a urologist, and I knew that I had to go through the process of primary care physician referral to a urologist and where I could get the information that I needed, and I really wanted to better understand my health. I went to the primary care physician on the third floor of this building, and she said, “Okay, Will, go to the fifth floor and schedule an appointment with a urologist, and you’ll be able to get the answers that you’re looking for.” I went to the fifth floor, I scheduled the appointment, and the woman at the desk said, “Okay, so the next available appointment is in three months.” That was debilitating because I really wanted to know what was going on. And I said, “Is there any…has there been any cancellations? Is there any way that I can come earlier?” She said, “No, wait three months.”

So I waited patiently for three months, and this, like, then the questions that I was trying to learn more about were pretty consuming. And I get to the appointment with the doctor, and the doctor says, “Okay, Will, as a next step, we need to do a urine analysis,” which seems very, very routine when seeing urologists. And I said okay, and so they gave me a cup. And I went to this terrible bathroom stall and just provided a urine sample, took it back to the doctor’s office, and I was like, “So, what are the next steps here?” expecting them to say, “Okay, come in next week, and we’ll give you the answer that you need.” And like, rinse and repeat, they said, “We need to come in and we got another appointment available in three months, and you’ll be able to get the answers that you need.” And that felt really, really debilitating.

And coming away from that experience, I was like, “Wait a second, like, let’s look into my, like, male reproductive health today, tomorrow, what that’s going to look like.” I was like, “We’ve got my, like, sexual health and trying to understand that.” That’s been a terrible experience so far. We’ve got fertility, and like, if I’m having fertility trouble, I’m in for a pretty, pretty terrible experience, and that’s not that great. Getting older, when thinking about my hormone levels, like, how does…there are these clinics that one can go to to understand that, but it’s not too well understood. And then going all the way into my 60, 70s, thinking about my prostate, for example, like, prostate, like, PSA testing today has a 75% false-positive rate. And just rewinding a little bit, I saw in front of me a terrible set of experiences for me to understand my male reproductive health, and that inspired me to go out and start with this next journey that I’d have to go through, fertility. And I was like, “Why is there no at-home male fertility evaluation? Let’s see what I can do to try and set something up in that space.”

Meb: Give us the timeline origin. What year are we at now at this point? And when did you take the jump and say, “Let’s try to make this a company?”

Will: We are in 2017. 2018, I set up a company, became full time in September 2018. We launched our test in April 2020. We’ve been live for just over a year now. And from 2018 to 2020, we got our own clinical lab. We got our own CLIA approval, which is the licensing you need to run a clinical diagnostics lab to provide insight to doctors. We developed our own research, had it published in the journal, “Fertility and Sterility.” And once we knew that we could accurately perform a semen analysis with a sample received through the mail where, up to this day, a sample has been required to be tested within one hour of generation, as soon as we validated the mail-in component, we launched, and that was April 2020.

Meb: Was that just an assumption at the time that it was impossible to do the analysis with that much sort of a gap between production and analysis, or was that just a guess, or you know, was there any evidence, or you guys just said, “Hmm, maybe we’ll test this?”

Will: So there is, like, a 500-page document by the World Health Organization that’s currently in its 5th edition, about to be in its 6th, that’s called the lab manual for the processing and handling of human semen. Within that manual, it says that, and it’s used worldwide at all andrology labs, like, it is the reference guide. It says that samples must be tested within one hour to be clinically relevant, and that is because the motility of the sample, so the movement of the cells, naturally, decreases over time. And so we set about with the thought that, “Wait a second, there are hundreds of thousands of cells here, if not, sometimes hundreds of millions of cells. Yes, they are going to decrease, but if we stabilize them through our preservation solution, and we control the temperature, can we accurately track the degeneration of the sample over time so that when we receive it in our lab, we can backtrack and be like, ‘This is what it was like when we received it?’ We know that samples decrease at this rate. This is what we believe the sample was like within one hour.” And so it hadn’t been done before, and we set about to try and prove that it was the case. And we’ve since become the first peer-reviewed journal article to demonstrate that it is possible.

Meb: You guys have one of the all-time, like, we call this frustration hour, but it takes on an entirely new meaning with your category, but like, it’s such any startup where there’s just something that just sucks, like the whole process, like you mentioned, not to mention the time where, you know, I had to go through this, I’d been doing some of the IVF stuff and went to a clinic in L.A. And this is probably TMI for the listeners, but those who have been through it will probably like to hear it because there’s probably similar stories everywhere where, you know, they usher you into this tiny room, and my favorite part was they had these old CD cases. And by the way, anyone under 30 is probably, like, “What in the world is a CD?” There’s a tiny computer, and this is no magazine, this is the material that males are supposed to watch, okay? Already, we’re TMI territory.

And my favorite part about it was it was, like, none of this was, like, PG-13, RX, or triple X rated. It was, like, the quadruple X stuff that, like, if you get to the furthest reaches in the internet. But then, also, I was, like, “I don’t want to touch anything in here. There’s been 50 people in here before me, and this is the grossest possible atmosphere to ever be a part of this reproductive journey about creating a child,” which is supposed to be, in my mind, you know, a very positive experience. And so, anyway, long story short, it seems so obvious. I feel like this is such a startup story where people just assume you can’t do it any other way. They’re like, “Well, you could never do it at home,” because of the reasons you mentioned. And then you guys had this critical insight where you’re like, “Well, it turns out you can.” All right. So you guys start launching, start collecting. How do you let people know? What’s been the process over the last year?

Will: That’s a great question. So we launched in April 2020. We have since found three channels that we use to work with customers and find customers. I mean, we have the first direct-to-consumer. We have people search for male search evaluation online. If they search for semen analysis near me, things like that, they typically come across us, and they’d buy a kit, where we provide a physician of record to order the kit, we send it out to them, they get it within a couple of days, they provide a sample, we give them results within one day. That’s one channel. We have also found clinics that have started using us for their patients, in particular, OB-GYNs and urologists. And we have also found biotech and research as a channel for us. And what I mean by that is that all being able to open up the catchment area for our lab to nationwide by receiving samples from anywhere, from Florida to Washington, we have enabled a standard in research that has universities and private biotech companies interested in using us. And so, right now, for example, we are powering a phase two clinical trial for a hypertension drug that is looking into whether it adversely affects fertility. We’re also powering a study with the U.S. Navy who are looking to understand environmental exposures for sailors in their day-to-day operation. Those are our three channels that we currently work with.

Meb: You know, it sort of reminds me of the origin story, like 23andMe back in the day kind of had this entry point of being like an ancestry or like, “Hey, here’s some cool information about your genetics.” But then, I think…are they public now? I think, as they’ve grown and become a multibillion-dollar company, they said, “Hey, look, we actually have this massive resource. Let’s start partnering with pharmaceutical companies. Let’s start thinking about other ways to utilise our information.” Is that accurate to say that’s sort of a similar pathway for you guys?

Will: That’s certainly been an inspiration for us. I think 23andMe have really paved the way and introduced consumers to the insight that can be generated from at-home mail-in tests of bodily fluids. And they have inspired us so much. I mean, we’ve brought on…we have a really incredible team that has come in and joined us on this mission. And two of our members, in fact, have come from 23andMe. So our engineering leader and our product leader both spent four or five years plus at 23andMe.

Meb: And so, what is the sort of wedge in the door as reproductive information diagnostic of direct-to-consumer, I assume? Is that the majority currently as the way the business is built?

Will: Actually, our fastest growing channel is direct-to-physician. And so we have physicians that are referring Fellow to their patients, because otherwise, it’s very difficult for them to go and provide a sample in these rooms. They don’t like to do it, they don’t do it. And in fact, we have, I mean, as I mentioned, we have OB-GYNs who typically see women as the first step in the fertility journey. And naturally, in order to understand what’s happening with the couple, one needs to understand what’s happening with the male in a heterosexual couple. And so the OB-GYN provides a Fellow kit to the woman who takes it home to her partner, and he generates a sample, mails it in, and then the OB-GYN gets the result to be able to understand, is this a male thing? Is it a female thing?

Meb: You know, I mean, if you think about you all’s timing on launching the company, I mean, there’s obviously the unfortunate timing of trying to get started during a pandemic but also the auspicious benefits of saying, “Well, this is now direct-to-consumer at home.” How did those sort of two forces play out as a headwind or tailwind of everything going on of getting this thing up and running?

Will: So we don’t have any prior data, so, from, like, pre-pandemic, and so I can’t tell you what it would have been like. But one thing we did see during the pandemic was that a lot of semen analysis labs just closed their doors, and they said, “You know what, we can’t do this anymore.” And that made it very difficult for…I mean, similar to my experience with that urologist a while ago, it made it very difficult for men and couples to get the answers they need when trying to conceive.

Meb: I saw a stat. Is this still the case about being the largest, essentially, semen analysis lab in the U.S.? Is that a reality for you guys?

Will: Yes, we’ve been really humbled by the number of people that have been purchasing kits, that have been trying to learn more about their health. And we now process multiple hundreds of samples per week. And I mean, as I’m sure you can imagine, like, a lab that has to do this in-person just doesn’t have the capacity to be receiving men for however long it takes them to generate a sample, and they just don’t have the ability to scale like we do from a lab that just gets a massive shipment of orders every day.

Meb: As you kind of look at the process, how much of this is very obvious extension, almost like a SaaS type of business too for the direct-to-consumer, and that’s storage, preservation? Is that something you guys do currently or looking into?

Will: Absolutely. So we’ve taken the approach that we are going to be a full-stack lab that owns its full operation. And so we received our federal tissue banking license in January, February of this year, and we have since launched cryopreservation. And we enable men to cryopreserve, and the types of people that have been storing are those that are interested in ensuring their fertility, especially in light of the statistic of fertility decreasing over time. We also have been supporting cancer patients. If men are diagnosed with some form of cancer and they’re about to undergo chemotherapy or radiation therapy, before they begin that, they have been cryopreserving with us. And we’ve also found ourselves supporting the transgender community, which have been really fantastic. As people transition, they store their fertility for future, because, who knows, maybe they would use it.

Meb: What’s the ballpark cost to you guys to the extent you can tell us for the preservation?

Will: We charge consumers $140 per year for cryopreservation.

Meb: You know the, like, going rate that labs charge is, like, 500 bucks. I remember looking into it, and it’s so expensive. So right there, I mean, just the ability to cut some of the cost on this, I mean, look, must be a great business for those labs because that doesn’t probably take up too much space in the freezer. But does that sound, like, about right for the kind of the competitors as far as cost?

Will: What we do is we have the whole semen analysis, which is $189, and then they can bolt on cryopreservation on top of that for $140 per year. And so from a cost perspective, I mean, we’ve seen as much as multiple thousand dollars, and we are really excited to increase access to men to be able to do this in a cost-effective way.

Meb: I’m sure all of the listeners would be very proud to know that my results were top of the class when I got mine tested. I was laughing as I was looking through it with a total motile count of how many millions it was. I mean, the question I always had was, though, and I used to be a biology engineer guy million years ago as an undergrad and remember reading a lot of evolutionary biology, and if you think about, you know, why do humans need this many sperm in the first place, and the only real reason that I could ever see in the literature was that the competition between multiple partners about you want more shots on goal. You know, you only need one, of course, but if there’s going to be multiple competitors, maybe that’s why you need hundreds of millions instead of just five.

Will: Yeah, yeah, exactly. I mean, and also, the female reproductive tract is also a pretty harsh environment, and so there needs to be many sperm to be able to make it in light of the female reproductive tract seeing this as a foreign substance. It’s, like, “What is this? Like, how do we…like this is…let’s protect ourselves,” and so the sperm need to be operating in numbers just to increase the chance of conception.

Meb: Yeah. I mean, there’s a fascinating evolutionary kind of competition not just between males of the same species but males and females of the same species. And we had an evolutionary biologist on the podcast a while back, Olivia Judson, and the book “Dr. Tatiana’s Sex Advice to All Creation,” fascinating book, but it would talk about how males and females evolved different traits to essentially see who could get the leg up in the evolutionary footrace. And I mean, I remember there being stories of, I don’t know if it was bees or what, but the male would…they would have sex, the male would ejaculate, the penis would break off and, like, block to prevent other partners, yadda yadda. Anyway, you got to be a science nerd to love this, but that book, go check it out. It’s one of my all-time favorites.

Wow, we just went off on a weird tangent. Okay. So, all right. So you have analysis, you have cryopreservation, you have partnering with pharma companies. As you look to the horizon, you guys are pretty, pretty new to this business, what are sort of the pathways of the future, whether it’s one year, three years, five years? How do you see this evolving? And you know, what do you see is the major sources of what you guys will be doing in a few years versus now?

Will: That’s a great question. I mean, we also have a vasectomy test, just adding that in the list, male fertility evaluation, cryopreservation, and the vasectomy test for men to confirm the success of a vasectomy.

Meb: Oh, to see if the snip held, or the knot held, or whatever it is, the plug held.

Will: To see if the tubes were effectively cut.

Meb: See if the pipes are fully blocked. Okay, got it.

Will: Exactly. Exactly. I mean, sometimes the same pipe can be cut twice, for example, and that leads to unsuccessful vasectomy. Around the future of the business, like, I believe that the semen is a sample with incredible data potential. And so over the last several months, we have sought to work with some incredible experts and bring in some incredible team members to set us up to further discover what is possible within semen. And what I mean by that is that, within the male reproductive system, you’ve got testicles, you’ve got prostate, you’ve got the bulbourethral glands. There’s a lot going on. And within a male reproductive system, for example, take testicular cancer. Testicular cancer is the most prevalent cancer for men between the ages of 20 and 39. Prostate cancer is the second most fatal cancer for men. It is, I think, the most diagnosed.

These are areas that don’t have the best diagnostics today. Yet, you have this semen sample that comes…some of it comes from the testicles, some of it comes from the prostate, some of it comes from the bulbourethral glands. I mean, a semen sample is a representation of multiple different organs within a male reproductive system.

And so where we are looking to go is in further supporting patient-clinician experiences to answer questions in male reproductive health and science, going much deeper within the sample. And there are some really fascinating research out there that has shown that it is possible to detect a lot, lot, lot more than fertility within a semen sample. And so that’s what we are currently working on.

Meb: Yeah. I mean, it seems like you have such an interesting resource of a database that, you know, probably no one else in the world has. Is there anything you guys can share, any insight from the first year of collecting all these thousands of samples to where you were surprised or where you’re like, “Hey, we actually are surprised about X, Y, Z,” or anything else, or maybe it’s proprietary but anything in general that you are about the whole process that was interesting insight?

Will: We’ve had a lot over the last year and a bit. But I mean, 40% of the people who buy our kit are women, and I would not have anticipated that such a high number, as has been the case. We have seen a…I mean, we’ve learnt a whole host of things over the last few years. I mean, sample quality has been pretty fascinating to learn more about. But I’d imagine that probably the greatest insight has been, like, we have the sample, there’s so much in there that we can learn more about. Let’s look to build more insight here, and that has been an interesting insight when looking more into research and talking to some incredible people who have chosen to support, advise, consult, join our business.

Meb: I was laughing as you were talking about, like, because I’m like, I wonder how many of these women, it’s like, people not married, they’re dating, and she’s like, you know, “I need to know if this guy’s boys swim, because otherwise, I’m wasting my time, my reproductive fitness years. I’m 34. I can’t be messing around. I’m not going to even tell him.” That’s amazing insight. I had no…I would have guessed it was, you know, a tiny minority of overall. You guys just in the U.S. or what?

Will: We are just in the U.S., yeah.

Meb: What’s the current state of global analysis? Is anyone else doing this abroad? Are you guys going to expand at any point in the U.K., in Europe, in Canada, in Mexico, and anywhere else?

Will: I mean, there are a few companies abroad, that’s for sure. But I mean, our main goal is, “Let’s get right where we are focused, and let’s create the most value we can for our users, for our customers, for patients, for clinicians, and let’s take that insight into new markets. But until we do that, let’s focus on the U.S. market.”

Meb: Do you have any guesses on what, you know…I was looking at my Fellow page when I had my results, and as you think about the things you can do, always, these are all, like, common sense life suggestions, but it’s, like, don’t smoke, have a healthy weight, drink less, eat better, get your cardio in, get your sleep. Here’s one of my favorites, two favorites, boxers are better than briefs. So I imagine, by an extension, no underwear is even better than boxers.

Will: I’ll give it to you.

Meb: Here’s the one I hate the most, stay out of the hot tub. Oh, you’re killing me, man. I’m a skier, so that’s, like, I’m just going to have to sacrifice for that one. And don’t stress. That’s a tough one for everybody.

Will: Yeah. I mean, the hot tub, like, routine hot tub use, unfortunately, is really not good for fertility, but I mean, it’s certainly recoverable. But you can see a measurable decrease from routine hot tub use.

Meb: Well, it makes sense. I mean, you can imagine that, at least on the evolutionary scale, that a lot of our ancestors were chilling out in the hot springs every day. That’s probably where most of the predators would come find you anyway, near the watering hole. So probably for a pretty modern phenomenon, I imagine. Is there any other sort of periphery sort of ideas around this that would be a natural extension for what you guys are doing? You know, if you become known as the sperm company, is there any sort of ideas that you guys kick around about anything else on your brand?

Will: Deeper diagnostics for men, for their male reproductive health, is what we are focused on, first, second, and third. That right now is fertility, but that extends into understanding hormone levels, understanding testicular health, understanding prostate health, understanding sexual health. And so, within a man’s lifecycle, we want to support clinicians and patients with the information they need to fully understand the status of their reproductive system. That is our focus.

Meb: Yeah. I mean, I imagine it’s sort of a blue ocean opportunity where there hasn’t been the scale and magnitude of database access and samples that you’re going to have over the next couple of years. I mean, just the amount of people that are going to opt in. And then, once you connect the entire physician network, I mean, how much happier are you to chat with your doctor and he’s like, “Yeah, just order this,” or “Do this kit at home,” instead of creeping around this office with everyone knows what you’re up to in there, in the room? Let’s talk about the business a little bit. How do you start a D2C fertility clinic business? Is it self-funded? Did you hit up some of the playmates for startup capital? How does it all work?

Will: We fundraised an initial seed round that we brought in on the premise of what we were going to build from a, like, lab, and test, and research perspective. We took that initial funding, and we built out the lab capabilities to build around these tests. We then validated our research that we could do this test through overnight shipping. And then we launched direct-to-consumer through Google, through Facebook, through the user channels, in the beginning, to test the market, test the messaging. That’s how we got up and running.

Meb: And what’s the plan with the biz? Are you guys going to try to self-fund it? Are you going to go the VC route? What’s the runway look like?

Will: So currently, we’re going down the venture capital route, continuing to invest in our research and our customer acquisition to, like, further enhance this flywheel, which is, like, more samples equals more data, which equals a better quality test, which equals more samples. And we want to take that flywheel and apply that to both our clinician channels and our direct-to-consumer channels.

Meb: All right. All you rich VCs, listen to this. Hit Will up. You’ll definitely get some inquiries potentially on the physician or partnership side. What’s the website or what’s the way that people get in touch with you?

Will: The website is meetfellow.com, so M-E-E-T-F-E-L-L-O-W.

Meb: You know, an interesting part about your story, and this is like so many founder stories, to me is that even the prospect of the idea seems so daunting, said, “Look, here’s the status quo. Clearly, something like this would never work,” and that would have been my estimate before I heard about it, and heard that it was working, and went through it. What’s been, like, the biggest challenge of this journey so far? Was it getting the science and packaging right of the storage? Was it partnering with clinics or regulatory? What have been some of the big challenges?

Will: I think the biggest challenge has been interpreting signal over noise as it relates to who makes sense as our most valuable customer base. And what I mean by that is that we work directly with consumers. Consumers come in, and they buy our test, and it’s a very fulfilling experience for them. We also work with doctors. And within doctors, we work with OB-GYNs and urologists. We also work with research, both federal and publicly traded companies. Identifying where to allocate our resources into which initiative is probably the hardest thing for us to do on a daily basis, given that we are a small team and it is important that we are operating under the assumption of true positives, not that we have a false positive, that we’re pursuing and investing a lot of effort into, that actually we misinterpret it. And so that has been probably the biggest challenge for us as we look to further scale the business.

Meb: How many folks you all got now?

Will: Currently, about 14.

Meb: Awesome. All Mission-based, or are you guys all over?

Will: We’re all over. We have a few people in Minneapolis. We have several people in the Bay Area. We have a few people that’s in COVID pickup and said, “You know what, we’re going to become pretty nomadic over the next several months,” and that’s been super fun living vicariously through them. We have a couple of people on the East Coast. And then we have field sales reps that are distributed across multiple states and across the U.S.

Meb: How much of an inspiration or ideas have you taken away from the success of some of these other companies in sort of the direct-to-consumer health category? I’m thinking of, like, HIMSS, in general, but a lot of these have been absolute rocket ship sort of unicorns that are now valued well into the billions for things like erectile dysfunction, all that other stuff. Do you kind of crib some of the ideas from some of those, or are they even potential partners at some point?

Will: Yes. So they’ve really built inspirational brands, and it’s remarkable seeing what they have achieved over the last few years. I mean, when thinking about the value that they are providing to customers, it’s incredible seeing them start with their, what I would say is like more of a prescription-based approach, in the beginning, leveraging telehealth. And I believe that, as a natural extension, as these businesses progress, they are going to want to have more insight about their users so that they can further provide better services. And so, within our…exactly as I mentioned earlier about our flywheel, more customers, more information, for us to build a better test. For the companies like HIMSS and Roman and a few of those others, I see us potentially supporting them with further insight into what could be happening within a male’s reproductive system to warrant further care and further support on the telehealth front, on the deeper diagnostics front, and things like that.

Meb: All positive trends, that’s for sure. What are we missing? We talked about a lot today. Anything that I’ve skipped over you think is particularly important and insightful about y’all’s mission and adventure that you’ve been on?

Will: That is mostly us. I mean, one thing I will say is that, especially for all the listeners out there, there’s certainly a stigma around this that has men putting this out of sight, out of mind. And what I have found in our users and the doctors that we work with is that, like, proactive testing, whether it’s just curiosity, whether there’s something that could have happened many years ago, proactive testing is really, really, really helpful for a man to understand where he’s now today, because best case scenario, everything is fine. Everything is going super well. Like, but on the other side of that, like, he’s operating early, and he’s able to understand what’s going on, and he’s able to take proactive steps to address this. And so this is, I guess, mostly PSA, if nothing else, but not the prostate-specific antigen but the public service announcement. I mean, that’s probably just my last takeaway.

Meb: PSA on the PSA. All right, we’ll take it. Will, this has been, I think, really insightful. Hopefully for the listeners as both potential patients, or users, investors, partners, doctors, all that good stuff, burrito aficionados in San Francisco. We mentioned already once, but place for people to go, they want to check out what you guys are doing, follow along, what’s the best spot?

Will: Our LinkedIn page is pretty active. We have @fellow on Instagram, @fellow on TikTok, @fellow on Twitter. And then our website is meetfellow.com. And you can reach us on there through our chat almost instantly. We’ve got a really great team that takes care of our customers and patients, and we’re really, really attentive to anyone’s needs.

Meb: Awesome. Will, it’s been super insightful. I’m a big supporter of what you guys are doing. Good luck on your journey, and thanks so much for joining us today.

Will: Meb, thank you very much for your time, and have a terrific rest of your day. I’ve really appreciated being here, and thanks again.

Meb: Podcast listeners, we’ll post show notes to today’s conversation at mebfaber.com/podcast. If you love the show, if you hate it, shoot us feedback@themebfabershow.com. We love to read the reviews. Please review us on iTunes and subscribe to the show anywhere good podcasts are found. Thanks for listening, friends, and good investing.

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