Solving Semen Analysis Barriers: Innovation & Accessibility

[Dr. James Smith]
I think this for me is one of the most exciting things that we can do. I'll back up a little bit. Fellow really began in this teeny little lab space. It was a startup of startups outside of UCSF. It was in this little incubator space. As we did these thousands of semen analyses, we're building the kit. Eventually we took that technology that we developed through this R&D process and transferred it to a CLIA lab. The first CLIA inspector told us that we had at a 50 square foot little bench that we had the smallest CLIA lab that he'd ever certified.

[Dr. Jose Silva]
Back when you met the founder, there was no CLIA, there was no company yet?

[Dr. James Smith]
There was nothing. No. When I met the founder, I met him outside of UCSF in a cafe. There was just an idea. He's a really bright guy, had been investigating the space, and wanted to do something in male reproductive health. It really came directly from doctors and patients and what are some of the needs that we have as urologists caring for our patients.

[Dr. Jose Silva]
Awesome, and then you went to work?

[Dr. James Smith]
Also that as a team. There were some terrific engineers and terrific folks who really did a lot of the hard work to get this done. It was a pretty expensive process to develop the Fellow kit. I remember back in the beginning, there were exciting ones that did turn into a company, was CLIA-accredited, where Will would tell me and he'd say, "Jim, there were 10 semen analyses this week." That just kept ramping up. Two weeks ago, there were about 450 semen analyses in one day. It's been a really exciting ride.

Where that leads to your question is that what we're able to do really well now is to get a semen sample from any place in the country to one really high quality lab in the Bay Area, in San Leandro, near the Oakland airport. There is a lot of information in a semen sample that we just don't currently have the capability to test at scale. There are certainly molecular markers. Some colleagues have looked for epigenetic markers in semen that perhaps could predict fertility outcomes. Perhaps there are environmental markers, whether it's environmental toxicants or other markers in semen that we could learn about. That's one of the things that I'm excited to do, down the road as the company continues to grow, is to try and develop brand new tests that can actually move the needle for our patients.

[Dr. Jose Silva]
Just like genomics for high-risk versus low-risk, just go straight to this. That would be awesome.

[Dr. James Smith]
That's right. The semen analysis is really helpful to put men into these groups, is this, "Things look generally pretty great. You're low, but okay, you may be able to conceive, get enough time to really low," like IVF may be the right thing, but can we do better than that? Can we do develop better biomarkers that are helping to predict who's going to succeed with your varicocele surgery? We still don't know that terribly well. Going down the road, could we predict something about BPH or other aspects of a man's reproductive health?