Inside Reproductive Health Podcast

What’s the definition of a cartel, and has the way we pay for care created one in fertility?

This week on Inside Reproductive Health, two practice-owning REIs with very different models join Griffin to push that question hard. Dr. Robert Kiltz (CNY Fertility) and Dr. Francisco Arredondo (Pozitvf IVF & The IVF Academy) dig into the economics, the ethics, and the possible alternatives to the status quo.

They discuss:

• Dr. Arredondo’s argument that today’s IVF system resembles a cartel (and what can be done about it)

• The right question to ask about access and cost in IVF

• How insurance helped create today’s medical-industrial complex

• Dr. Kiltz’s meeting with HHS leadership and what it revealed

• Lessons from Aravind Eye Care in India (Could that model work for IVF?)

• What the IVF Academy is teaching clinicians about entrepreneurship and sustainable practice

  
  

This episode doesn’t offer easy answers. It’s a clear-eyed conversation about structural incentives, mission, and what it will take to make IVF more affordable and accessible.

If you’ve ever tried to get doctors, embryologists, and executives on the same page…you’ll want to hear this one.

In this episode of Inside Reproductive Health, Dr. Alison Bartolucci (CSO) and Cara Reymann (CEO) of First Fertility talk candidly about leadership, lab management, and network-wide decision-making.

They discuss:

– The emotional cost of leading a fertility network

– When to build consensus (and when to just drive the bus)

– The decision to implement digital witnessing across all nine IVF labs

– The “magic question” Cara uses to align stakeholders

– Why First Fertility abandoned plans for a single EMR

– Why Alison swears by using a lab monitoring service (and the business benefits beyond happy embryologists)

Overwhelm. Anxiety. Cases that stay with you.

That’s how some of the field’s most experienced professionals describe genetics in reproductive medicine today.

In this episode of Inside Reproductive Health, we brought together leaders from RMA, CCRM, Shady Grove, and GeneScreen to talk about the genetics overload in modern ART.

They talk with Griffin about:

• The liability landmine that genetics has become

• Why one lab’s “positive” is another lab’s “negative” (The Panel Paradox)

• Real cases where rare findings blindsided experienced REIs

• Smart strategies to stratify counseling (Without missing critical risks)

• The growing complexity of third-party reproduction

• The coming wave of whole genome sequencing and polygenic risk scores

This isn’t a high-level overview. It’s a blunt conversation about the real risks, broken workflows, and what’s coming next for your lab and patients.

Doctors used to dream not just of earning well, but of controlling how they practiced and how they cared for patients.

Doctors Cristin Slater, Kevin Maas, and Kyle Tobler—partners at the independently owned Idaho Center for Reproductive Medicine—explain why that dream feels so far away for many.

Here’s what we cover:

• Why Dr. Maas says he’d never go back to a private equity-owned network

• Hidden legal clauses & earn-outs that can trap REIs

• The tug-of-war between business interests and clinical decisions

• How independent practices can innovate (including the tech they love)

• The advice they’d give to any fellow or young REI thinking about their future, and how they can still live the dream

Beth Zoneraich, CEO of Pinnacle Fertility, is back on Inside Reproductive Health to share the hard numbers and the deeper philosophy behind what she calls the Pinnacle Operational Model.

We deep dive into::

• Why they automate the back end of patient care (but never the front)

• How 3,000 unanswered phone calls became 500 new patients

• The “J curve” of operational change (where things get worse before they get better)

• Whether business leaders can help achieve work-life balance for clinical staff

• The build vs buy debate

  How they saved $1M saved by building (not buying) a witnessing system

With a very limited number of genetic counselors nationwide, it’s impossible for every fertility patient to see one. Clinics like RMA New York are getting strategic.

In this week’s episode of Inside Reproductive Health, genetic counselor Teresa Cacchione explains why genetic counseling in IVF is becoming increasingly critical and complex.

Teresa discusses:

• Why and how RMA-NY relies on a partner called GeneScreen Why even low-risk carrier results can confuse patients (and what to do about it)

• The growing demand for informed consent around PGT

• The risks of relying solely on lab panels

• How RMA decides which patients need in-house counseling

• The legal and ethical implications of not providing sufficient counseling before treatment

They were lucky.

The gas to the incubator stopped flowing, but XiltriX caught the failure in time, no embryos were lost… and no headlines were made.

But what happens if the next failure isn’t?

In this episode, Dr. Matthew “Tex” VerMilyea of Ovation and US Fertility, and Moises Eilemberg, CEO of XiltriX North America, return to Inside Reproductive Health to ask a hard question:

What would your lab do in a crisis?

You’ll hear:

• The catastrophic loss Sweden’s biobank suffered (and what you need to learn from it)
  

• Why embryologist shortages are reshaping the IVF lab
  

• What standardizing monitoring protocols could mean for your network
  

• Why Tex believes monitoring as a service is the future
  

• The steps to take after a public lab failure (and how to avoid needing them)
  

• How XiltriX helps fertility labs gain 24/7 visibility, rapid response alerts, and peace of mind

This isn’t about tech. It’s about protecting the future of your lab, your brand, and your patients.

What happens when managed care surges in IVF, reimbursements drop, and physicians are expected to do more work for less?

Dr. Ravi Gada and Manish Chhadua are back on the show, and they don’t hold back. Dr. Gada is a partner at one of the largest independently owned practices in the United States and he and Manish co-own and operate a firm called CloudRx, 

In this episode, they dig into:

• What 70 fertility centers are doing to slash administrative costs from prior authorization chaos

•  How medication side savings are shifting into the medical services side (and what that means for practices)

• Changes in the payer market and insurer preferences you need to know about

• Why Organon and Follistim have gained so much market share in the past 5–7 years

• Why academic fertility center ratings are shockingly low (and what private practices can learn from that)

From a founding partner about to retire, to an associate just out of fellowship, all five REIs at Carolina Conceptions sat down to share their takes on staying private, staying aligned, and staying real.

Carolina Conceptions invited us in, and we talked real talk about:

• The golden parachute of private equity (and why they’ve resisted it)
  

• The tension between high-touch care and the operational demands of growth
  

• How they’re navigating succession, new tech, and alignment across multiple generations of REIs

I've captured and interrogated one of fertility doctors’ enemies…a lawyer.

But this one’s on your side.

Matthew Maruca has served as General Counsel for Inception Fertility since 2019, and he’s here to walk you through the legal threats and legislative currents shaping the future of fertility care. 

While this episode isn’t legal advice, Matt brings insight into how reproductive health is being fought for, and fought against, in the courtroom and the legislature.

In this episode, Matt covers:

- What’s behind the rise in lawsuits and how they’re modeled after personal injury cases

- The emerging legislative strategies from think tanks like the Heritage Foundation

- Which reproductive treatments are being targeted (like PGT)

- How to draft your consent forms to reduce liability

- The #1 thing providers can do to protect themselves from unnecessary litigation

- How to keep your premiums down when litigation is on the rise.

Listen and learn with Matt Maruca.