Khaled Kteily might never have founded his Boston home health care startup, Legacy, if not for spilling a hot beverage in his lap.
The accident left him with second-degree burns around some sensitive areas. And when a friend mentioned he was having his sperm tested and saved before chemotherapy, Kteily decided he should also get tested in case the burns affected his future fertility.
A student at Harvard’s John F. Kennedy School, Kteily went to a Cambridge sperm bank, where he was quizzed about intimate details of his sexual history in the waiting room, then sent to the “specimen collection room.” As he sat in the dark, he tried not to think of how many people had sat in the same spot to perform the same task.
“Everything about that experience was so dehumanizing for someone who just wanted to be proactive about their fertility,” Kteily recalled.
But the experience also gave him the idea for Legacy, an at-home sperm testing and collection service. He set up the company at Harvard’s Innovation Labs in May 2018 and went through the startup accelerator Y Combinator in 2019. So far, Legacy has raised more than $45 million, including a $25 million round this year led by Bain Capital Ventures that also included celebrities DJ Khalid, Orlando Bloom, and Justin Bieber. (Including the celebs was “part of our effort to de-stigmatize and normalize the conversation around infertility,” Kteily said.)
More chemicals in the environment, higher stress levels, and other illnesses are contributing to a decrease in male fertility, Kteily noted. Sperm concentration declined by 50 percent or more from 1973 to 2011, according to a widely cited study by the European Society of Human Reproduction and Embryology — though a Harvard study last year challenged those findings.
Legacy offers sperm testing and storage at much lower prices than typical sperm banks. Charging about $300 upfront for testing plus about $100 per year for storage, Legacy is undercutting the industry by hundreds of dollars per year.
It’s sometimes a challenge to conduct marketing like a typical health startup. Legacy wanted to run advertisements in Texas and New York using the word “sperm,” but the term was prohibited by the billboard companies.
“It’s the medical term,” Kteily said. “So that’s one of the challenges you face working in a stigmatized industry like ours.”
The latest effort at Legacy is a joint research project with the Veterans Health Administration and the agency’s New England Center for Innovation Excellence, located in Bedford. Legacy will take sperm samples from veterans of recent conflicts and measure their fertility over time. Soldiers can be exposed to chemical toxins on the battlefield and also suffer other injuries that affect fertility.
“We know based upon existing evidence that male veterans are at high risk of infertility, but we don’t really know why, we don’t have a good scientific reason,” said Dr. Ryan Vega, chief officer for health care innovation and learning at the VA. The research project with Legacy “is really aimed at trying to begin to put the puzzle together.”
While both male and female veterans suffer from infertility problems, males are less likely to seek treatment, according to surveys conducted by the VA. The agency hopes Legacy’s project will also help it encourage more veterans to get help.
“We want to make sure that we can present an opportunity for our veterans to have that space to have the conversations with their providers to seek care for infertility issues,” Leandro DaSilva, acting director of the innovation excellence center, said.
In addition to its fertility services, Legacy is also expanding its services to include home testing for sexually transmitted diseases.
“We believe that on the path to parenthood, there are a number of products and services that we’re going to be able to offer as part of our vision, which is to unlock sperm as a biomarker of health,” Kteily said.