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When Dr. Zaher Merhi began his fertility apply, he did what each different reproductive endocrinologist does: he adopted the usual playbook. Excessive-dose stimulation drugs. Weeks of preliminary testing earlier than a affected person might even start remedy. Protocols constructed round consistency, which means what labored for the common affected person was utilized to each affected person.
He was good at it. However he saved working into the identical wall.
Ladies would come to him of their early 30s, wholesome, motivated, with good ovarian reserve, and the system would swallow them entire. 4 to eight weeks of consumption testing earlier than their first injection. 1000’s of {dollars} in medicine, a lot of it unused. Embryo assessments accomplished by a technician eyeballing cells beneath a microscope twice a day, then placing the embryos again in an incubator and hoping for the perfect. They’d depart exhausted and $20,000 lighter, with outcomes that didn’t mirror how arduous that they had labored.
He saved pondering: there needs to be a wiser means to do that.
The Drawback With “One Measurement Suits All” Medication
Picture Credit score: Aurea
Fertility remedy, like most of drugs, was designed round averages. Medical protocols are constructed from population-level information, then utilized uniformly. The result’s a system that works fairly properly for a theoretical common affected person, however that theoretical affected person doesn’t truly exist.
Each lady’s hormonal profile, her ovarian reserve, her response to medicine, it’s distinct. And but, most clinics begin everybody on the similar stimulation dose, modify based mostly on crude blood check markers, and choose embryos utilizing subjective visible evaluation.
The pharmaceutical trade has no incentive to vary this. Extra medicine means extra income. Longer remedy timelines imply extra monitoring visits, extra ultrasounds, extra billable touchpoints. The incentives of the standard fertility mannequin aren’t all the time aligned with the affected person’s finest final result.
Dr. Merhi didn’t wish to run that form of apply.
What AI Truly Adjustments (Not the Hype, The Actuality)
In 2025, Dr. Merhi started exploring whether or not synthetic intelligence instruments might shut a few of these gaps. He’s exact about this as a result of “AI” in healthcare has change into a advertising and marketing time period that’s been stretched previous its which means.
The instruments that modified how he practices are particular:
- Treatment dosing algorithms. Earlier than beginning a affected person on stimulation, Dr. Merhi runs her baseline hormone ranges and ovarian reserve markers by means of a predictive mannequin that recommends a beginning dose tailor-made to her profile. This alone has diminished medicine waste at his clinic by greater than 70%. Sufferers aren’t over-stimulated. They’re not under-stimulated. They obtain what their physique truly wants.
- Steady embryo monitoring. The EmbryoScope system retains embryos in an uninterrupted tradition surroundings whereas a time-lapse digital camera pictures them each ten minutes. An AI scoring mannequin used at Aurea analyzes hundreds of developmental parameters and assigns a likelihood rating for every embryo reaching a viable blastocyst. As an alternative of a technician’s subjective opinion, there’s a information mannequin skilled on tons of of hundreds of embryo growth sequences.
- AI-assisted sperm choice. Aurea makes use of laptop imaginative and prescient to investigate sperm morphology at a degree no human eye can match. For {couples} coping with male-factor infertility, this modifications the calculus of ICSI completely.
None of this replaces doctor judgment. Each protocol Dr. Merhi runs, each determination he makes, continues to be his. What AI has accomplished is give him data he didn’t beforehand have, and provides it to him sooner.
The Enterprise Case Is the Affected person Case
Picture Credit score: Aurea
Right here’s what he didn’t anticipate: constructing a extra environment friendly medical mannequin didn’t simply enhance outcomes. It essentially modified the economics of fertility care.
When medicine waste drops from 35% to beneath 10%, sufferers spend much less. If you get rid of weeks of redundant preliminary testing and transfer sufferers from session to retrieval in roughly two weeks, you cut back the carrying value of remedy. When embryo choice is extra correct, fewer switch makes an attempt are wanted.
The standard fertility clinic mannequin income from complexity. Dr. Merhi discovered that eradicating complexity, changing subjective selections with data-driven ones, truly made the enterprise stronger, not weaker.
Each entrepreneur has in some unspecified time in the future checked out a bloated, inefficient trade and requested: who is that this designed for? That query is what led him to construct one thing totally different.
His clinic, Aurea Fertility Heart, is designed particularly for ladies beneath 40 with good ovarian reserve, the sufferers almost certainly to learn from a streamlined, AI-optimized protocol. It isn’t the proper match for everybody. Advanced circumstances, diminished ovarian reserve, superior maternal age, vital male-factor, belong at a clinic constructed round that complexity. (That’s why there’s a sister clinic for precisely these sufferers.) Realizing who you serve is the primary precept of constructing something that truly works.
What Entrepreneurs Can Study From Fertility Medication
Dr. Merhi has thought loads about why healthcare, which has every little thing to achieve from effectivity, has been so sluggish to undertake instruments that different industries take with no consideration.
A part of it’s regulatory warning, which is suitable. A part of it’s legal responsibility tradition, which regularly isn’t. However a big half is solely institutional inertia: we do it this manner as a result of we’ve all the time accomplished it this manner.
Disruption in healthcare doesn’t come from ignoring the science. It comes from being trustworthy about the place subjective human judgment has been masquerading as evidence-based medication, and changing it with one thing higher.
Dr. Merhi sees three ideas from this expertise that apply properly past fertility care:
- Effectivity and high quality aren’t in pressure. The belief that doing much less (much less medicine, fewer testing steps, shorter timelines) means worse outcomes is sort of all the time flawed. Waste shouldn’t be the identical as care. If you strip a course of all the way down to what truly strikes the needle, outcomes enhance as a result of the sign isn’t buried in noise.
- Know your affected person, or your buyer, with specificity. Generic options serve generic wants. The second he determined to construct a clinic designed for one particular profile of affected person, every little thing bought sharper: the protocol, the pricing, the communication, the know-how stack. Attempting to serve everybody usually means serving nobody significantly properly.
- Know-how adoption requires explaining the “why” earlier than the “what.” His sufferers aren’t information scientists. They don’t care that AI rating makes use of a convolutional neural community. They care whether or not their embryo has a greater probability. When he leads with the result, you’ll get a rating that tells us which embryo to switch, as a substitute of the mechanism, the dialog modifications. Entrepreneurs introducing new know-how into conservative markets usually make this error in reverse.
What He Nonetheless Doesn’t Know
Dr. Merhi is trustworthy concerning the limits.
AI in reproductive medication continues to be younger. The fashions in use are skilled on massive datasets, however these datasets have their very own biases and gaps. The instruments accessible at this time will look primitive in ten years. He holds his medical selections with confidence and his know-how assumptions with humility.
He additionally doesn’t know whether or not what he’s constructed can scale the best way a software program product scales. Medication continues to be essentially a human endeavor. The physician-patient relationship, the belief, the judgment, the presence within the room when somebody will get information they weren’t anticipating, that doesn’t get changed. Constructing a tech-forward clinic means threading a needle between effectivity and intimacy. He hasn’t totally found out how to try this at quantity.
What he does know is that the established order wasn’t ok. For his sufferers, the standard mannequin value an excessive amount of, took too lengthy, and made too many selections by intestine when information was accessible. Altering that was definitely worth the threat.
Dr. Zaher Merhi is a reproductive endocrinologist and the founding father of Aurea Fertility. He has been featured in Forbes, The New York Instances, and USA Immediately for his work in AI-integrated reproductive medication. Aurea Fertility serves sufferers from throughout the USA and internationally through telemedicine at aureafertility.com.
When Dr. Zaher Merhi began his fertility apply, he did what each different reproductive endocrinologist does: he adopted the usual playbook. Excessive-dose stimulation drugs. Weeks of preliminary testing earlier than a affected person might even start remedy. Protocols constructed round consistency, which means what labored for the common affected person was utilized to each affected person.
He was good at it. However he saved working into the identical wall.
Ladies would come to him of their early 30s, wholesome, motivated, with good ovarian reserve, and the system would swallow them entire. 4 to eight weeks of consumption testing earlier than their first injection. 1000’s of {dollars} in medicine, a lot of it unused. Embryo assessments accomplished by a technician eyeballing cells beneath a microscope twice a day, then placing the embryos again in an incubator and hoping for the perfect. They’d depart exhausted and $20,000 lighter, with outcomes that didn’t mirror how arduous that they had labored.
