Why Fertility Care Starts Too Late with Branch Care CEO Katie Jaxheimer Agarwal | Golden Hour, Episode 59
Golden Hour
What if one of the biggest problems in fertility care is that we wait too long to start talking about fertility?
For much of our reproductive lives, the healthcare conversation centers on preventing pregnancy. Then, when someone decides they're ready to conceive, we often expect them to try for months—or even a year—before fertility becomes a meaningful part of the conversation.
Katie Jaxheimer Agarwal thinks we can build a better on-ramp.
Katie is the CEO and co-founder of Branch Care, a fertility care company working to bring fertility education, diagnostics, and specialist collaboration closer to the doctors patients already know and trust. Before founding Branch Care, she held leadership roles at digital health companies including Cedar and Maven Clinic. She also brings another perspective to this work: she went through IVF herself and is now the mother of two children conceived through IVF.
In this episode, Katie and I talk candidly about what her own fertility journey taught her about the gaps in our current system—and what needs to change.
We explore:
• Why waiting six or twelve months for a fertility workup may make sense clinically but still feel excruciating to the person living through each cycle
• The surprising gap in preconception counseling—and why fertility conversations should begin before someone is struggling to conceive
• Why fertility care isn't truly accessible just because a fertility clinic exists
• The reality of “fertility deserts,” with some patients traveling 60–70 miles for care they may need every other day during an IVF cycle
• Why financial access remains one of the biggest barriers to fertility treatment
• The difference between treating infertility as a disease versus treating fertility care as a “nicety”
• Why a $50,000 IVF journey can offer far less certainty than almost anything else a person might spend $50,000 on
• How earlier information can give patients more options without automatically pushing them toward IVF
• The role OB-GYNs can play as gateways—not gatekeepers—to fertility information
• What Katie's own IVF experience taught her about isolation, anxiety, patience, and the emotional cost of waiting
This conversation also challenged me as an OB-GYN.
Early in my career, I held tightly to the guidelines: under 35, try for a year; over 35, six months. Those guidelines matter. Evidence matters.
But so does the person sitting in front of us.
There is a difference between asking, “When does the textbook say this patient needs testing?” and asking, “What information would help this particular person make an informed decision about her own life?”
Maybe improving fertility care doesn't begin with getting everyone to a fertility specialist sooner.
Maybe it begins with making sure people don't have to struggle first before we're willing to talk seriously about their fertility.
🎙️ Season 3 of Golden Hour continues with Katie Jaxheimer Agarwal, CEO and co-founder of Branch Care.
Thank you for listening ❤
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