Fertility treatment is incredibly hard and takes its toll on your emotionally and financially. It is important to stay organized during your treatment and learn your rights as a patient so you can become the best advocate for yourself and be an equal partner in your care. Studies show that patients who are active participants in their care, access their records, and communicate with their doctors have better perceived outcomes, are more satisfied with their care, and can become key stakeholders in the development of better care delivery. As a patient undergoing fertility treatment, you know how hard it can be to access and find your complete medical history. You want to make sure your OB/GYN and your Reproductive Endocrinologist both know what is going on, but you are not sure they are talking. You can help yourself by becoming a better patient advocate and drive this information sharing through access to your records, enshrined in the law, and tools like Grain Fertility. But what are your rights as a patient and how do you get your health records to become a patient advocate for yourself? As a patient, you have the right to access your health information under the Health Insurance Portability and Accountability Act (HIPAA). This includes medical records, lab results, and other health information. As a way to help fertility patients, we are drafting a two part blog series to discuss in depth your rights under HIPAA and newly created Information Blocking regulations, steps you can take to access your health information, and how Grain Fertility can help you once you get your information. Part 1 will go into detail about your rights as a patient and the steps for accessing your information from your doctor. HIPAA and Your Rights As a Patient HIPAA is a federal law that protects the privacy and security of patient health information. It gives patients the right to access their health information, as well as the right to request corrections to that information if it is incorrect. HIPAA also requires healthcare providers and other covered entities to provide patients with a notice of privacy practices that outlines how their health information is used and disclosed. Under HIPAA, patients have the right to: Access their health information: This includes medical records, lab results, and other health information. Patients can request access to this information in various forms, including paper records, electronic records, and even verbal communication. Request corrections to their health information: If patients find inaccuracies in their health records, they can request that the information be corrected. Receive a notice of privacy practices: Healthcare providers and other covered entities must provide patients with a notice of privacy practices that outlines how their health information is used and disclosed. We often hear from patients that doctors tell them they are not allowed to email information to a patient due to HIPAA if the patient requests. Unfortunately, this is a common misconception of the rule. HIPAA regulations specifically say an individual has the right under the Privacy Rule to request and have a covered health care provider communicate with him or her by alternative means or at alternative locations, if reasonable Next time a doctor tells you this, you can point them to guidance and ask them to provide you with the information you want by the means you request. HIPAA not only gives you as a patient the right to access your information, it also gives you the ability to file a complaint with a branch of the federal government called The Office of Civil Rights under the Department of Health and Human Services. If you believe a doctor or clinic is wrongly withholding your health information, you can report them here. Information Blocking Regulations In addition to HIPAA, there are newly created Information Blocking regulations that also give patients the right to access their health information electronically. The regulations, which went into effect in April 2021, were designed to prevent healthcare providers and other entities from blocking or delaying patient access to their health information. Under the Information Blocking regulations, healthcare providers and other covered entities are required to: Share electronic health information with patients: Providers must provide electronic health information in a format that is easily accessible and shareable with patients. Respond to patient requests for access to their health information: Providers must respond to requests for access to health information within a certain timeframe, usually within 30 days. Not engage in practices that block patient access to their health information: Providers are prohibited from interfering with a patient's access to their health information, such as by charging excessive fees or delaying access. These regulations are designed to not only help patients get access to their information electronically, but to help patients get their information in the most useful format. A 200 page PDF is not very helpful to you or your doctor. Instead, these new rules will allow applications like Grain Fertility to develop alternative methods to securely access, store, and let you see your information in easy to understand ways. Much like HIPAA, the Information Blocking regulations give patients the ability to report doctors, hospitals, clinics, and others that do not give patients access to their health information. You can find out more about how to report these information blockers here. Steps for Access Your Health Information Now that you are empowered with a basic understanding of your rights as a patient and want to access your health information, there are several steps you can take. Contact your healthcare provider: Your healthcare provider should be able to provide you with a copy of your medical records. You may need to submit a written request and provide identification. We recommend you do this with all of your doctors. We often hear about important information being left out of a patient’s medical history, some of which can be very important to helping your reproductive endocrinologist understand what may be the cause of your fertility issues. Check if your provider has an online patient portal: Many healthcare providers now have online patient portals that allow you to access your health information online. Some of these portals will let you download summaries or your entire record directly from the portal. If this is the case, we recommend doing so and saving them in a secure location, like Grain Fertility’s Medical Record feature. Submit a request for access to your health information: If your healthcare provider does not have an online portal or you prefer to receive a physical copy of your records, you can submit a written request for access to your health information. You can use a template form, such as this one, or create your own request, but your request should include specific details such as your name, contact information, and the information you are requesting. Follow up on your request: If you do not receive a response to your request within the timeframe specified by the provider or if you have any issues accessing your health information, follow up with your provider. Often, offices are simply busy and understaffed, and following up will help you get what you need. Stay Tuned for Part II In Part 2 of our series, we will provide fertility patients with information about the benefits of accessing and using their health information and provide specific information about the capabilities of Grain Fertility and how to maximize the use of our tools. You can sign up for updates from Grain Fertility on our homepage to make sure you do not miss any resources or content to help you on your fertility journey.

Last April, I debuted the idea of Grain Fertility as a way to get feedback from the fertility community, work to truly understand the problems patients face when trying to organize and use their information, and try to develop some solutions to make the fertility process easier. Since we launched, I have spoken to nearly 100 patients, fertility care clinicians, and professionals in the fertility field. Their feedback was enlightening, emotional, and empowering. So often, I heard stories that reminded me of my own and it has powered my work to develop this app. The culmination of these conversations is the debut of the Grain Fertility pilot, which you can sign up for today. We are using this pilot to test out different features, get detailed, uncensored feedback from real patients, and work to identify what are the best ways we can achieve our mission, the empowerment of fertility patients and making them equal participants in their care. At Grain Fertility we believe an educated patient is an empowered patient and by giving them access to their health and financial information in one easy to use, secure location, we believe we can put patients at the center of the fertility experience. Our goals for this pilot Transparency is a hallmark of our vision for fertility care and I thought it would only be fair to share what I am hoping to achieve with our pilot. First off, it is important to know this is not a finished product. Trust me, there are a million things I want to build, but it is important for us to focus on the bare minimum and get feedback from real patients to understand their goals and desires for using an organizational health application like Grain Fertility. Specifically, I hope to see how willing patients are to use a tool to put their health and financial information in one place and start to see what information you need access to, how you want it input, and how it should be presented. We want to learn how Grain Fertility can help keep you more organized, make you feel more confident in your care, how it can help spur more detailed and honest conversations with your doctors, and how it can help you spend less time on stressful administrative tasks like filling out duplicate forms or transferring your records between your doctors. Our pilot users will inform and direct us as we work to implement our vision for Grain Fertility. For us, the patient is always front and center and this pilot is one way we are hoping to ensure your voice guides us. Our vision for Grain Fertility We all know the saying “Rome wasn’t built in a day.” Unfortunately, modern digital health applications are not either. We know this version of Grain Fertility is very basic and relies on manual processes. But imagine something better. A infertility diagnosis can be heartbreaking and the process of finding a fertility clinic can be daunting. Layer on the stress of needing to coordinate with your OB/GYN and primary care physician to make sure all of your records go to your new clinic before your first appointment and filling out all of those forms, and it can be overwhelming and consume hours of your day. It doesn't have to be like that anymore… Imagine being able to transfer your entire health record to your new fertility clinic with a few clicks on your smartphone? Imagine having a cheat sheet of the most important information you and your doctors need to know available whenever you need it. This is not a dream, but what we are building. Soon, we will be able to link all your health information securely, using the logins you already have. No more patient portals. No more fax machines. No more folders of printed pages being mailed between doctors. Grain Fertility will save you time and money by expediting the information sharing process and will ensure your doctors have the most accurate, important information they need when you meet with them. Our Next Steps I am incredibly excited about what comes next. The pilot is just the start of something special and a new age of patient empowerment through technological innovation. To achieve this, I want to talk to as many people as possible, getting input on what can help them make fertility treatment easier and less stressful. I hope to take the momentum from this pilot to power our next steps: a widely available, easy to use, secure application available to every fertility patient in the United States. I want to build an empowered network of confident self-advocates, working with their doctors to make the fertility process more efficient, more equitable, and less time consuming. I want Grain Fertility to be the app you turn to during fertility treatment to let you focus on what matters most, your care. Joe Cody Founder

by Eran Amir, Founder and CEO of GoStork Grain Fertility is dedicated to giving patients, advocates, and healthcare providers the opportunity to provide their unique, diverse insights and experiences of what it is like to deal with fertility issues. Grain Fertility is proud to provide Eran Amir, Founder and CEO of GoStork, with the opportunity to help patients by giving tips on how what they should consider when making the important decision of choosing a fertility clinic. Deciding to start fertility treatment, such as in vitro fertilization (IVF), is an emotional and life-changing step in your family-building journey. Having the right fertility clinic accompanying you ensures that you get the expertise and support you need along the way. While there is no one size fits all when it comes to the ‘best’ fertility clinic, there are several common factors to consider as you research your options and try to find the best match for your needs and preferences. We hope this article will help you make a much more informed decision! What to Consider When Choosing an IVF Clinic Choosing the best fertility clinic for you is highly dependent on your personal situation. Nonetheless, there are elements which you should consider during your decision-making process. While most fertility clinics have a structured discussion prepared for new patients, it helps to go into that appointment prepared (with both your questions and something to take notes on the answers!). Let’s go over what you should consider as you research your options, as well as what to ask if you have further questions. 1. Experience and Success rates: The number of successful treatments the clinic performs each year is a good indication of its success. Fertility clinics are bound by law to report and verify data annually related to the assisted reproductive technology (ART) cycles carried out in their clinics, as well as the outcomes of these cycles. This data can help you get a better idea of your average chances of success per ART cycle or transfer – though of course, ART success rates do vary from person to person. Look out for success rates for patients with similar cases to yours, including your age and the fertility services you’ll need. For example, if you’re doing surrogacy, you may want a clinic with a strong surrogacy program or, if you and your partner are doing Reciprocal IVF, look for a clinic with significant experience and check those specific success rates. This data can help you get a better idea of your chance of success per IVF cycle or embryo transfer. At GoStork, we make this part easier than ever before. Our fertility clinic marketplace contains in-depth profiles for clinics spanning over 100 locations and we share each clinic’s most relevant success rates based on your personal journey ahead, taking both your age and the services you need into consideration. Only GoStork personalizes success rates in this way - providing a much more accurate picture than the more general success rates you may see published elsewhere. 2. Extent of patient-centered care offered: It’s fairly common knowledge that IVF can be an emotional roller coaster – which is not always easy to manage on your own. This is why you need providers who really care. As support is integral during the IVF journey, a number of clinics offer access to patient support groups. You can also get a sense of the team during your consultation process, as well as by checking ratings and reviews. And on that note… 3. Patient ratings and reviews: Looking at past patient’s experiences is another great way to gain insight into the fertility clinic, its practices and how patient-centered and inclusive the clinic is, including when working with and welcoming LGBTQ+ patients and international patients, as well as if women of color feel welcomed, heard, and understood. Reputable IVF clinics openly feature reviews from patients. 4. How they handle testing: Ask the fertility clinic how they handle the tests required as part of the IVF process, specifically FSH, LH, estrogen, and progesterone hormone level testing. Larger clinics handle these in-house, others use third parties. For the latter, check that the testing facilities they are using are reputable. 5. Timeline: As you plan out your upcoming months, it will help you to understand things such as the overall treatment timeline, how soon you can start, how many times you’ll need to visit the clinic, etc. Going even beyond that; you can look into if pregnancy isn’t achieved, how long you’ll need to wait to try again per treatment protocols and your case. 6. Consistency & communication: Going through fertility treatments can be stressful. Knowing in advance that you can count on how frequently/consistently the clinic will communicate updates to you, or even that you will consistently have the same physician throughout all of your treatments, can help bring some peace of mind. 7. Doctors’ certifications and experience: You want the best possible care delivered by the best in the industry - all fertility clinic profiles on GoStork include a detailed overview of their Reproductive Endocrinologists’ education, certifications, experience, and research, as well as the languages they speak. 8. Technology used: An elective single embryo transfer (eSET) enables you to potentially experience the same success rates when transferring one embryo but with a greatly reduced risk of multiples. This is due to significant advancements in clinical and embryological techniques. In a double blastocyst embryo transfer (2BET), two embryos are transferred. The risk of multiples is high as one of the embryos (or less frequently, both) can split and produce identical twins. 9. Location: You may need to visit the clinic often during treatment so you may want to take travel time into consideration. A fertility clinic close to home does have its benefits, especially if you’re usually busy with work or family life - it can also reduce your travel costs. Additionally, if you’re growing your family through surrogacy, you may want a clinic that’s closer to your gestational carrier. If location is not that important, or you’re traveling to the US from overseas specifically for treatment, you may want to consider a clinic with specific experience dealing with cases similar to yours as a higher priority over location. 10. Costs: The cost of IVF varies from state to state and from one clinic to another. It is also highly dependent on your own specific case, the nature of treatments required, and how many cycles you’ll need. According to the American Society for Reproductive Medicine (ASRM), the average cost of one IVF cycle in the United States is $12,400. This only covers the egg retrieval and embryo transfer and excludes all other accompanying procedures (such as ICSI or preimplantation genetic testing) as well as the required fertility medications. It’s no secret that IVF is expensive, and for many the cost of treatment is one of the very first factors to consider. At this stage, you want to ask for a full breakdown of costs (including a list of all costs related to testing and medications) and not just the price tag attached to one IVF cycle. Some clinics have in-house financing options to help you pay for treatment or allow you to pay in installments - so do ask about this, as well as what can be covered by insurance. Insurance coverage varies according to your specific policy and your state, so it’s advisable to get in touch with your insurance provider for more detailed information. You may also want to keep in mind that many patients are successful at the second or third IVF cycle (not the first). For a more complete estimate, factor into your calculations the cost of a hospital delivery based on your insurance coverage. You can see an estimated total cost based on services for your journey for each clinic on GoStork. In Conclusion Deciding to move to IVF, choosing the best fertility clinic for your journey, and identifying ways to pay for treatment can be challenging - it’s also a highly personal process. As you move through each stage of your family building journey, it’s important to have a supportive and patient-centered fertility clinic accompanying you along the way. We hope that you find this article helpful as you research your options. GoStork is here to support you in your search for the best fertility clinic. Our Fertility Clinic Marketplace contains in-depth profiles for clinics spanning over 100 locations, as well as over 60 surrogacy agencies and more than 10,000 egg donors. Register for free at gostork.com to research and match with your ideal fertility provider. And - if you have additional questions about the process or your choice of providers, do reach out to us at GoStork for a free, one-on-one personalized call with our concierge, Erin. You can view Erin’s calendar here and book a free call whenever it is convenient for you. Good luck! Eran Amir Founder & CEO of GoStork With more than 20 years of experience, Eran Amir has worked as both a software development and product management executive in Israel and New York. GoStork combines his professional skill-set with a personal mission. After undergoing a long, difficult, and costly process to expand his family via surrogacy and egg donation, Amir vowed to help other intended parents avoid the complexity and confusion he experienced. His passion led to the creation of the first ever fertility marketplace where intended parents can find, compare and connect with fertility providers. GoStork proudly names his four-year-old daughter as its co-Founder.

Accessing and understanding your health information can make you more confident about the care you receive and research suggests can help improve outcomes. However, every person has experienced the frustration of trying to track down your records, only to get caught in an endless loop of portals and passwords. Grain Fertility is changing the way you access and understand your fertility information. by Joe Cody, Founder When I started to think about Grain Fertility and what it could do to help patients who are undergoing fertility treatment, I sought to not only build a tool that my wife and I wish we had when we were undergoing IVF, but I wanted to build something that was based on a scientific understanding of how patients view their health information and how I could help reduce the stresses associated with fertility treatment, improve the doctor patient relationship, and empower patients to serve as better advocates for themselves. Finding Your Health Information Is Not Easy Today 89% of Americans have collected their personal health information or records at some point in time. Among them, about 1 in 4 (24%) – or 59 million* – didn’t find the process easy. We all know the feeling. You get an email from your doctor saying there is a test result or new message in your inbox. You then have to click to a new window, sign into a patient portal with a different password, and then navigate to find yet another inbox. You then see a message with a bunch of numbers, no context, and then a directive to call your nurse or doctor if you have any questions. No wonder nearly 2 in 3 (62%) Americans are not extremely confident in their understanding of the health information they discuss with their doctor. Grain Fertility Amplifies the Patient Doctor Relationship By Promoting Shared Decision Making Grain Fertility is changing the patient doctor relationship for the better by providing patients with an easy way to access, review, and learn from their health information. Using state of the art electronic health information exchange processes and top of the line security protocols, Grain Fertility will allow patients to download, view, use, and share their health information from a single log in. Not only will users find the process for finding their health information or records easy, they will find it can help them increase confidence in the care they are receiving and potentially help improve their outcomes. The process of empowering patients to be more informed advocates for themselves and talking through decisions with their doctors is called Shared Decision Making. “Studies show consistent evidence that the practice of (shared decision making) is associated with increased patient satisfaction with treatment outcomes and perception of personal control, reduced decisional conflict, greater trust in providers, and better self-management and adherence to treatment for complex chronic conditions.” The process of reviewing and understanding your medical information can help you and your doctor discuss what fertility treatment protocols work best for you, taking into account your personal preferences, finances, and your complete medical and family history. Grain Fertility is not designed to supplant your relationship with your doctors, but to enhance it. Studies have shown that patients that access their health information have a perceived enhanced communication with their doctors and health team, better appointment recall, and more prepared for upcoming appointments. Patients overwhelmingly believe that having easy, secure access to their health information will help them. One study showed, “4 in 5 (81%) Americans agree that if they had access to all their health information, including medical records, recommendations, conditions, and test results, they’d see at least one improvement in their health management. Among them, about 3 in 5 (59%) believe they’d see such a change in their confidence in understanding their health. Others say the same about the management of their health (52%) and their trust in their doctor’s recommendations (47%)”. Grain Fertility’s mission is to empower patients by giving them access to their health information and providing them with the tools to take control of their fertility journey. If you have any questions about accessing your health information, how you can become a better advocate for yourself or loved ones, and how Grain can help empower your fertility journey, reach out to me at joe@grainfertility.com. I would love to personally help you in any way possible. You can also join us by signing up to serve as a beta user for Grain when it launches by visiting our home page at https://www.grainfertility.com/ and help us build the first open notes fertility focused health information platform.

Fertility treatments are stressful and expensive. However, you can help ease your costs and be financially prepared with tools offered by Grain Fertility Fertility treatments are stressful and can be incredibly expensive. Patients are often overwhelmed with a litany of decisions with incomplete information. Focus Fertility strives to help patients fill in some of these gaps by providing patients with the tools to access, use, and learn from their fertility related health and financial information. Based on my experiences working in the healthcare space for over a decade, our family’s own fertility journey, and conversations with patients, we wanted to provide you with some very basic concepts to help you understand your fertility finances and give you some tools to help you become a better advocate for yourself, stay organized to avoid unnecessary financial surprises, and hopefully help save or recoup some of your health related expenses. Fertility Coverage 101 According to RESOLVE: The National Infertility Association, as of April 2021, 19 states have passed fertility insurance coverage laws, 13 of those laws include IVF coverage, and 11 states have fertility preservation laws for iatrogenic (medically-induced) infertility. In addition to state law, there are insurers who provide some level of coverage for fertility services. If you do have some level of coverage, there are a number of important questions that need to be asked before starting treatment, such as: Are there limits to the coverage? Are only certain brands of medications covered? Is pre-certification required? What are your copayment, coinsurance, and other financial commitments? Are there other potential costs and limitations to your coverage? Every insurer defines plan benefits through a detailed document you have access to as an enrollee. They can be called a benefit plan description, description of benefits, evidence of coverage, or other name. Here is an example from a Carefirst BlueChoice Advantage POS plan in Maryland A document like this will help you understand what is and is not covered. Every insurer will have a copy on their website for their beneficiaries. If you ever have any questions about your policy, you can contact your insurer and ask as many questions as you have to ensure you are comfortable with your understanding of coverage levels. You will also likely get Explanation of Benefits (EOBs), bills, statements and other documents that list all of the procedures that are done during your fertility treatment and describe the costs for medical care or products you’ve received. One item that many of these documents will have is a CPT code, or Current Procedural Terminology codes. Every medical procedure is assigned one of these codes to help with billing and tracking purposes. While knowing the codes themselves is not important, it can be helpful to know where to find what the codes mean so you can ensure your doctor, clinic, or insurer are properly billing you. A list of CPT codes associated with fertility services can be found here. These codes become especially helpful for patients who are paying out of pocket. Some clinics may work with you to negotiate the prices of services. This is something my wife and I did with our first clinic. If you have any questions or want advice on how I did this, reach out to me at joe@grainfertility.com. If you are working with a fertility clinic that offers a bundled package, you can ask for a full list of all of the services covered in the bundle. This will help you more accurately understand and budget for your treatment and help ensure you are not caught off guard with unexpected expenses. By understanding potential coverage limits, non-covered procedures, or any other potentially unaccounted for expenses, you can better prepare for your fertility treatments, avoid unwanted financial surprises, and focus on what matters most, your health and fertility journey. Infertility and Taxes Another important financial consideration during your fertility treatment is your tax obligations. One bright side to fertility treatments being very expensive is they can help you improve your tax liabilities and may help you with a refund. IRS Publication 502 allows for itemized deduction of medical expenses, including fertility related care. You can deduct on Schedule A (Form 1040) only the part of your medical and dental expenses that is more than 7.5% of your adjusted gross income (AGI). As a service to our users, Grain Fertility has created a spreadsheet to help keep track of expenses and mileage to calculate your medical expense totals and help you or your tax professional determine if you are eligible to deduct your medical expenses. This sheet can be accessed by signing up for the Grain Fertility waitlist on our homepage. For tax purposes, the IRS defines medical expenses as the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and for the purpose of affecting any part or function of the body. The IRS says you can include in medical expenses the cost of the following procedures performed on yourself, your spouse, or your dependent to overcome an inability to have children. Procedures such as in vitro fertilization (including temporary storage of eggs or sperm). Surgery, including an operation to reverse prior surgery that prevented the person operated on from having children. In addition to the medications, diagnostic tests, therapies, and procedures associated with your fertility treatment, the IRS also allows you to include in your medical expenses amounts paid for transportation primarily for, and essential to, medical care. This includes buses, public transportation, and airfare, as well as allowing you to calculate car expenses using the standard medical mileage rate of 16 cents a mile. Grain Fertility’s Medical Expense Tracking Worksheet allows you to track all of this and calculate total costs in one easy to use spreadsheet. You can get this worksheet right now by signing up for Grain Fertility's waitlist on our homepage. Grain Fertility is also building an in depth expense tracking system, allowing fertility patients to add, calculate, and search expenses so you can stay organized and quickly pull up any cost associated with your care. A tool like this can help you quickly provide documents to whoever does your taxes or for reimbursement from your FSA or HSA If you decide to pursue adoption as a family building option, the National Council for Adoption has put together an amazing resource guide, which can be found here. It is important to note that Grain Fertility does not provide tax, legal or accounting advice. This material has been prepared for informational purposes only, and is not intended to provide, and should not be relied on for, tax, legal or accounting advice. You should consult your own tax, legal and accounting advisors to determine your own eligibility. Hopefully, some of this information will be helpful for you during your fertility journey. The unfortunate reality is, until we have universal access to fertility care across the country, finances will continue to play a major role in fertility care. It is why Grain Fertility is dedicated to advocating for expanded coverage for all family building options including fertility treatment, adoption, and surrogacy.

I believe it is important to clearly and transparently outline the ways I hope to help patients undergoing fertility treatment so users can better understand how joining Grain Fertility can not only help make their own treatment journey easier, but help advance science and promote better care. Over the last few months, I have talked with patients, clinicians, and allied organizations and companies fertility patients, gaining valuable insights into the current care patients receive when undergoing fertility treatment and hoping to better understand the problems that patients face. Based on these conversations, my own family’s struggles with infertility, and insights gained talking to healthcare professionals and technical experts, I wanted to more clearly articulate my vision for fertility care in the future and how Grain Fertility can help make this a reality. I believe it is important to clearly and transparently outline the ways I hope to help patients undergoing fertility treatment so users can better understand how joining Grain Fertility can not only help make their own treatment journey easier, but help advance science and promote better care. 1. The Patient Controls Their Journey I believe that empowered patients are educated patients and in order for patients to make the most informed choices, they need to be armed with not only a more complete picture of their own health and options available, but tools to help them better understand the care they receive. Every fertility patient knows there are no guarantees and every journey is different. However, too often, fertility patients feel like they are on a rudderless sail boat drifting in the sea of the unknown. During my family’s journey, I often felt powerless and the lack of access to information and input in the decision making exacerbated these feelings. With Grain Fertility, I aim to give the patient back some control of their journey by giving them the tools they need to access, understand, and use their health information to make the choices that best suit them. I believe that empowered patients are educated patients and in order for patients to make the most informed choices, they need to be armed with not only a more complete picture of their own health and options available, but tools to help them better understand the care they receive. Grain Fertility will empower users by giving them comprehensive access to their health records, medical history, and fertility related finances in a way that provides a complete picture of their fertility experience for the first time. In addition to giving them access to their health information, Grain Fertility will give patients control over their health information. Grain Fertility trusts patients to make decisions that are best for them and will provide users with the ability to opt out of information sharing with trusted partners at any time. No questions asked. Grain Fertility will transparently display a list of Grain Fertility partners and intended uses of data sharing and promote values that patients can trust. 2. Give Patients A Seamless Experience Using state of the art processes, Grain Fertility will be able to electronically connect to your doctor’s office, get your health information, and import it directly into Grain for complete control by the patient. Currently, our healthcare system has numerous barriers that prevent access to care and prevent the exchange of information between different doctors and systems. While I am encouraged by developments taking place to help modernize information sharing, Grain Fertility will address specific and common problems patients have in accessing and sharing their health information today. Too often patients are forced to receive their health records through the mail or through a patient portal where they download a PDF and the burden of information sharing with their doctors falls on them. Grain Fertility will let patients access, download, and share their health information through an easy to use interface and seamless customer experiences. Using state of the art processes, Grain Fertility will be able to electronically connect to your doctor’s office, get your health information, and import it directly into Grain for complete control by the patient. All the patient has to do is securely log into the system and Grain Fertility takes care of the rest. Just as Mint lets users take charge of their finances by connecting banks and credit cards into one easy to access application, Grain Fertility will empower patients and let them take back control of their fertility journey. 3. Privacy by Design Not only will Grain Fertility follow HIPAA security requirements, I am establishing a culture of security and transparency from the beginning. Patients rightfully want to know that their health and financial information is safe and secure. At Grain Fertility, we are building an application that incorporates privacy by design. Not only will Grain Fertility follow HIPAA security requirements, I am establishing a culture of security and transparency from the beginning. Grain Fertility users can trust the application because we will voluntarily adhere to and attest to the Carin Alliance Code of Conduct so patients know their information is safe and Grain is completely transparent with what information is collected and how it can be used. To that end, Grain Fertility will always provide users with an easy to understand privacy policy and a list of trusted partners we are working with to ensure users know exactly how any information on the application is being used. Users will always have the ability to opt out of any data sharing agreements, no questions asked. I promise Grain will only and always work with trusted partners whose missions align with Grain Fertility and actively are working to promote scientific advancement in the fertility space and advocating for expanded access to fertility care for all. 4. Drive Research and Development To Improve Care By working with trusted partners and research organizations that use cutting edge scientific and computational processes, Grain Fertility can help advance research and innovation and improve fertility care for everyone. When I look at the lack of access to care for fertility treatments in the US insurance system, one thing I see is a lack of research and data proving the efficacy of different technologies and techniques that insurance companies require to cover medical procedures. Grain Fertility aims to help augment existing gaps in research and development through dedicated partnerships with research organizations and innovative fertility companies to help power new advancements, insights, and innovations in fertility care. By working with trusted partners and research organizations that use cutting edge scientific and computational processes, Grain Fertility can help advance research and innovation and improve fertility care for everyone. I believe that many of the answers to more effective, more personalized fertility protocols exist in the medical data we collect today, but in order to unlock these insights, we need to invest in the people and partners that want to help patients. 5. Trust is Key Grain Fertility will always work to earn the trust of our users because I was once a fertility patient who felt powerless and ill-prepared for my fertility journey. I have spent years thinking about how I would want to run a fertility related startup and the single word that best describes what I hope to build is “trust.” Grain Fertility will always work to earn the trust of our users because I was once a fertility patient who felt powerless and ill-prepared for my fertility journey. I am striving to build the tool I wish my wife and I had when we were undergoing fertility treatment and I want to ensure that the tool is something I would trust to keep my wife and my fertility treatment information safe. You can always reach out to me at joe@grainfertilty.com to ask any questions and I encourage you to sign up to serve as a volunteer tested to ensure we are properly incorporating the patient voice into the development of Grain below Joe Cody Founder

Grain Fertility is your fertility health information platform created to empower patients undergoing fertility treatment by giving you control of your health information. 1 in 8. We know how many people will experience fertility issues in their lifetime. However, it is impossible to quantify the impact fertility and infertility issues have on us and our loved ones as we struggle to start or continue to build the family we want. The emotional toll of countless appointments, shots, failures, bloating, bleeding, more shots, stress, financial hardships, insurance denials, managing prescriptions, and other associated issues can be overwhelming. What if there was a way to even take some of these issues and make them easier to deal with? However, it is impossible to quantify the impact fertility and infertility issues have on us and our loved ones as we struggle to start or continue to build the family we want. During our fertility journey, my wife and I felt every one of these problems and more. To help stay organized, my wife started carrying a large 3 ring binder to different appointments to ensure all of her specialists knew her medical history. I kept thinking to myself, it really is amazing that we can bank, buy a house, book tickets to fly anywhere, or video chat with anyone across the globe from our phones, but it is nearly impossible to access all of your health information in one place when you need it. The goal of Grain Fertility is to change this. Grain Fertility was born out of the idea that there has to be a better way for patients to access, utilize, and learn from their health information and medical bills. Data shows that patients who are more engaged in their care believe they will have better outcomes and more positive experiences interacting with healthcare professionals. At Grain Fertility, we believe that patients undergoing fertility treatment deserve the tools to experience more collaborative care, organize all of their information, and have access to trusted sources of information. Grain Fertility was not created to interfere with the doctor patient relationship, but augment it. What is Grain? You may be asking, why Grain? I took Latin in high school and have always had a soft spot for Greek and Roman mythology. Demeter or Ceres, depending on your flavor, is the goddess of harvest and agriculture presiding over grains and the fertility of the earth. Worshippers would make sacrifices and wish for bountiful harvests to the goddess, something anyone going through fertility treatment knows something about before each protocol starts. Grain has been associated with our own fertility journey throughout time. Finally, our health data is granular, spread out across the ecosystem in different silos and hard to find and even harder to use. Grain Fertility will help patients undergoing treatment take this previously siloed information and transform it into something greater, more bountiful, and useful. I am setting out on a journey to build a health information platform designed by a fertility patient for fertility patients to change how patients think of their health information and medical bills. During this journey, I hope to meet and talk with patients, clinicians, professionals, and allies who no longer believe the status quo of health technology is acceptable. People who believe they have the right to access, use, and learn from their health information. People who strive to stress less about mundane organizational tasks necessary to properly account for the exorbitant costs associated with fertility treatment. People who want to focus on their fertility journey, wherever it may take them, rather than spending hours trying to track down their health records and dealing with fax machines and certified mail. Grain Fertility will be a journey for all of us and like all journeys, it will take time. Grain Fertility will not be perfect or have every feature available immediately. However, I can promise several things from day one that will serve as the north star guiding development of the platform. First off, there is no information more sensitive than your health information and because of this, Grain Fertility will use HIPAA compliant, industry-best data security practices and promises to protect sensitive health information. Users will have complete control of where and how their information is used and Grain Fertility will be one hundred percent transparent about data use practices. Second, Grain Fertility is founded with a scientific advancement and advocacy-driven purpose. Grain Fertility will only partner with organizations and companies whose values align with ours and are actively advancing patient privacy, health equity, and infertility science. Grain Fertility will advocate for expanded access to fertility services across the country because we believe every individual should have equal access to fertility services. Finally, I will always be responsive to the needs, concerns, and sensitivities of our users. Without you, Grain Fertility is nothing more than another administrative platform. Grain Fertility will always actively seek collaborative feedback from the fertility community and our allies to ensure we are upholding our mission. I look forward to taking this journey with you and learning how to better serve those who are experiencing fertility issues. You can always reach out to me at info@grainfertility.com for anything, whether it is feedback, advice, or if you just need someone to talk to. - Joe Cody, Founder