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  "documentTitle": "Progyny, Inc. (PGNY)",
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  "authorName": "Spruce Point Capital Management",
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      "text": "Despite the seemingly sound logic of single embryo transfer, research suggests that PGNY's claims that this practice will ensure the reduced incidence (and, most importantly, resultant costs) of pre-term births are questionable, or at least provide an incomplete picture of the aggregate outcomes.",
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      "text": "Despite the seemingly sound logic of single embryo transfer, research suggests that PGNY’s claims that this practice will ensure the reduced incidence (and, most importantly, resultant costs) of pre-term births are questionable, or at least provide an incomplete picture of the aggregate outcomes.",
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      "text": "PGNY focuses its pitch to clients on how its treatment protocol can reduce the incidence of expensive pre-term births, primarily through the practice of single embryo transfer. However, research suggests that PGNY's intensified approach to fertility does not necessarily reduce all prematurity. Admittedly, a move from multiple to single embryo transfer will limit the number of multiples and their associated risk of preterm births. However, even among elective single embryo transfer (eSET) cycles, IVF pregnancies have a greater risk of preterm birth compared with matched singleton births conceived without reproductive technologies. A recent meta-analysis concludes that 'moving towards eSET as the primary transfer paradigm during IVF will likely not succeed in reducing the elevated risk of preterm delivery seen in IVF singletons' (Fechner et al., 2015, Goisis et al., 2019). As van de Weil (2022) notes, 'while single - as opposed to multiple - embryo transfer does indeed reduce multiple pregnancies, these findings suggest that, in order to decrease preterm births, it is advisable to limit rather than broaden the indication for IVF, as the proactive fertility management model proposes.'",
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      "text": "PGNY discloses that its client contracts contain service level guarantees regarding its outcomes. PGNY's clients, the employers, certainly consider the cost impact of the fertility treatments. Therefore, we believe PGNY's treatment plan is designed with the best interests of its employer clients in mind, and may not give complete consideration to scientific considerations we've highlighted above to its treatment strategy.",
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      "kind": "quote",
      "text": "\"Progyny's contracts also include potential service level agreement refunds related to outcome-based service metrics.\"",
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      "text": "‘moving towards eSET as the primary transfer paradigm during IVF will likely not succeed in reducing the elevated risk of preterm delivery seen in IVF singletons’ — Fechner et al., 2015, Goisis et al., 2019; \"while single - as opposed to multiple - embryo transfer does indeed reduce multiple pregnancies, these findings suggest that, in order to decrease preterm births, it is advisable to limit rather than broaden the indication for IVF, as the proactive fertility management model proposes.\" — van de Weil (2022); \"Progyny’s contracts also include potential service level agreement refunds related to outcome-based service metrics.\" — PGNY 2021 10-K",
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      "text": "Source: Disrupting the biological clock: Fertility benefits, egg freezing and proactive fertility management, Lucy van de Wiel, Reproductive Biomedicine & Society Online, Volume 14, March 2022, Pages 239-250, PGNY 2021 10-K",
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      "text": "PGNY Service Level Guarantee Disclosure in Its 2021 10-K:",
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      "text": "Research Suggests That Single Embryo Transfer May Not Reduce The Incidence of Pre-Term Births; Should It Really Be Subject To A Service Level Guarantee?",
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