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My kids' (16 & 11) cord-blood and tissue were frozen with a similar service at birth.

I saw your pricing and was a bit shocked that it's 3x what I pay on an annualized basis. However, my rate seems to have been grandfathered in - the other service has also updated their pricing to match yours.

1. Is there anything particularly different from the competition that you offer?

2. Is there a reason for such a steep price increase? (While I understand the monthly payments, a 3x multiple over 16 years seems pretty steep. You, like the service we used, offer ~20 year storage commitment. Should I be preparing to pay 10 times as much if we want to preserve it for the 20-40 year age span?)

It's good you did that. We passed on doing it for both our daughters (11 & 7). In hindsight after my younger daughter was diagnosed with Leukemia the decision not to do it wasn't really good. She's in remission and fine now. But you never know when treatments would be facilitated by the stem cells.

Saving your youngest daughter's stemcells might not have done much, since they likely were "contaminated" with very early stages disease already. Your oldest daughter's stemcells would have had a 1/4 chance of being compatible, but maybe that was what you meant. The chances of needing stem cell treatment for your children are not that high though, so I don't think you should feel bad about not doing it. I'm glad it worked out in the end, I wish her a good life!

I've heard of other services that will extract and then culture stem cells from milk teeth or even from bone marrow. Have halfway considered it, but making a special trip and expense to get bone marrow extracted on the off chance it'll be useful in the future is a bit tough to convince oneself to do...

I'm so sorry about your daughter. Did she ever find a cord blood donor?

The regular chemo treatment was good enough. For childhook Leukemia the remission rates are almost approaching a cure. So in a sense we were lucky.

I'm glad!

Nothing to add except I'm glad your daughter is doing better!

Hi! 1. Yes - we are more affordable, offer placenta banking (which few other banks offer), and we process stem cells manually (by hand) as opposed to automatically, which recovers up to 25% more stem cells than other automated approaches 2. It depends on the agreement you signed - some agreements have disclosures about inflation impacting pricing, so perhaps. We structured our pricing around expedited shipping to our lab with biological goods & cryopreservation

What part of the world do you live in? Do you know what treatments they can be used for, if any are even approved and they can even be utilized?

In Canada from my understanding is people can store these tissue products but they're not approved for any use yet.

>What happens to all of Anja's clients if the business exits?

>All biological goods stored with Anja will stay in our New Jersey lab regardless

>of what happens to Anja as a business. Client relationship management and

>connection will be securely transferred to a responsible, experienced party if

>necessary.

Another comment asked this and other questions but this one was not answered other than 'there is insurance'.

How does this work? Will customers lose their existing 20 years they paid for and have to pay the new party all over again? How is Anja incentivized to find a good party to transfer to at the time of business failure? How is the funds for the lab guaranteed after Anja goes out of business?

Cryonics organizations have solved this problem with a non-profit structure, but I'm really curious how it is handled in this for-profit case.

Clients sign an agreement stating that it is their property. We shift the management of this property to another company in the case that anything happens. All samples remain in our lab, unless specifically requested otherwise. We have a legal obligation to turn over client relationship management elsewhere.

Can you answer this question: In the case of business failure, will customers lose their existing 20 years they paid for and have to pay the new management company all over again?

The big question is how many people benefited from having stem cells frozen. If that number is large enough then this might be an important development, if that number is very low or even zero then this is essentially a scam.

There is no proof that if your brother had had such a precaution taken (which were already available at the time, so this is not something novel) that there would have been a benefit.

At $29400 CLTV at current life expectancies there had better be some very clear benefit, especially given that the vast bulk of those will never be used. If one in 100 actually gets used then you're looking at $3 million per treatment, and that's the cheapest plan.

Also, I could not find any terms of service nor a way to cancel the service.

> Side note: plancentas are so valuable that physicians - especially in Europe - sometimes prefer to take them for themselves to sell to cosmetics research for ~$50k.

Is a pretty strong accusation to make, do you hide behind the undefined value of 'sometimes' to be able to walk this back or are the statistics such - and the amount so specific - that this is well known and supported by evidence, and subsequent removal from the roster of practicing physicians because of gross breach of medical ethics?

edit: I just found your video:

https://www.youtube.com/watch?v=M64L_Koe8Vw

Which claims this is just hearsay, so I'm calling BS on your claim that this 'happens especially in Europe' or even at all.

I think people do not realize that blood is the lifeline of human being. Cord blood banking has the cells frozen at the youngest age possible. Cord blood rich with stem cells and immune cells and exosomes can be infused back to the baby herself or himself for the rest of her or his life. Because it is his own blood, just rich with the youngest and healthiest cells of every type. So theoretically, the cord blood should never be wasted. Ten years ago, there was no cord blood treatment for cerebral palsy. Now they do. Just ask thousands of families around the world. Science develops, but for the children, they only have one chance to bank and they cannot even make this decision without being represented by the parents.

What percent of people who have banked cord blood who are not explicitly susceptible to specific genetic disorders known to utilize them for treatments have ever ended up using it?

IIRC, this entire business is a scamola with the the major players going as far as giving kickbacks to OBGYNs to pitch their services to impressionable soon-to-be parents. They feed on the fear of parents who want to “do anything they can just in case” when in reality the statistical chance of using it when you’re not predisposed is next to nil.

Or is this entire pitch that maybe someday you’ll be able to use this for some unforeseen solution that would require you’re own stem cells? Which still seems like quackery.

And yes the prices are at least 3x the established players. Displaying the monthly pricing ($35) rather than the standard annualized rate ($35 x 12 = $370) is a good marketing gimmick, but the big names in this space charge closer to $125 for what I’m assuming is the exact same fedex box that gets shipped out after birth.

Anja has $35 per month for 8 years paid for 20 years of storage. The big player you have mentioned charge around thousand at the beginning and then an annual fee of around $165 for every year. Yes, Anja is the cheapest so far.

Why would it be quackery? This is a pain point that my family faced. My brothers cerebral palsy was an unforeseen circumstance due to a near drowning accident. The odds of that happening are unpredictable, but it did happen and my family wished as a result that we had cord blood stem cells.

Annualized rate of 370 goes for 8 years but covers 20 years of storage. Others with 125/year - at the end of 20 years - amounts to more

What are the odds that stem cell treatment proves successful for people like your brother? And in case it is successful, do patients return to full health?

This service seems like an insurance to me. In case of an unfortunate event, you are covered. People are right to question the efficacy of stem cell treatments. Unless treatments are effective, it’s not worth paying for.

I’m also interested to learn the answer to this question GP asked:

> What percent of people who have banked cord blood who are not explicitly susceptible to specific genetic disorders known to utilize them for treatments have ever ended up using it?

In the case of my brother there was quite a bit of evidence surrounding cord blood improving motor and social skills. I linked a Duke article on it in another comment

The percent of people who have banked cord blood who are not explicitly susceptible to specific genetic disorders is unknown. It would be a compounded probability of freak accidents occurring, sports injuries, other diseases ie certain cancers, environmental issues, etc

I understand that patients don't return to full health. Here's the study [0] that the article [1] reports.

> The percent of people who have banked cord blood who are not explicitly susceptible to specific genetic disorders is unknown.

Makes sense. I wonder what percent of people suffer from conditions that could be treated by the service offered by Anja Health.

[0] https://pubmed.ncbi.nlm.nih.gov/29080265/

[1] https://pediatrics.duke.edu/news/umbilical-cord-blood-improv...

> Why would it be quackery? This is a pain point that my family faced. My brothers cerebral palsy was an unforeseen circumstance due to a near drowning accident. The odds of that happening are unpredictable, but it did happen and my family wished as a result that we had cord blood stem cells.

Do you have any evidence that the treatment would have cured your brother? Wishing for a miracle treatment is something anyone with a child or sibling would do. That doesn't mean it would have done anything.

Do you have stats on the number of such incidents that occur annually and how many of them may be solved with such a treatment? Wouldn't that be part of your market analysis?

Do you have stats on the number of people who would not be able to get the same treatment from a public bank? The ones that offer this service for free and add it to a general pool for anybody that it could benefit. The bi-racial angle is interesting and maybe that changes the statistics, but without real numbers it's more hand waving quackery.

Do you currently or plan to ever provide kickbacks, either directly or indirectly, to doctors to promote or advertise your services? That's a massive conflict of interest and the coord blood industry is particularly dirty: https://www.prnewswire.com/news-releases/cord-blood-banking-...

I have a very dim view of medical services that are directly advertised to consumers. This type of "product" simply preys on the fears of parents-to-be by pitching it as either a cure for some statistically insignificant risk, or even worse, a "theoretical" cure for unknown diseases that might be developed from it in the future.

And any industry that compensates medical providers to promote its services is inherently corrupt as it's violating the sanctity of the relationship between a doctor and patient.

> Annualized rate of 370 goes for 8 years but covers 20 years of storage. Others with 125/year - at the end of 20 years - amounts to more

Based on what math are you cheaper? Your offering is clearly more expensive.

At an interest rate of 0%, the total expenditure is 8 x $370 = $2960 v.s. 20 x $125 = $2500.

At an interest rate of 4%, the net present value (NPV) is $2491 v.s. $1698.

At an interest rate of 7%, the net present value (NPV) is $2209 v.s. $1324.

At an interest rate of 10%, the net present value (NPV) is $1973 v.s. $1064.

In every situation the competitor is less expensive. The higher the interest rate, the larger the discrepancy.

Plus your prices being front loaded means that customers lose the option of canceling after the 8th year. All the money has already paid. It's worse in every way.

Furthermore, ask a CP child who was crawling before the cord blood transplant to walking after the transplant even if he was not 100% cured of CP if it was worth it. Ask a child who could not raise the spoon to feed herself before the transplant to able to do so after if it was worth it. Ask a parent of a CP child who could not jump before the transplant to be able to participate in birthday party jumpers if it was worth it. These was written before by Dr. Joann Kurtzberg at Duke University that did the trials. I would not want to be the one who’s words could potentially damage the chance of a family’s possibility. I applaud Anja for making this possible for all income types.

Like I said, you forgot to mention that the bigger player charge upfront fee of around $1000, some at $1500, not just the annual fee. Second, ask thousand of families who benefitted from cord blood, to them, it is 100% chance of using.

Evidence that it would’ve helped my brother: https://pediatrics.duke.edu/news/umbilical-cord-blood-improv... Evidence that people of color have a harder time finding a match: https://www.cancer.net/blog/2021-03/why-bone-marrow-registry... Using interest rates and comparing old prices isn’t the comparison I was using to illustrate that we’re cheaper. I was using current cord blood banks’ prices. Cord blood banks in the US.

This is a whole lot of noise over a medical thing that costs less than $3k. I can hardly remember a medical bill under $3k.

and where are you getting ten percent on anything?

That's the silliest argument I've ever heard. If this is not helpful, then clearly it's a bad idea for low income families to spend 3k on it. They could spend it on something that actually helps. If it's quackery, the false hope it provides is evil in itself. And if they are paying kickbacks to doctors, then clearly it harms the patients' trust in doctors, as mentioned.

As to 10%, the average returns from S&P 500, since 1957 when it was formed, is 10.5%, so 10% is pretty much what you'd expect if you put the money in stocks. Especially over a longer term like 20 years.

From what I can tell it's better to donate to a public bank. According to the AAP the child itself is almost certainly not going to be able to benefit from their own stem cells because whatever disease you're trying to treat them for is most likely already present in the stem cells. It can be used to treat siblings though. But overall the advice is to donate to a public bank unless you already have a child with a medical condition in your family that could benefit from cord blood from their sibling.

http://pediatrics.aappublications.org/content/pediatrics/119...

Donation is a good idea. Except that even with a match from the public bank, the survival rate from transplant is half of what would be if you use your own or related cord blood. I think racial differences has always been overlooked in the medical board recommendations. Angela Julie recently commented on her own experience given her Children’s racial diversity.

Congrats on your launch!

How is Anja Health different from other established US providers such as Cord Blood Registry, Via-Cord, or Cryo-Cell?

Also, if our family already has a sample frozen at one of these other facilities, and assuming there's a compelling reason to switch, do you have a tissue sample transfer mechanism/protocol?

>>If you didn’t, what prevented you from doing so?

Didn't for our first child because we weren't aware (education/awareness issue), but we did it for the second child. It feels like a tail risk hedge, and literally YOLO-type analysis is what motivates us to continue paying for the sample to stay frozen.

Thank you! We're different in a few ways: 1. More affordable pricing. 2. We manually process stem cells vs. automatically processing them (can yield up to 25% more stem cells this way) 3. We offer placenta banking 4. We have a brand and community behind us! I've built out a following on TikTok of about 80k thus far (has grown by about 25k since the batch began, so growing quickly), and I think many resonate with our brand and especially my personal story, which I talk about often

So glad you did it for your second! Siblings can be a 75% match, so that's awesome. Love the term YOLO-type analysis haha

Perhaps I'm in the minority here, but I don't necessarily feel that having a large tiktok following is a plus for a medical service provider.

Especially when you're considering something very long term. What does TikTok branding mean in 20-year timespan?

Distribution is distribution :)

I don't doubt that it's a good way for you to quickly get customers. I just would never use it myself.

But it's getting pretty clear that the only innovation here is to target lower income families than your competitors, by using platforms like tiktok and charging a low upfront fee (but higher monthly fee).

Yup! Lower income families like us because we are accessible. Higher income families & providers as well like us because of our personalization and onboarding

Well, you're much more expensive in the long run. But that's pretty typical for companies targeting poorer people. So you're essentially a very expensive financing solution.

I have looked around, Anja is the cheapest. Other company has a big upfront cost that is around $1000 or more, not Anja. In the long run, it is also cheaper.

Low income families themselves have told us they’re so happy they finally found an affordable solution. So I’d beg to differ (qualifying low income as <75k household income. They self reported)

I can no longer reply to your last comment @Grustaf for some reason haha but I'm guessing you're still reading these. We are currently the most affordable in the industry. When you add up cord blood alone amongst all cord blood banks and make the plans specific to 20 years, ours comes out to be ~3000. Others come out to be 3500+. Can send you some data on this if you'd like to correspond via email

Yeah you have to wait a minute or something until you reply.

No need, I believe you. It's just that it seemed others here pay less than that.

But it's a bit confusing that you only pay for the first 8 years. That makes it look more expensive than it is. Why not lower the monthly fee to $20 but keep it for the full 20 years?

Didnt want parents to have to worry for an extended period.

It seems to me that lowering the monthly cost is precisely what they'd prefer. 8 years later both parents are probably back to working full-time, and with promotions etc they will have better economies.

Why would a young not so well off family prefer to pay 35 dollars a month for eight years, to paying say 20 for 20 years?

I'm really confused by this because it seems that it would benefit both your customers, and you, since you could charge more overall while imposing a smaller burden. Plus it would sound cheaper.

Which tiktok is that? I only found these:

2173 followers (personal account): https://www.tiktok.com/@kathrynjc7

699 followers: https://www.tiktok.com/@anjahealth

10 followers: https://www.tiktok.com/@anja_health

it is @kathrynanja

thanks

This is brilliant and I wouldn't be surprised if this doesn't lead to many years of extra life for people who get this for their children. I think in 60-70 years time the possibilities of this material being used for both injuries, diseases and life extension could be huge. And what a beautiful story to try to help people like your brother. I've no doubt you'll be hugely successful with it. Good luck.

In Ukraine there's a company called EmCell who has been using fetal stem cells for treating a wide range of diseases and autoimmune issues for the last 30 years; research for 30 years, clinical practice 25 years.

There's a free documentary on the clinic that can be watched that explains why they believe it's safe to inject fetal stem cells that are 7-12 weeks old into anyone; there are 50 million legal abortions done annually around the world, and that tissue is otherwise thrown out and considered bio-waste.

There are a number of diseases that aren't curable in North America, however based on their data/experience that it appears that if treated early enough before disease progression damages the healing mechanisms of the body, that different diseases can be not only stopped but also regress (heal/be cured).

Anyone else find the idea of using aborted fetal cells unsettling? There's just something really strange about it. I would 1000% be on board if there was some way to synthesize it artificially.

There are new methods of harvesting stem cells from adult somatic cells, such as yamanka factors (for which the Nobel Prize was awarded) & CRISPRa: https://www.cell.com/stem-cell-reports/fulltext/S2213-6711(2...

Not really, these cells are no longer being used, might as well do some good with them. Or are you suggesting people are getting abortions to harvest stem cells?

Ah I see - we’re from the umbilical cord so they’re a bit different from fetal stem cells!

Can you explain how umbilical cord tissue differs from placental tissue, and its potential/known uses? I realize this reply will probably get lost being 3 days later.

Umbilical cord stem cells are categorized as adult stem cells because a human being has formed. They are more stable. Embryonic stem cells from fetus are not and much more unstable. Umbilical cord blood would be treated as a medical waste otherwise.

Thank you so much! Your support means the world :)

A wonderful idea and lots of positive comments. As I'm reading this, I'm trying to understand how you could ever trust a company with a long time horizon like this. The modern world to me is: personal information for sale; corporate takeovers changing privacy obligations; rates change at the drop of a hat; bankruptcy to discharge apparent moral obligations (pensions).

Even if the company is still here and morally sound in 20 years, what will the costs be? I'm hoping the headline "treat dementia" is not going to be a concern for 20 year olds.

I searched the FAQ for "how do I access [my stem cells]"... maybe I missed that part?

Good luck to you in spite of my doubts.

We’re HIPAA compliant. No data for sale. Checkout anjahealth.com/lab where we answer how to retrieve stem cells

This is something that exists in Poland from at least 2017. I've done it for 2 of my children. Setup cost 700usd (based on package), yearly 200 usd - https://www.pbkm.pl/

It existed at least in 2006 in Serbia, and probably few years before that. Operated by Swiss CryoSave company. It was upfront lifetime payment, something around 2000EUR. Although this price was more affordable than cumulative monthly payments, there was a scandal with that company. I think they bankrupted, but some Polish cryo bank took the bio material. So maybe upfront payment is not that sustainable (who would have thought?).

Btw. we deposited stem cells for our second child born in 2010, and when this scandal happened I tried not to think too much about it and just be grateful that we don't need that material. It should be still safe in that other bank though.

Amazing! So glad you did

This seems very expensive to me.

We got something similar from a private company here in London - umbilical cord, blood, placenta - and the storage fee is £100 per year.l (there was an initial "set up" fee of approx £2,000 too). 85USD a month for storage seems like a lot for the same thing.

We figured that we'd spend perhaps £3,800 all-in to "insure" our kid until they're an adult which seemed like a great deal. 18k USD just for storage seems like less of a clear-cut value proposition.

Hi! How long are you paying that? Is it for life?

Our's is $35, 65, or 85/mo for 8 years to cover 20 years of storage. So it's nowhere near 18k

The pricing page says 85USD/month so I multiplied 85 x 12 x 18 for 18 years storage - I.e. 18,360.

We are paying £100 a year for as long as we want to keep it.

I guess it's like data backups: you don't actually know if you have a good deal until you need to retrieve and use it.

If someone else is offering the same service cheaper, then you know it's not a good deal.

we send parents a stem cell certificate 1 month after birth. so you'd actually know that it's a good deal pretty immediately

For sure. We're 8 years * 85/mo for payments * 12 months per year for 20 years of storage. So much less than 18k

> However, we couldn't find a match because matching happens via ethnicity (at a high level), and my brother and I are mixed race. So, lack of access to cord blood stem cells is a pain point that my family knows deeply,

I am a mix of White, Chinese, and Caribbean Black, so this alarms me, as I seriously doubt that there are many people with my particular makeup out there.

A long way from having kids, but at least for me, this made the value proposition for this a lot more relevant for if/when I do.

For sure! So glad you will!

My understanding is that stem cells are special because they have the potential to turn into any type of specialized cell the body needs, whereas regular cells have already turned into specialized cell types and there's no un-frying the egg, as it were.

Has there been any research on producing stem cells from specialized cells? Or is there something fundamentally impossible about this, akin to producing the original content given only a hash value?

There has been a significant amount of work in this area. One of the most notable breakthroughs was from Shinya Yamanaka (and his lab) in 2006 & onward where they defined a core set of factors that can be expressed in adult cells to convert them back to embryonic stem cell-like states [1,2]. These cells are commonly referred to as induced pluripotent stem cells (abbreviated as iPSC's if you want to google them). There are a bunch of folks working on potential applications of the technology, but as you might imagine, it will take a lot of work the demonstrate safety & efficacy.

[1] https://en.wikipedia.org/wiki/Shinya_Yamanaka [2] https://pubmed.ncbi.nlm.nih.gov/16904174/

https://www.nature.com/articles/d41587-022-00002-4

Even though nobody is quite sure how it works, it's possible to reverse the epigenetics of a cell back to its original differentiated state and even back to stem cell form not entirely unlike rolling back git commits.

I haven’t kept up with the latest research, but the term for what you’re asking about is “induced pluripotent stem cells”.

> Has there been any research on producing stem cells from specialized cells?

Unsurprisingly, lots.

People have been researching this for a long time, with some famous success stories, eg.

https://dolly.roslin.ed.ac.uk/facts/the-life-of-dolly

For some extra context, Dolly was not made using the iPSC approach (reversing differentiation from adult cells). Dolly was cloned using a process called Somatic Cell Nuclear Transfer, where the nucleus of an adult cell is placed inside an embryo, replacing the embryo's nucleus. The embryo then develops using the DNA of the individual that donated the nucleus.

The article kind of alludes poorly to this, but somatic cell nuclear transfer (developed by John Durdon) was a huge milestone in the field that eventually led to Yamanaka's discovery of the pluripotency factors, for which they both won the Nobel prize in 2012.

That's some excellent context, thank you.

I recall when Dolly was in the news, but only understood the broad strokes of the process. I did scan through that page for 'stem', and found a reference to future research, and noted the replication from an 'adult cell' (which I'd assume analogous to differentiated cell).

I'd guess the transfer process is why she arrived with shorter telomeres at birth?

> 'adult cell' (which I'd assume analogous to differentiated cell)

That's correct.

> I'd guess the transfer process is why she arrived with shorter telomeres at birth?

Also spot on. The donor somatic cell likely had shortened telomeres, resulting in shorter length in the embryo. It's kind of an interesting research question, because telomere length gets "restored" for germ cells (otherwise every time an organism produced sperm/eggs the telomeres would shorten), and these types of experiments demonstrate that there is a limit to that restorative process.

Those types of stem cells can be extremely unstable and carcinogenic even, so yes, the ones that we collect are specialized specifically for either blood or tissue regeneration which is why they are more stable and not inclined to be carcinogenic.

Parent of three kids in Ontario. We definitely looked into this when our first was born 10 years ago, but the costs were way out of reach as something so speculative for a young couple just starting out and needing to choose our battles as far as finances.

I don't think donation was ever raised as a possibility; given that we never signed a consent for that, I assume it was all just disposed of.

For the most part, it is disposed of unfortunately :( there's super limited awareness on cord blood banking in the US

We're expecting our second here in a few months, and from my research it's really expensive and most folks would be better off donating. I feel like banks feed too much off of peoples fears instead of the better good. What are the odds of someone needing their own cord blood vs. it being a publicly accessible thing? It feels like donating blood to a bank to store it for myself in case I ever need it.

Again, it's an exciting field with a lot of really good outcomes, but it kind of plays into the whole, "what if something happens to your kid fear" to sell it to people, instead of thinking about all the other kids that you could be saving.

Congrats!! Donating can definitely be positive, but I think in a perfect world everyone has access to their own stem cells. Chances of survival are higher if you use a genetically related donor for a stem cell treatment. Beyond that, I'm a firm believer in the fact that if someone has access to these stem cells, they will use it at some point in life. Even if someone spends their whole life being healthy, they could be used for dementia/whatever old age brings. In the US, this is not quite as popular, but in other countries, people use stem cells in the same way they use botox - for anti-aging purposes. It could potentially be used for that down the line too.

Plus, standards for donations are very high. Some donations are rejected, so if you try to donate and it's rejected, then nobody wins :(

As for the fear mongering-related marketing, we do our very best to stay away from that, but truthfully it's a necessary thought when it comes to positioning a preventative care product.

Standards for donations meaning volume, certain history of disease, etc.

Congrats on your launch!

We had our baby two weeks ago (a mixed race kid as well) -- luckily we managed to find a service here in Australia and get his cord blood stored at the last minute. I didn't know this is a thing and could be vital for my kid's future health. My in-laws work in the medical industry and they were the ones who suggested us to do it. I was curious why isn't this suggested or recommended by OB/GYNs during pregnancy? Are there still any medical restrictions for using of cord blood?

Also, is 20 years the maximum effective storage period for it? Is it possible to transfer it between countries in case we decide to migrate in the future?

Recently spoke with a OB who said that he didn't like to mention it in the past because he felt slimy knowing that companies were hiking up their prices (since demand can be inelastic for baby health related products). He recently signed with us as an advisor because he knew we were well-intentioned and properly building an onboarding flow & company made for parents and for them only.

No evidence to show that extensive storage will damage the product! Potentially re: transfer, although it would depend on who is transferring & how

Congrats on the launch!

I have considered this in the past, but had a some questions on the investment (and typically high recurring cost):

1. How many years will cord blood usable when frozen?

2. Do you think ongoing research like the way Harvard researchers found ways to reprogram skin cells to stem cells [1], if eventually commercialized, would be a headwind for your business?

[1] https://news.harvard.edu/gazette/story/2015/10/converting-sk...

1. They don't expire - there is not any evidence of detrimental deterioration 2. No - it's a different type of stem cell. The stem cells from cord blood are much more stable. Others have a risk of being carcinogenic even! ie embryonic stem cells

Services exist since a very long time now. The reality in the field seems to be that doctors are skeptical of the benefits due to lack of research breakthroughs. If you store the cells for 20 years, it's also a question as to whether they are still usable or have degraded when stored for so long.

Curious if you have any thoughts and of course, good luck with your company!

They will be usable - no other research to demonstrate otherwise right now :) For sure - doctors are skeptical, but we've been able to reach OBs and convince them otherwise. Time will tell!

Congrats on your launch! We chose not to bank, although it was offered to us. So I guess the first question I’d have is that if this is already offered at the time of delivery, how is your service different. Also, the ACOG currently states “Storing a child’s stem cells in a private bank as “insurance” against future disease is not recommended.” But I realize despite this it’s a personal decision, because who knows what the future holds for these stems cells and their ability to provide a cure for whatever the child may encounter in its future.

Congratulations on the launch! Would love to know (1) what’s the science like supporting this and (2) as a startup how do you guarantee the stems cells will still be around in 10/50 years?

We have an open source cord blood banking library if you'd like to take a look (https://anjahealth.notion.site/Cord-Blood-Banking-Library-60...) Highlights include real cases of cord blood being used to reverse type 1 diabetes (https://www.medicalnewstoday.com/articles/240160#1), significantly improve symptoms of Chron's (https://www.dvcstem.com/post/stem-cell-crohns-case-study), promote CAR-T cell therapy (https://www.cancertherapyadvisor.com/home/cancer-topics/hema...), treating neuroblastoma on a 7-year-old (https://pubmed.ncbi.nlm.nih.gov/1357627/), and more!

Most notably, I like to point out that banking over donating is what we advocate for because using a donor's hematopoietic stem cells risks rejection and even fatality, so using a genetically related (or your own) stem cells increases your chances of survival (https://www.nejm.org/doi/full/10.1056/nejm199708073370602)

As a startup, we have a legal obligation to ensure that the CRM is handed off in case anything happens to the company. Our lab has been around for over 40 years processing different kinds of blood products, so they are definitely not going anywhere (and the blood products our clients stored wouldn't either), and they would simply communicate with a new CRM.

Is this business viable anymore? Don't we have the Yamanaka factors to reprogram any kind of cells to various levels of undifferentiation? Sounds like an investment with guaranteed zero return at some point in the near future.

Also as ohter say there are public banks for these in many european countries and the cost is ~ $1000 (but they are not available for everyone). There is also a perception that these companies are selling a service that won't be needed - just feeding off the hopes/fears of young parents.

It's an investment with tremendous return - I personally know the return first hand. If my brother had access to these stem cells, his motor skills could've been improved, which could've led him to more easily be able to do things like cough when he had pneumonia (which ultimately led to the downfall of his health). Reprogramming into other cells can create an extremely unstable cell and a carcinogenic environment

Survival rates from stem cell treatments are also much higher if the stem cells come from a genetically related sample - the best is your own. Beyond that, many may not find a match if you're a person of color or mixed race. This is also a pain point my family personally faced

That was decades ago though. AFAIK nowadays all countries operate large banks - the UK has a big one. It s likely that a donor CAN be found through such banks. Besides, this kind of commercial approach is not systematic and doesnt guarantee diversity of samples in any way -- in fact people from economically disadvantaged genetic backgrounds will have less access to it. Diversity is somethign that public bases do take into account.

Why do you think they'd have less access? They have greater access because they will 100% find a donor - themselves. It guarantees access to a sample regardless of genetic background

As I understand it many of the common potential use cases only work if you have a donor who isn’t yourself. Because if you have a genetic disease that disease will be present in your stem cells. The most common example I’ve heard is of storing stem cells to help a potential future sibling, not the baby directly. Or am I mistaken?

It has been used for the baby themselves & siblings :)

Some cases where babies use them themselves: https://www.nature.com/articles/bmt2012146

https://pediatrics.duke.edu/news/umbilical-cord-blood-improv...

I understand that it happens, my question is the prevalence. When I looked into banking cord blood I found a lot of ‘possible’ and one-off cases, but no actual statistics about how likely it was to be useful. That made it unpalatable, especially compared to the known benefits of delayed clamping.

is there any science backing this? case studies of actual people actually benefiting from it?

Definitely! Many. We have an open source cord blood banking library if you'd like to take a look (https://anjahealth.notion.site/Cord-Blood-Banking-Library-60...)

Highlights include real cases of cord blood being used to reverse type 1 diabetes (https://www.medicalnewstoday.com/articles/240160#1), significantly improve symptoms of Chron's (https://www.dvcstem.com/post/stem-cell-crohns-case-study), promote CAR-T cell therapy (https://www.cancertherapyadvisor.com/home/cancer-topics/hema...), treating neuroblastoma on a 7-year-old (https://pubmed.ncbi.nlm.nih.gov/1357627/), and more!

Are you familiar with this practice in Canada?

From my understanding you can pay to have these tissues frozen, but you're still not allowed to actually use them for anything?

I am! I know it does happen in Canada-https://parentsguidecordblood.org/en/family-banking/canada

This is a record of successful uses there!

Interesting. What services to you provide to help manage and analyze material from multiple siblings, and do or will you take any special continuity measures?

We process them all separately! We do this for twins as well.

For someone who hasn’t encountered this before and is expecting their first child in a couple months — how common is this in practice today?

Congrats!! We pride ourselves on our customer service, so if you have any questions, definitely feel free to reach out to us.

In the US, only about 2% of parents bank cord blood due to a huge awareness issue (that 2% is concentrated in wealthy, urban areas - think Greenwich, Beverly Hills, Upper East Side). In Singapore, however, rates can be as high as 30%, and in certain areas of China it's at around 10%. The greatest barrier in the US is for sure awareness and secondarily pricing, so we're working on trying to lower costs. When you first read this post, what was your first reaction? What are you most curious about?

We found it was quite common, and for the prices we paid (which are significantly cheaper than this startup - YMMV) it was a no brainer.

I was not convinced on the science today, but when it is cheap I figured that it is worth a punt on the assumption that science will improve in the next two decades. If not you've only spent about as much as a new Mac book Pro (from most providers) so worth the gamble.

For those who can afford it, it’s somewhat common. I did this for our son. Just another insurance policy to give your kid every chance

So glad you did!

My wife and I had our first child last October, and we wanted to collect the cord blood to donate, but the hospital said they didn't do cord blood collection. I know you can't speak for our specific hospital, but would that be a problem for other customers? Hospitals preventing nurses from collecting blood because of safety or liability concerns?

Donations are pretty heavily concentrated in New York City and they have a hard time collecting from other areas.

As for cord blood banking, anyone who can get a kit (which should be everyone because we ship nationally) should be able to bank, but in the rare cases that doctors push back, you can request that they put in your medical record that they are refusing, and usually they will reconsider because - inversely -they don't want to take on the liability of not banking haha

> ... Anja banks the placenta amnion, which

Heads up: The placenta banking FAQ answer ends abruptly.

Q: Is there a card or something that will alert hospitals should folks get injured and no one else is available/aware of the bank materials that could be of help (e.g. spinal cord injury)? An opt-in permission or something?

Thanks for raising awareness! I had no idea this existed.

Oh sorry about that! We've fixed it a few days ago, but perhaps a glitch. I will look into it. Thank you!

I'm just curious/ignorant, but I thought I just saw a news study (here on HN) that said DNA has a half-life of 5 years at room temperature, and became unusablely corrupted even at below freezing temperatures in a similar time period (with 1% corruption). Does the supercooling change that timeline significantly?

Not sure what that study applies to. Our lab director who was a former AABB accreditor has a stance that they do not expire or diminish in quality to the point that they are not effective for treatments.

> To conclude, if you had a baby recently and banked cord blood, I’d be curious to know what your experiences were. If you didn’t, what prevented you from doing so?

I had no idea this was a thing when my son was born. I trusted the doctors and staff of my medical HMO (Kaiser) to tell us what steps to take at each point in the process.

Ah I see - we'd love to help out next time!

How do you compare to Cellino?

Cellino is looking to automate the process we use to create human cells, most specifically, induced pluripotent stem cells (iPSCs). IPSCs are made from other cell types, like blood cells, then transformed back into stem cells, which can eventually differentiate into many different cell types.

Those stem cells are more unstable than the ones we collect & can be carcinogenic

This is great! Couple of questions…

- Who owns the stem cells/blood?

- Can I move them to a different bank in the future if I choose to?

Parents sign an agreement with us that it's their property! You could, but it would be costly. There's not really ever a reason to. May as well have it stay put. Cryopreservation is cryopreservation.

> There's not really ever a reason to.

I thought the pricing was a monthly subscription. In that case I would want to be able to transfer to a similar, but more affordable option in the future if that becomes available.

Also 23andMe was purchased by an advertising company, so there is some precedent to be concerned with.

> All biological goods stored with Anja will stay in our New Jersey lab regardless of what happens to Anja as a business.

Can you explain this more? How is this guaranteed in the contract?

Perhaps they are using an outside firm to do the actual harvesting and storing, and Anja is just handling marketing and financing? I think that would explain a lot of the comments, including this one.

Oh I see. Yeah I think it depends on which bank youre working with. They may have their own policy!

We have an insurance guarantee :)

> We have an insurance guarantee

What does this mean?

> Side note: plancentas are so valuable that physicians - especially in Europe - sometimes prefer to take them for themselves to sell to cosmetics research for ~$50k

What is the reason that some placental material can’t be sold to completely cover, or just defray, the storage costs?

It’s illegal to sell them in the US - it mainly happens in Europe

Surely it's even more illegal in Europe?

The cost at established banks was 180 - 300 per year after the initial deposit. Some also separated the stem cells into multiple packets on deposit so you don’t use all of it on one incident, unless you need to. How are you guys better?

The multiple packets on deposit is actually a marketing tactic haha. There's a lot of chatter about using 2 vs. 5 compartments (our lab uses 5), but in reality, they are 2 large compartments or 5 small ones and people will generally use as many stem cells as they can if an emergency health situation comes about.

We're different because 1. pricing - we offer monthly payments (we have offered annual upon request). When you add up all banks' costs to cover 20 years, we are the cheapest option. 2. We process stem cells manually (by hand), which can yield up to 25% more stem cells than if they are processed with a machine/automatically. Our brand is built around evidence-based personalization. 3. We offer placenta banking, which requires a more advanced lab that we have access to. 4. We have a brand and community behind us. Many parents tell us that they choose us over other banks because we have such personal customer service where everyone feels educated walking into the process of banking and they feel comfort walking out of the process of banking.

But you are MORE expensive than all the examples cited. How is that an advantage?

As to brand, how does that help?

What kind of personalisation do you offer?

We are LESS expensive than current other options - I believe the other options mentioned are price points offered many years ago haha. We are $35/mo for 8 years to cover 20 years of storage. That is our cheapest - check our a price breakdown at anjahealth.com/shop/#pricing

As a brand, it helps because people of color can be most affected by being unable to find a stem cell match. And people of color - on average - have lower income in the US, so having lower prices makes us more accessible.

Personalization happens technically with manual processing. It also happens emotionally because we cater to every single customer to make sure that they feel supported regardless of what their birth plan/unforeseen circumstances are

This seems very expensive to me. We are paying approx £8/11USD per month for umbilical cord, blood and placenta. This pricing was from last year.

Yeah I googled it quickly and that gives me prices around 100 a year. Random example from NBC News below. Perhaps Anja's initial costs are lower?

"Private cord blood banking can be expensive. Depending on the bank, current promotions and whether you're storing cord blood, cord tissue or both, initial processing fees can run from roughly $500 to $2,500, with annual storage fees of $100 to $300 each year thereafter." https://www.nbcnews.com/business/consumer/cord-blood-banking...

Right - so in total for 20 years of storage for instance, (100-300)20 + (500-2500 down payment) comes out to more than our current prices which are (35-85) 8 for 20 years of storage as payments go over the course of 8 years to cover 20 years of storage.

I can guarantee we are the most affordable in the industry at this moment.

You having a strong brand helps people of color? Now you completely lost me. What do you mean?

So personalisation doesn't mean that the harvesting or storing is personalised? It just means you are emotionally supportive? Aren't your competitors supportive?

Do you have an alternate investment in this space or something? You've commented like 10 times with low quality content.

To spell this one out: Branding resonates with different groups of people. If the only brands that are in this space are ones that speak to non-people of color, by definition, the people of color wont see it, and by consequence, they wont have access to the treatments.

This applies to all things. Replace "people of color" with whatever you want. It's why there are "investment app for Gen Z" because the Merrill-Lynch doesn't reach anyone under 50. This is not rocket science, dude.

She didn't say anything about targeting, or not excluding, people of colour in their marketing. She just said having a brand is beneficial for them, and that confused me. Perhaps she said somewhere that they are targeting that group, if so I missed that.

I definitely don't have any investments in this space, I find it distasteful.

Appreciate the reply. Personally, I would rather hear your thoughts on why it's distasteful, seems like valuable discussion material. I got that impression from the comments and don't really know enough about the space to have an opinion. If you did, I missed it and I'm sorry.

tbh too many comments here are 'excited' about a business that is rather commonplace everywhere around the world, and is considered ethically ~dubious, since there are few cases where these cells are being used. Plus in past few years there were major advances in reprogramming live cells to back to various stages , and it seems that this is the future (partly the reason why investors invest in anti aging startups).

Agreed. As someone who has actually considered these services there are significant downsides not being presented here- not the least of which is the small number of actual use cases at the moment, especially for your own blood (which may demonstrate the same illness you’re trying to cure). I would have expected a bit more inquisitiveness from the audience here.

It just goes to show that being knowledgeable about technology doesn’t mean that you don’t have other significant blind spots.

Re supportive. Not necessarily. Time and time again I hear stories along the lines of "I had to hand over my credit card in the middle of labor because I couldn't pay online and didn't know when I should pay" or "their supposed sales reps didn't have a lot of knowledge when I asked them questions specific to my birth plan."

Relevant to people of color because people like me - who are mixed race - will have a harder time finding a donor if they ever need stem cells. So banking their own ensures access

This is really interesting! I had no idea about this industry but it seems fascinating.

Are you hiring?

Soon!! :D Find me on bookface & email me?

Bookface is private and only accessible to YC founders.

Oh yes sorry - kathryn@anjahealth.com

What kind of kick backs do you offer doctors?

My partner’s obg will gladly market the highest bidder’s box until this space gets regulated.

How do you plan to protect stem cells from ‘bit flips’ in dna induced by cosmic rays?

Isn’t it a bit strange to market a brand new startup as the “reliable” alternative?

It's not marketed as "reliable" moreso "accessible." haha although I would say that we are reliable as well. If anything ever happens, we have a legal obligation to shift CRM. It's as if a storage unit were to shut down and had other people's items in it. We have a legal responsibility to make sure that it's managed safely and accordingly

The second sentence on your website is "Finding a reliable place to bank your umbilical cord, cord blood, and placenta stem cells is hard".

By the way, the first sentence is "Get your personalized cord blood plan in minutes." but it seems from the other thread that there is no personalisation, every plan is the same?

Haha you're doing your research! Yes, in that sense we are reliable for the reasons I mentioned. There is personalization according to different birth plans. At its core, cryopreservation is the same, but we cater to different scenarios whether its a doula, midwife, nurse etc. being involved and whether they bank cord blood, cord tissue, placenta. Whether they do a home v hospital birth. Whether they want to do delayed cord clamping or not. Whether they are encapsulating their placenta or want to bank. Whether they are doing a lotus birth or not.

what does it take to freeze stem cells ? I think a better business model would be to sell special freezers so anyone could preserve stem cells of his family members autonomously forever

Launch HN: Anja Health (YC W22) – Freezing stem cells at birth for future health