 Hello, everyone. It's absolutely great to be back at Slash. My name is Sarah Kempinen. I'm the founder in residence at 50 years. We're an early-stage VC firm focused on supporting entrepreneurs who are using d-tech to solve the world's biggest problems. I have the absolute pleasure to be here today with Dina, Dr. Dina Radenkovic, the co-founder and CEO of Gimido, a biotech startup that is utilizing advances in cell engineering to develop normal therapeutics for the diseases of the female reproductive systems. Thanks, Dina, for being here. Thank you so much for having me. It's such a pleasure to be here. Amazing. Before we jump into your very, very interesting story, Dina, I'd love to ask something from the audience. How many of you already have kids or are planning to have them in the future? Raise your hand if you are. You have kids or planning to have them in the future. So this is certainly going to be relevant for you, but also for others. As a society, we are having kids later than our grandparents. But unfortunately, nature is agist, especially against women. In the mainstream media, we often talk about biological clock, acknowledging that age is an important factor in the baby-making formula. Dina, putting on your medical doctor hat, could you tell us a little bit more about what's going on in our bodies in the ovaries specifically, and why should we care about it, regardless if you want to have kids or not? Yeah, absolutely. So this is an important point. If you think about the process, how we make our sex cells or gametes, it is very different if you're XX versus if you're XY. So while XY men start making gametes a bit later, they can make them throughout life. If you were born like XX, what happens is that you're born with a very finite number of gametes, or eggs, essentially. And you keep losing them throughout life. So not only that you're born with a finite number, and we may have even lost a few, unfortunately, Sarah, while waiting to come on stage. We got a later slot on Friday. But it's also that ovaries are an organ that ages up to five times faster than the rest of the woman's body. And what does that mean? That quite early in a woman's life, you experience a relative decline in ovarian function that causes infertility. And that's where we get all these terms, even a geriatric pregnancy after the woman is 35, when certainly our skin, our liver function, is not geriatric. It's out of synchrony to the body. And then later on, you get the absolute decline in ovarian function that causes menopause. And menopause has historically been a taboo topic. Nobody wanted to talk about it. But it does cause in 8 out of 10 women very severe physical, mental, and sexual health symptoms. And not only that, but the age of women experience menopause is associated with women's life expectancy. So earlier menopause is associated with shorter life. And when men turn on, it's usually that there is even a weaker association before your life expectancy with the age of menopause of your sister. And then after menopause, obviously I come from the aging medicine background, women experience a lot of diseases that historically we've associated with aging and frailty. Like weak bones and osteoporosis, loss of lean muscle mass, dementia, cardiovascular disease. So it's really important acknowledging and addressing these in order to really improve healthy life expectancy and ensure that we have therapies that provide us with good quality of life in this space. Absolutely, yeah. One of the surprising and shocking things I encountered when I entered this space was actually how recently we started studying female bodies. It was only in 1993 when the National Institute of Health in the United States, which is a major financing body for basic science research, mandated that clinical trials should be run both on men and women. 1993, that's 28 years ago. Considering how little time we have studied these bodies, what are some of the unsolved problems or on the positive flip side, white space opportunities in the reproductive health space? Thank you for asking that question. I think it's very important just to let that sink in. Like you've said, in 1993. And to make matters worse, the way we experience ovarian aging that causes this infertility menopause is so unique for humans. It's only humans and four types of whales that experience in this way. So not even like what we call mice like murine models or primates experience in that way. So the way we test certain drugs, we have to burn their ovaries with a chemotoxin in order to artificially induce menopause or ovarian aging in order to test what happens. So what that means is that women were not part of trials. And then to make matters worse, we didn't have good models to study disease. So obviously diseases that affect reproductive system of the vast majority of them don't even have a first line medication, right? Like endometriosis is a very common condition. Women suffer from it because it's real suffering throughout like their reproductive and healthy years. Polycystic ovarian syndrome, again, like very little. We have like an off label use of metformin. We don't have cures for these diseases that cause real suffering to half the population. So I think that is an important area. And then another field obviously, like we are trying to address it at gamito is that we have a cell engineering platform that we've developed in partnership with George Church's lab at Harvard Medical School that we use this new field of cell engineering that Shina Yamanaka was kind of like the early openers. If he won an Nobel Prize in 2012 for this, we can take stem cells and convert them of the cells of the reproductive system. And we build the first stem cell-derived organoid of the reproductive system so we can now use it to test things quicker in something that mimics human biology and model diseases. But there are also, I think it's important to mention here, is that even conditions that we are not directly addressing, like heart disease, right? Because historically trials were done in men, the treatments we have right now work better in men. And they don't work as well in women for our heart disease because the way we develop heart disease is different. So I think this really should be a call to action more inclusion of women to study our biology because we're talking about diseases that affect half the population. Absolutely. That's both sad, but also fascinating. There are so many white space opportunities to actually enter this field and start solving those really real issues that have not only affect women, but our next generations. Exactly, like women account for 80% of healthcare spending and you don't need to get that lucky to start solving given that you're competing against pretty much nothing or a couple of available medicines. So it's a less crowded space, so you're more likely to get lucky if you do your stuff well. Absolutely, makes sense and business-wise. So now you're leading the charge against accelerated ovarian aging that we learned just now as the co-founder and CEO of Gemido. We have a really interesting background. You were trained as a medical doctor. You worked in the aging field as a researcher at the Buck Institute, not far from where I'm staying. You have also co-founded a longevity clinic and you are a partner assault. I mean, I'm not gonna even go to ask like, how did you have time to do all of that? But longevity seems to be the through line of your career. How did, where that interest come from? So I guess like as a medical doctor, you end up realizing that a lot of the current medical care is provided at this end stage of life. It's provided where most of the efforts go to late disease. And I remember when I graduated, I was working in a very large prestigious teaching hospital and I've had patients who were just like, be like, oh, but I don't want these treatments. Like this is not helping my quality of life doctor. You're lovely, but like don't take it personally. Better let's just go home and spend like my last days with my family. This is not really improving my quality of life. And then you realize it as a physician, you're more like a, you're not as powerful and you're more of like a consultant. You only have very little time with a patient and then the right time if you're optimizing for the benefit and improvement of quality of life is much earlier. It's while people are still healthy, while people are still enjoying their life to the fullest and then they will take your advice. So I became very passionate around switching that mindset from sick care to well care, transitioning that the brightest minds don't deal with end stage disease, but with prevention and removal of this dichotomy of like, you're a patient and you're not a patient, right? Like we should all be improving, both our physical and mental health. And I feel that like with everything that we can do with this new field of longevity or preventative medicine will really be around improving that health span and switching care from hospitals to homes in our day-to-day lives. Yeah, everyone's a patient. Exactly, like we can all be a better version. We all have something to improve. We'll are at risk of something. And then I think like I really wanted to play a role in that new ecosystem. And I've done so both as a doctor, entrepreneur and an investor. Amazing. And when did you choose and why more importantly did you choose to specialize in reproductive longevity? So frankly, as many good things in medicine they happen by accident. And it was kind of like this. So obviously like, you know, I built the clinics with the CEO, the Buck Institute, Dr. Eric Verdin. And we started working with a research group where we were looking at like how can we sort of like metabolize for like cell energy? Could we like build a medicine to make our mice live longer? And then what ended up happening is that the mice were living like slightly longer. But the big impact was that they were dying with young ovarian follicles. And my father is actually a professor of embryology. So it was like you could fail at anything in life but you need to know how to look at like the histology and embryology, right? So I was just like, oh my God, this is actually true. So it hit me that ovary is a faster aging organ. Is an organ that ages up to five times faster? So if you even want to study aging and test something in real time starting from the ovary makes sense, right? Like if you wanted to, you know, test if this pill is gonna make us live longer we'd have to wait until like we're 85. So, you know, it might be good for our kids like the babies we started talking about at the start of the session but it's gonna be a bit too late for the two of us, right? Whereas ovary ages faster so you could see potentially gain of function even earlier, right? Like is the 35 year old woman having a better fertility? And then another problem was that unlike aging which is a very slow subtle and sophisticated process we celebrate our birthdays, right? And there was very little still that there was a lot around prevention of disease and that is something we were already doing with clinics but there was very little that like, okay I can give you a drug and promise that this is gonna increase your health span or lifespan whereas in the female health suddenly you had a problem that phenotypes of ovarian aging in fertility IVF is one of the largest out-of-pocket markets, right? One in eight couples experience infertility and the way we live it's on their eyes, right? Like it's no longer fit for purpose and then menopause, I mean we're gonna have one billion women living with menopause, right? And they have very little solutions and it's no longer gonna be a taboo topic. We'll scream and shout and ask for something better. Yeah, menopause does not discriminate against women. Exactly, so I was just like suddenly you have this intersection of Venn diagrams almost is that you can already provide clinical benefit. It is a great business which is very important when building a venture-backed company you need to ensure that if your hypothesis works you will be able to provide returns within a certain venture fund timeframe because it's already established businesses and infrastructure, you're not reinventing them. And then something that I'm personally as a woman who has done a medical degree in a company and wants to build a huge company in this space, very passionate about it. I mean, we are mostly women company and we all got skin in the game and this has to work. We gotta fix it for poor ovaries. Well, Gamida is a really interesting company. A large year cell engineering platform essentially developing therapeutics for the diseases of the female reproductive health. But actually you have three different programs. Could you tell us a little bit more what you're developing and how do you prioritize between three problems? Absolutely, so again, like starting, we started in stealth mode. I founded the company with Martin Bershawski, serial deep tech entrepreneur and the founder of largest fertility clinic chain in North America. And we really wanted to kind of build the underlying science and that's when I jumped to be a full-time CEO. So what we've done is that we built from stem cells. We could convert them to different cells of the reproductive system and we build that organoid platform and we said we can now use it to derive therapeutics. And initially the program is that one unit focuses on this biologic that we have for egg freezing and IVF, right? Like just democratizing access to that, making it more convenient, cheaper, effective and then using the platform to model some of these other diseases and then finally the biologic for menopause, right? Like could you dissociate the symptoms so that menopause is lost of fertility but you don't have this like, oh, I lose 80% of my hormones within one year and suddenly like my whole body is in this mess. And certainly we're very committed to solving these problems and being a larger portfolio company, right? Allows it to have multiple shots on goal where we know that biotech even with this precision biotech obviously has a much higher failure rates. So however, even since we've started a company up until now a lot of things have changed in the market and the way we thought about sequencing it is that you focus initially on the fertility. So almost the majority of, almost 100% frankly right now is focused on the fertility program which is the IVF and egg freezing and it was really for three reasons. The first one is it is a product that is done in vitro, right? So in a dish, so very easily we were able to test it and see that it works. That also means because it's done in a dish and not to the patient themselves that the regulatory process is easier and faster. And then finally there's that we knew that the IVF is a large market and we've already had a lot of the commercialization advantage with our relationship with clinics, right? So the idea was try to get to market quicker, try to prove your science, try to get more tangible results and that with that build upon being able to solve some of the bigger problems but with much higher clinical and execution risk. So even, you know, you could start with like, oh, there's so many things I'm passionate about when women's health but in the end, you know, you need to ensure that you're really proving the science that the team grows, that you've done it once and then it's much easier to repeat. So we are actually even though there are many things we'd like to address in the future we're really, really focused on IVF and egg freezing, bring fertility, change that and then move on to the next. Yes, please. You are a second time founder. So I'd love to hear because it's a pleasure to love hearing about like the very tangible hands-on advice. What's something that you learned from your first company in the hard way that you're now taking into your second one? Oof. I would say that it's always the worst the first time you go through an experience and I think we've had the conversation, right? So Sarah has just launched Reaper Grants which is an incredible program, funding research in this space as she mentioned, a lot of the traditional research funding doesn't go to women's health. And you know, we shared like your experience with the entrepreneurial story and I feel like a lot of difficulties that you experience the first time just feel like emotionally, you're just like more vulnerable and when it happens next you're like, oh yeah, that's totally fine. I've got everything under control and I feel like maintaining that self-discipline and calmness in the areas of uncertainty and stress and being the person who is calm and who will solve problems and like calm everybody down and say like, yes, this is what we're gonna do and being that like shock absorber not shock amplifier and clarity. I think that is something you learn certainly with experience and I am still learning it but I've certainly got a little bit better at it. Absolutely, absolutely. As someone who is building company, what part of the day-to-day company building that you enjoy the most? Taking a look into the inside the gameto, yeah. I guess here is that this ability to combine like science with building it into products that people love. As I mentioned, you know, in healthcare, like the way traditionally we brought new medicines to market has often been like, oh, there's this physician who will prescribe it and then it goes through an insurance company and then patients may not, you know, even want to use this, right? Whereas what, you know, if you, now what we're seeing, I think we're seeing the consumerization of healthcare and we're seeing that actually, like if you address commoner conditions, you have a much larger total addressable market. So you now suddenly need to not only convince the physicians and the traditional body but you also need to produce something that patients love. So I think that being able to wear both hats is that you could go really, really deep into the science but then, you know, you come and you talk to people and you see like how what you're building is affecting people and then you get that feedback back. It is something that is so unique and you only really get it when building companies and you end up like affecting like a much larger patient population than the number of patients you could see if you were just working day-to-day in clinical practice. Amazing, amazing. Your co-founder Martin has been quoted saying that sex should be for fun and IVF for making babies. I'd love to know what's your long-term vision for Guamido. Yeah, I mean, he came for that saying because even the World Health Organization definition of infertility was around like, oh, couples who have regular sexual intercourse for 12 months but then now they're introducing, oh, but if perhaps, you know, that only is true if a woman is under 35 or this. So if you actually look at the percentages of human reproduction, it is a pretty inefficient process and much more inefficient than other species. So he obviously, when he was starting prelude was trying to destigmatize uses of assisted reproduction so that people who need access to infertility care would feel more likely to do so. I think with Guamido, what we've seen is that egg freezing when it started, like it was initially developed for cancer patients, it's still, even though we now have data that egg freezing is the most effective intervention to combat age-related or variant decline, it is really only used, for example, in the United States, about like 7% of IVF cycles. And the barriers are, is that it's like pretty expensive. Very expensive, I think like 30K for one. Yeah, like $20,000 sometimes, like get around national average. And it is pretty inconvenient. So, you know, if you're a woman and you need to get your eggs out, you end up being with like two weeks of hormonal injections, you have some blood tests, ultrasounds, you might experience side effects like nausea, vomiting, bloating, even in rare occasions, a more severe complication, cold ovarian hyper-stimulation syndrome. So, when it's kind of on the balance of risk and benefits, a lot of women just don't do it because of the cost and the inconvenience. So, one of the things that, you know, we think it's really important for just optionality and a security policy is that if that makes sperm throughout life, women should just get access to cheap and convenient egg freezing. And that is why we focus there on our first products and we really hope to build like a quick, efficient egg freezing and then even see like large employers offering it and covering it because in the end, it is very important for equitable healthcare and just as an optionality and a security policy, whether it's for medical condition, whether if you, you know, sometimes it happens, whether it's for being able to do so in later life, a lot of studies show that even mothers never fulfill like the number of children they wanted to have because they just run out of time, right? So, giving that optionality to women is really important and I really dream of a world where women would not make decisions because of this like biological clock, right? Like, oh, I have to do it now. Like, I'm a little bit scared. I kind of don't want to, but I may not be able to. So, it's all about choice and empowerment and I think that would be amazing if we were able to do it that every woman can do it and have access to it because still, assistive reproduction is not for everyone and I think we need to do a lot more with hopefully science and technology to allow everybody who wants to use it to be able to do so. Absolutely, it's not just about health but it's also about equality and giving people the autonomy to make those decisions. Yeah, absolutely. Well, Dina, thank you so much for your time. I'm so glad you made it to Helsinki and thanks everyone for coming and listening. Thank you, Sarah. Thank you for a great tap.