Reflections ahead of the AUKSA Real-World Impact Lab panel at Imperial College.
We’re seeing some genuinely exciting developments in women’s health innovation right now here in the UK. Cyclana Bio just raised £5M to target the extracellular matrix to potentially reverse endometriosis scarring. Genie Fertility raised $1.2M to develop menstrual blood diagnostics to replace painful uterine biopsies. U-Ploid Biotechnologies showed 84% reduction in age-related egg chromosomal errors in preclinical studies. And Emm raised $9M for a smart menstrual cup that measures flow volume and cycle patterns.
At Femtech Insider we really excited covering these success stories of course, but we also need to be clear about one thing: It’s not a great climate right now. Early-stage health and deeptech funding remains constrained, the exit environment is challenging, and the quality bar for investment has increased substantially. These successes are happening despite the headwinds.
Years ago, when I was working in the Vienna ecosystem – this was when companies like mySugr and Eversports were coming through INiTS, Vienna’s university spin-off and startup incubator – I had a chat with Dr. Irene Fialka, who led INiTS at the time. She described visiting universities and seeing brilliant innovations just sitting on shelves. Why? Because the researchers and students would rather continue in academia or “find a job” than deal with the complexity of commercialization.
That conversation has stayed relevant. Later this week I’ll be at Imperial College for a fireside chat on what actually distinguishes the spin-outs that succeed from those that stall. And here’s what I’ve learned from covering and analysing hundreds of ventures globally over the past years.
Three Things That Stall Promising Ventures
IP terms that look protective but make companies uninvestable.
Excessive reach-through rights. Restrictive field-of-use limitations that prevent pivots. Sublicensing revenue shares that make partnerships difficult. Universities operate on committee timelines when startups need market speed. When it takes 12-18 months to negotiate terms, founders lose momentum, teams fall apart, and investors may move on.
Misunderstanding funding cycles
Health and deeptech fundraising is cyclical, tied directly to exits. When pharma and strategics are actively acquiring, early-stage capital flows because investors can see their path to returns. When the exit environment contracts – whether through M&A pullback, subdued IPO markets, or strategic buyers being more cautious – seed and Series A funding dries up. It’s not that the science got worse. It’s that investors can’t confidently model how they’ll get their money back.
Geographic reality
The exit market is heavily international. Most significant biotech and medtech exits involve international acquirers or IPO markets. European spin-outs that want to access these exit opportunities need to build international relationships from day one.
What Should Be in a Core Support Package
- Speed and clarity on IP terms: Standard, founder-friendly agreements. Published equity policies. Deals done in weeks, not years.
- Realistic expectations about fundraising: Prepare founders that funding is cyclical. Right now this means longer runways, more non-dilutive funding need, maintaining strategic relationships even when not actively fundraising.
- Access to networks that matter: Investors, strategics, operators who’ve built health companies through difficult funding environments. Not only other academics. Facilitation matters here.
- Transparency about economics: What are the financial expectations? What returns does the university need? This should be clear upfront.
Where Founders Need to Step Up
Founders need to own their commercial strategy. The university gave you the foundation, but they’re not building your go-to-market plan.
Be realistic about market niche and who you need in a team, time-to-market, resources required to sell the product, and what you’re actually good at vs where you need to find support or talent.
The best relationships are where both sides acknowledge their roles. Universities create IP-clear, well-supported pathways. Founders take responsibility for commercial execution and navigating market realities.
The Women’s Health Dimension
This is all amplified in women’s health. We’re operating in a historically underresearched and underfunded sector with structural disadvantages – fewer women GPs making investment decisions, less institutional knowledge, lingering squeamishness about reproductive health.
When a women’s health spin-out faces an 18-month IP negotiation or an ecosystem that hasn’t built relationships with the specialized investors who actually fund this space – those are existential threats.
In a contracted funding environment, these relationships matter even more. When capital is tight, knowing the right 20 people makes the difference between getting a round done and shutting down.
The One Change That Would Make the Biggest Difference
If I had to name one change that would most improve odds of success, it would ask universities to stop optimizing for short-term licensing revenue in ways that kill the company’s chance of success.
Structure IP deals accordingly – simple, fast, founder-friendly. Take reasonable equity. Defer cash payments until companies are revenue-generating, not when they’re burning capital to prove their science works.
The data shows that equity in successful companies can generate much larger returns than traditional licensing fees – but many universities still structure deals around protecting licensing income. The problem is that when those terms make the company uninvestable, universities end up with neither licensing revenue nor equity value.
This matters even more in challenging funding environments because any friction kills deals. When capital is flowing freely, investors might overlook suboptimal IP terms. When funding contracts investors have more options and choose deals with clean, simple structures.
It’s about increasing the facilitation and building of market connections for founders, so that they can develop as they wish. Universities that do this well create deal flow that international investors want to see. They build ecosystems, not just process IP paperwork.
The Bottom Line
The technical excellence coming out of European universities is world-class. The question is whether institutional structures will allow that talent to compete globally.
We’re not talking about scientific problems. We’re talking about institutional design problems. And those are solvable.
The innovations sitting on university shelves that Dr. Fialka described years ago? They’re probably still there. But they don’t have to be. With the right support structures – fast, clear, founder-friendly, operator-heavy – those innovations could be companies. And in women’s health, where we desperately need more innovation reaching patients, we can’t afford to waste them.
