I’ve often found that the essence of building something meaningful, whether it be a human life in the form of an embryo or a business from the ground up, revolves around navigating uncertainty. It was during an IVF consultation last week that this thought crystallized for me. A young couple sat across from me, eyes filled with both hope and apprehension, as they entrusted me with the delicate task of helping them conceive a child. The emotional stakes in such moments are immense, and yet, it is the same kind of hope and risk that I see mirrored in the eyes of every ambitious startup founder I meet.
In the world of startups, embracing uncertainty isn’t just a necessity—it’s a strategic advantage. Some might argue that the key to a successful startup is a groundbreaking idea or an innovative product, but I would contend that the real bedrock of any successful venture is a team that can dance with the unknown. Just as in IVF, where every cycle is a new dance with variables and possibilities, a startup’s journey is fraught with unknowns that must be embraced rather than feared.
I once backed a founder who came to me with a remarkable concept but was nearly paralyzed by the fear of failure. The irony is that failure is often the best teacher. I told him that the customer might not always understand the product on the first go, and that’s okay. It’s not disloyal to acknowledge this; in fact, it’s essential. If a team rewards only positive updates, they’re setting themselves up for a rude awakening when the bank balance eventually tells the unvarnished truth. The real challenge is building a culture where employees can say, “The customer didn’t get this,” without fearing retribution.
Holding a short weekly learning review can be transformative. Start by revisiting the experiment promised last week. Compare the intended test with what actually happened. Look at customer evidence, delivery problems, spending, and the decision now required. This isn’t about presenting momentum, but about grounding discussions in observable events. It’s akin to how we review patient progress in IVF—less about the glossy charts and more about the nuanced details that tell the real story.
In both domains, it’s crucial to distinguish between a failed hypothesis and poor execution. A well-run test that reveals weak demand can save a startup from unnecessary expenditure. Conversely, a rushed or poorly defined test can lead to misleading conclusions, necessitating a re-evaluation. While honest reporting should be praised, accountability for the quality of work remains paramount. The phrase “We learned a lot” should lead to specific changes, not serve as a shield from scrutiny.
Assigning ownership to each experiment is another key practice. Someone must bring back the evidence and recommend a next step. I’ve seen too many unowned experiments turn into endless activities with recurring bills, much like how an IVF cycle without clear leadership can become an expensive, emotionally taxing endeavor.
Keeping the customer visible to those building the product is invaluable. Allow a developer to observe a customer struggle with a confusing task—much like letting a junior doctor sit in on patient consultations to understand the human side of medical care. A founder’s summary is useful, but it can filter out the details that might lead to pivotal design decisions. In medicine, missing these details can mean the difference between a successful treatment and a failed one.
Mentors can play a vital role in challenging your reasoning. Bring them a clear question, a short record of the test, and your proposed decision. Ask what evidence might contradict your interpretation. Advice becomes more useful when it addresses a defined uncertainty. But remember, you remain responsible for the decision; a mentor’s enthusiasm is no substitute for a customer’s behavior.
This discipline should extend to hiring as well. Identify the recurring work and the outcome you need before adding a role. A short, properly scoped engagement may resolve a temporary bottleneck. A permanent hire makes more sense when the work is durable and the business can support the commitment. Cheap labor without clear responsibility can create expensive confusion, a lesson I’ve learned the hard way both in clinics and startups.
Finally, protect the founder’s ability to think. Exhaustion makes every setback feel final and every encouraging message feel like a rescue. Agree on realistic working patterns and personal spending limits. Frugality is intended to extend your capacity to learn, not consume it. A sustainable business needs people who can keep making careful decisions after the excitement of the first launch has faded.
In my experience, both in the fertility clinic and the startup world, the real magic happens when you embrace uncertainty. Every embryo transfer, like each startup launch, carries its own set of unknowns. But that’s where the growth lies. As I reflect on my journey with IVF patients and startup founders, I realize that the surprising comfort in uncertainty is not in knowing the outcome but in trusting the process. It’s about building a team, a culture, and a mindset that thrives on learning from every twist and turn. Maybe that’s the true measure of success—not the absence of failure, but the ability to rise above it and move forward with renewed clarity.
Part of the Building Frugal Startups: Lessons from the Trenches series — read the full guide.