Item 2. | Management’s Discussion and Analysis of Financial Condition and Results of Operations |
The following discussion and analysis of our financial condition and results of operations should be read in conjunction with our financial statements and related notes included elsewhere in this in this Quarterly Report on Form 10-Q and our Annual Report on Form 10-K filed with the U.S. Securities and Exchange Commission, or the SEC, on March 30, 2023. This Quarterly Report on Form 10-Q contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, which are subject to the “safe harbor” created by those sections. Forward-looking statements are based on our management’s beliefs and assumptions and on information currently available to our management. In some cases, you can identify forward-looking statements by terms such as “may,” “will,” “should,” “could,” “goal,” “would,” “expect,” “plan,” “anticipate,” “believe,” “estimate,” “project,” “predict,” “potential” and similar expressions intended to identify forward-looking statements and reflect our beliefs and opinions on the relevant subject. Our actual results could differ materially from those discussed in the forward-looking statements. Factors that could cause or contribute to these differences include those discussed below and elsewhere in this Quarterly Report on Form 10-Q. The forward-looking statements included in this Quarterly Report on Form 10-Q are made only as of the date hereof. These statements are based upon information available to us as of the filing date of this Quarterly Report on Form 10-Q, and while we believe such information forms a reasonable basis for such statements, such information may be limited or incomplete, and our statements should not be read to indicate that we have conducted an exhaustive inquiry into, or review of, all potentially available relevant information. These statements are inherently uncertain, and investors are cautioned not to unduly rely upon these statements.
Overview
We are a biomedical company focused on transforming women’s healthcare by developing novel solutions and next-generation advancements providing significant clinical impact to address severely underserved areas. Our mission is to provide women with superior minimally-invasive, non-surgical product technologies, accessible in the office, improving patient care and overall health economics. We are a woman-founded and led company with an expansive, internally created intellectual property portfolio with over 150 patents globally, in- house chemistry, manufacturing, and controls (CMC) and device manufacturing capabilities and proven ability to develop and commercialize products. Our suite of products and product candidates address what we believe are multi-billion dollar global market segments in which there has been little advancement for many years, helping women avoid pharmaceutical solutions, implants and surgery that can be expensive and expose women to harm. With an initial focus in the area of reproductive health, our two lead product candidates offer solutions for two ends of the spectrum: FemBloc for permanent birth control and FemaSeed as an artificial insemination infertility treatment.
Corporate Update
On April 18, 2023, we announced that Health Canada, the Public Health Agency of Canada, has granted product approval of FemaSeed, the first-ever infertility solution designed to deliver sperm directly to where contraception occurs. FemaSeed is Femasys’ localized artificial insemination option that is designed to be less invasive and more affordable than assisted reproduction, such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).
Effective April 18, 2023, we suspended our “at-the-market” facility with the Sales Agent pursuant to a certain prospectus supplement dated July 12, 2022 and Equity Distribution Agreement, dated July 1, 2022 and terminated the continuous offering under such prospectus. The Company will not make any sales of its Common Stock pursuant to the Equity Distribution Agreement unless and until a new prospectus supplement is filed with the Securities and Exchange Commission; however, the Equity Distribution Agreement remains in full force and effect.
On April 18, 2023, we entered into a definitive agreement for the issuance and sale of an aggregate of 3,196,722 of its shares of common stock (or common stock equivalents) at a purchase price of $1.22 per share (or common stock equivalent) in a registered direct offering priced at-the-market under Nasdaq rules. In a concurrent private placement, we also issued and sold unregistered warrants to purchase up to an aggregate of 3,196,722 shares of common stock. The gross proceeds from this offering was $3,900,000. The net proceeds to us from this offering was approximately $3,400,000, after deducing placement agent fees expenses and estimated offering expenses payable by us. We intend to use the net proceeds from this offering for general corporate purposes. The offering closed on April 20, 2023.
On May 3, 2023, we announced that Health Canada, the Public Health Agency of Canada, has granted product approval of FemCerv, the first endocervical tissue sampler (curette) designed to collect and contain a comprehensive sample to maximize quality and quantity. FemCerv captures a tissue sample in a relatively pain-free manner and has the potential to be an improvement over the existing standard of care to diagnose the presence of cancerous cells in a woman’s cervix.
Clinical Update
FemaSeed – Our Artificial Insemination Solution. In April 2021 we received an IDE approval from FDA that allowed us to initiate a pivotal trial for the FemaSeed device. The first subject was enrolled in July 2021. In October 2022, we announced an updated study design for the pivotal trial, which now focuses on couples experiencing male factor infertility. This update reflects a revised strategy to address this underserved population experiencing infertility with a goal of facilitating accelerated enrollment. Completion of enrollment is now expected in the fourth quarter of 2023 followed by a planned submission of the results from the trial to FDA in support of a future de novo classification request for FemaSeed. Extenuating circumstances at clinical trial sites have resulted in a slowdown in enrollment due to consolidation activities, staffing shortages and the aftermath of the overturn of Roe v Wade. It has been reported that there have been over 25 transactions since the start of 2021 (including 25% of our clinical trial sites) in the infertility market, which is rapidly evolving into large commercial entities. This rapidly changing market dynamics may be disruptive to the practice and affect the conduct of clinical studies as integration occurs. The American Society of Reproductive Medicine (ASRM) issued a statement March 17, 2023 on the abortion policy proposals affecting reproductive medicine. ASRM stated, “At the crux of the issue many of the proposals to ban or otherwise limit access to abortion care fail to protect the use of assisted reproductive technologies, including IVF, and so-called “personhood” measures (defining life as beginning at conception or fertilization) are multiplying across the nation, causing alarm bells to sound for medical practitioners and infertility patients alike. Such proposals could, intentionally or not, limit and even ban the use of IVF and routine, safe, and medically proven procedures, such as the removal of an embryo that fails to implant in a uterus, or the disposal of unused embryos.” This uncertainty and limitations of staff availability may affect subject enrollment in clinical studies being conducted at facilities providing infertility services.
Results of Operations
Comparison of the Three Months Ended March 31, 2023 and 2022
The following table shows our results of operations for the three months ended March 31, 2023 and 2022:
| | Three Months Ended March 31, | | | | | | | |
| | 2023 | | | 2022 | | | Change | | | % Change | |
Sales | | $ | 293,984 | | | | 321,405 | | | | (27,421 | ) | | | -8.5 | % |
Cost of sales | | | 105,120 | | | | 122,675 | | | | (17,555 | ) | | | -14.3 | % |
Gross margin | | | 188,864 | | | | 198,730 | | | | (9,866 | ) | | | -5.0 | % |
Operating expenses: | | | | | | | | | | | | | | | | |
Research and development | | | 1,537,439 | | | | 1,421,063 | | | | 116,376 | | | | 8.2 | % |
Sales and marketing | | | 244,896 | | | | 68,863 | | | | 176,033 | | | | 255.6 | % |
General and administrative | | | 1,315,137 | | | | 1,447,355 | | | | (132,218 | ) | | | -9.1 | % |
Depreciation and amortization | | | 133,066 | | | | 144,199 | | | | (11,133 | ) | | | -7.7 | % |
Total operating expenses | | | 3,230,538 | | | | 3,081,480 | | | | 149,058 | | | | 4.8 | % |
Loss from operations | | | (3,041,674 | ) | | | (2,882,750 | ) | | | (158,924 | ) | | | 5.5 | % |
Other income (expense): | | | | | | | | | | | | | | | | |
Interest income | | | 97,089 | | | | 2,454 | | | | 94,635 | | | | 3856.4 | % |
Interest expense | | | (1,672 | ) | | | (2,734 | ) | | | 1,062 | | | | -38.8 | % |
Other income (expense), net | | | 95,417 | | | | (280 | ) | | | 95,697 | | | | -34177.5 | % |
Net loss | | $ | (2,946,257 | ) | | | (2,883,030 | ) | | | (63,227 | ) | | | 2.2 | % |
Sales
Sales decreased by $27,421, or 8.5%, to $293,984 for the three months ended March 31, 2023 from $321,405 for the three months ended March 31, 2022. U.S. sales increased by $30,624, or 11.6%, for the three months ended March 31, 2023 as compared to the same period last year; however, there were no international sales for the three months ended March 31, 2023 as compared to $58,045 reported for the same period last year resulting in a net decrease of $27,421 in sales. U.S. units sold increased by 7.1% for the three months ended March 31, 2023 as compared to the same period last year.
Cost of sales and gross margin percentage
Cost of sales decreased by $17,555, or 14.3%, to $105,120 for the three months ended March 31, 2023 from $122,675 for the three months ended March 31, 2022 mainly due to the decrease in sales, sales mix, and certain manufacturing efficiencies. Gross margin percentage was 64.2% for the three months ended March 31, 2023 as compared to 61.8% for the three months ended March 31, 2022.Gross margins improved due to higher U.S. sales which have lower cost of sales than international sales.
Research and development
The following table summarizes our R&D expenses incurred during the periods presented:
| | Three Months Ended March 31, | |
| | 2023 | | | 2022 | |
Compensation and related personnel costs | | $ | 900,288 | | | | 764,792 | |
Clinical-related costs | | | 366,360 | | | | 443,970 | |
Material and development costs | | | 167,161 | | | | 131,450 | |
Professional and outside consultant costs | | | 91,935 | | | | 68,664 | |
Other costs | | | 11,695 | | | | 12,187 | |
Total research and development expenses | | $ | 1,537,439 | | | | 1,421,063 | |
R&D expenses increased by $116,376 or 8.2%, to $1,537,439 for the three months ended March 31, 2023 from $1,421,063 for the three months ended March 31, 2022. The net increase of $116,376 mainly consists of the $135,496 increase in compensation and related personnel costs primarily due to increasing costs associated with hiring and retaining personnel to support our clinical trial costs.
Sales and marketing
Sales and marketing expenses increased by $176,033 or 255.6%, to $244,896 for the three months ended March 31, 2023 from $68,863 for the three months ended March 31, 2022 largely due to an increase in compensation and related personnel costs due to an increase in headcount and marketing costs to promote our commercial efforts.
General and administrative
General and administrative expenses decreased by $132,218, or 9.1%, to $1,315,137 for the three months ended March 31, 2023 from $1,447,355 for the three months ended March 31, 2022. The decrease was largely due to a decrease in salaries and related personnel costs, a decrease in facility and other overhead costs mainly for directors & officers insurance, and a decrease in legal and certain professional costs.
Depreciation and amortization
Depreciation and amortization expenses decreased by $11,133, or 7.7%, to $133,066 for the three months ended March 31, 2023 from $144,199 for the three months ended March 31, 2022 due to reduction of depreciation expense associated with our fixed assets and a reduction in amortization expense associated with our intangible assets.
Other income (expense)
Other income (expense), net increased by $95,697, or 34177.5%, to $95,417 for the three months ended March 31, 2023 from $(280) for the three months ended March 31, 2022 mainly due to an increase in interest income.
Liquidity and Capital Resources
Sources of liquidity
Since our inception through March 31, 2023, our operations have been financed primarily by net proceeds from the sale of our common stock and convertible preferred stock, indebtedness and, to a lesser extent, product revenue. As of March 31, 2023, we had $10,161,338 of cash and cash equivalents and an accumulated deficit of $97,080,762.
On July 1, 2022, we entered into an Equity Distribution Agreement (the “Equity Distribution Agreement”) with Piper Sandler & Co. (“Piper Sandler” or the “Sales Agent”) and filed a related Prospectus establishing an “at-the-market” facility, pursuant to which we may offer and sell shares of our common stock having an aggregate offering price of up to $8,800,000 from time to time through the Sales Agent pursuant to the Prospectus. As of March 31, 2023, 54,120 shares of our common stock had been sold under the Equity Distribution Agreement.
On April 18, 2023, we entered into a definitive agreement for the issuance and sale of an aggregate of 3,196,722 of its shares of common stock (or common stock equivalents) at a purchase price of $1.22 per share (or common stock equivalent) in a registered direct offering priced at-the-market under Nasdaq rules. In a concurrent private placement, we have also agreed to issue and sell unregistered warrants to purchase up to an aggregate of 3,196,722 shares of common stock. The gross proceeds from this offering was $3,900,000. The net proceeds to us from this offering was approximately $3,400,000, after deducing placement agent fees expenses and estimated offering expenses payable by us. We intend to use the net proceeds from this offering for general corporate purposes. The offering closed on April 20, 2023.
Funding requirements
Based on our current operating plan, our current cash and cash equivalents, along with the net proceeds from our recent financing are expected to be sufficient to fund our ongoing operations into the second quarter of 2024. Our estimate as to how long we expect our existing cash and cash equivalents to be able to continue to fund our operations is based on assumptions that may prove to be wrong, and we could use our available capital resources sooner than we currently expect. Changing circumstances, some of which may be beyond our control, could cause us to consume capital significantly faster than we currently anticipate. We do not expect liquidity to be sufficient for twelve months from the date of these financial statements. As a result of our current limited financial liquidity, we have concluded that substantial doubt exists about our ability to continue as a going concern.
Our cash and cash equivalents as of March 31, 2023 will not be sufficient to fund all of our product candidates through regulatory approval, and we anticipate needing to raise additional capital to complete the development and commercialization of our product candidates. However, we can give no assurances that we will be able to secure additional sources of funds to support our operations, or if such funds will be available to us, that such additional financing will be sufficient to meet our needs or be on terms acceptable to us. This risk may increase if economic and market conditions deteriorate. If we are unable to obtain additional financing when needed, we may need to terminate, significantly modify, or delay the development of our product candidates, or we may need to obtain funds through collaborations or otherwise on terms that may require us to relinquish rights to our technologies or product candidates that we might otherwise seek to develop or commercialize independently. If we are unable to raise adequate additional capital as and when required in the future, we could be forced to cease development activities and terminate our operations, and you could experience a complete loss of your investment.
Cash Flows
Comparison of the Three Months Ended March 31, 2023 and 2022
The following table summarizes our cash flows for the three months ended March 31, 2023 and 2022:
| | Three Months Ended March 31, | |
| | 2023 | | | 2022 | |
Net cash used in operating activities | | $ | (2,647,637 | ) | | | (2,754,021 | ) |
Net cash used in investing activities | | | (8,901 | ) | | | (120,368 | ) |
Net cash used in financing activities | | | (144,060 | ) | | | (141,006 | ) |
Net change in cash and cash equivalents | | $ | (2,800,598 | ) | | | (3,015,395 | ) |
Operating activities
For the three months ended March 31, 2023, cash used in operating activities was $2,647,637, attributable to a net loss of $2,946,257, offset by a net change in our net operating assets and liabilities of $32,666 and non-cash charges of $265,954. Non-cash charges largely consisted of $133,066 in depreciation and amortization, $75,635 in right-of-use amortization, and $56,954 in stock-based compensation. The change in our net operating assets and liabilities was primarily due to changes of $46,485 in accounts receivable, $64,318 in inventory and $91,211 in lease liabilities, which were offset by changes in accounts payable and accrued expenses of $81,719 and $150,654 in other assets.
For the three months ended March 31, 2022, cash used in operating activities was $2,754,021, attributable to a net loss of $2,883,030, a net change in our net operating assets and liabilities of $148,482 and offset partially by non-cash charges of $277,491. Non-cash charges largely consisted of $144,199 in depreciation and amortization, $86,233 in right-of-use amortization, and $44,359 in stock-based compensation. The change in our net operating assets and liabilities was primarily due to changes of $86,044 in accounts receivable and $97,851 in lease liabilities, which were offset partially by changes in accounts payable and accrued expenses of $64,296.
Investing activities
For the three months ended March 31, 2023, cash used in investing activities for the purchase of property and equipment was $8,901.
For the three months ended March 31, 2022, cash used in investing activities for the purchase of property and equipment was $120,368.
Financing activities
For the three months ended March 31, 2023, cash used in financing activities was $144,060, attributable to repayments on a note payable of $141,298, payments under lease obligations of $6,135, and offset by proceeds from issuance of common stock of $3,373.
For the three months ended March 31, 2022, cash used in financing activities was $141,006, attributable to repayments on a note payable of $135,457 and payments under lease obligations of $5,549.
Critical Accounting Estimates
Management’s discussion and analysis of our financial condition and results of operations is based on our financial statements, which have been prepared in accordance with U.S. generally accepted accounting principles, or GAAP. The preparation of these financial statements requires us to make estimates and assumptions for the reported amounts of assets, liabilities, revenue, expenses and related disclosures. Our estimates are based on our historical experience and on various other factors that we believe are reasonable under the circumstances, the results of which form the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources. Actual results may differ from these estimates under different assumptions or conditions and any such differences may be material.
While our significant accounting policies are more fully described in Note 2 to our financial statements appearing the Annual Report on Form 10-K for the year ended December 31, 2022 as filed on March 30, 2023, we believe the following discussion addresses our most critical accounting policies, which are those that are most important to our financial condition and results of operations and require our most difficult, subjective and complex judgments.
Revenue recognition
Our policy is to recognize revenue when a customer obtains control of the promised goods under Accounting Standards Codification 606-Revenue from Contracts with Customers (Topic 606), which we adopted effective January 1, 2018. The amount of revenue recognized reflects the consideration to which we expect to be entitled to receive in exchange for these goods, and we have elected to exclude amounts collected from customers for all sales (and other similar) taxes from the transaction price. We do not have multiple performance obligations in our customer orders, so revenue is recognized upon shipment of our goods based upon contractually stated pricing at standard payment terms ranging from 30 to 60 days. All revenue is recognized point in time and no revenue is recognized over time.
The majority of products sold directly to U.S. customers are shipped via common carrier, and the customer pays for shipping and handling and assumes control Free on Board (FOB) shipping point. Products shipped to our international distributors are in accordance with their respective agreements; however, the shipping terms are generally EX-Works, reflecting that control is assumed by the distributor at the shipping point. Returns are only accepted with prior authorization from the Company. Items to be returned must be in original unopened cartons and are subject to a 30% restocking fee. As of March 31, 2023, we have not had a history of significant returns.
Accrued expenses
We accrue expenses for estimated costs of R&D activities conducted by our third-party service providers, which include the conduct of preclinical studies and clinical trials. We record the estimated costs of R&D activities based upon the estimated amount of services provided but not yet invoiced. These costs, at times, may be a significant component of the research and development expenses and the Company makes estimates in determining the accrued expense each period. As actual costs become known, the Company adjusts its accrual. These accrued R&D costs are included in accrued expenses on the balance sheet and within R&D expense on the statement of comprehensive loss.
Item 3. | Quantitative and Qualitative Disclosures About Market Risk |
Not applicable.
Item 4. | Controls and Procedures |
Evaluation of Disclosure Controls and Procedures
We maintain disclosure controls and procedures that are designed to ensure that information required to be disclosed in the reports that we file or submit under the Exchange Act is (1) recorded, processed, summarized and reported within the time periods specified in the SEC’s rules and forms, and (2) accumulated and communicated to our management, including to our principal executive officer and principal financial officer, to allow timely decisions regarding required disclosure. Our management, with the participation of our Chief Executive Officer (principal executive officer) and Chief Financial Officer (principal financial officer), has evaluated the effectiveness of our disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act of 1934, as amended) as of the end of the period covered by this Quarterly Report on Form 10-Q. Based on such evaluation, our management has concluded that our disclosure controls and procedures were effective at a reasonable assurance level as of March 31, 2023.
Changes in Internal Control over Financial Reporting
There were no changes in our internal control over financial reporting identified in connection with the evaluation required by Rule 13a-15(d) and 15d-15(d) of the Exchange Act that occurred during the quarter ended March 31, 2023 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.
Inherent Limitations on Effectiveness of Controls
Our management, including our Chief Executive Officer and Chief Financial Officer (principal financial and accounting officer), does not expect that our disclosure controls and procedures or internal control over financial reporting will prevent all errors and all fraud. A control system, no matter how well designed and implemented, can provide only reasonable, not absolute, assurance that the control system’s objectives will be met. Further, the design of a control system must reflect the fact that there are resource constraints, and the benefits of controls must be considered relative to their costs. Because of the inherent limitations in all control systems, no evaluation of controls can provide absolute assurance that all control issues within a company are detected. The inherent limitations include the realities that judgments in decision-making can be faulty and that breakdowns can occur because of simple errors or mistakes. Controls can also be circumvented by the individual acts of some persons, by collusion of two or more people, or by management override of the controls. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions or that the degree of compliance with the policies or procedures may deteriorate. Because of the inherent limitations in a cost-effective control system, misstatements due to error or fraud may occur and may not be detected.
PART II OTHER INFORMATION
From time to time we may be involved in legal proceedings arising in connection with our business. Based on information currently available, we believe that the amount, or range, of reasonably possible losses in connection with any pending actions against us in excess of established reserves, in the aggregate, is not material to our consolidated financial condition or cash flows. However, losses may be material to our operating results for any particular future period, depending on the level of income for such period.
You should carefully review and consider the information regarding certain risks and uncertainties facing us that could have a material adverse effect on our business prospects, financial condition, results of operations, liquidity and available capital resources set forth in Part I, Item 1A. Risk Factors, of the Company’s Annual Report on Form 10-K filed with the SEC on March 30, 2023.
Item 2. | Unregistered Sales of Equity Securities and Use of Proceeds |
None.
Item 3. | Defaults Upon Senior Securities |
Not applicable.
Item 4. | Mine Safety Disclosures |
Not applicable.
Not applicable.
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| | Incorporated by Reference | |
Exhibit |
| File | | |
| Number Description of Document | Schedule/Form | Number | Exhibit | Filing Date |
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| First Amendment to the Amended and Restated Bylaws of Femasys Inc. | Form 8-K | 001-40492 | 3.1 | March 30, 2023 |
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| Certification of Principal Executive Officer Pursuant to Securities Exchange Act Rules 13a-14(a), as adopted Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002 | | | | |
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| Certification of Principal Financial Officer Pursuant to Securities Exchange Act Rules 13a-14(a), as adopted Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002 | | | | |
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| Certification of Principal Executive Officer Pursuant to 18 U.S.C. Section 1350, as adopted Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002 | | | | |
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| Certification of Principal Financial Officer Pursuant to 18 U.S.C. Section 1350, as adopted Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002 | | | | |
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101.INS | Inline XBRL Instance Document (the instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document) | | | | |
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101.SCH | Inline XBRL Taxonomy Extension Schema Document | | | | |
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| 101.CAL Inline XBRL Taxonomy Extension Calculation Linkbase Document | | | | |
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101.DEF | Inline XBRL Taxonomy Definition Linkbase Document | | | | |
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101.LAB | Inline XBRL Taxonomy Extension Label Linkbase Document | | | | |
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101.PRE | Inline XBRl Taxonomy Extension Presentation Linkbase Document | | | | |
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104 | Cover Page Interactive Data File (formatted as inline XBRL and contained in Exhibit 101) | | | | |
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*Filed herewith | | | | |
Pursuant to the requirements of the Securities Act, the registrant has duly caused this registration statement to be signed on its behalf by the undersigned, thereunto duly authorized, in the City of Suwanee, State of Georgia, on this 11 day of May 2023.
FEMASYS INC.
Dated: May 11, 2023 | By: /s/ Kathy Lee-Sepsick | |
| Kathy Lee-Sepsick | |
| Chief Executive Officer and President | |
| | |
| By: /s/ Dov Elefant | |
| Dov Elefant | |
| Chief Financial Officer | |
| (principal financial and accounting officer) | |