Progyny NASDAQ: PGNY reported what management called a strong start to 2026, with first-quarter revenue reaching a record level and profitability exceeding expectations amid continued investments in its platform and member experience.
On the company’s earnings call, CEO Pete Anevski said first-quarter revenue came in “at the higher end of our expectations,” while net income, earnings per share and adjusted EBITDA were “all above our guidance ranges.” Anevski attributed the performance to “healthy member engagement,” utilization that trended toward the high end of historical levels, and “continued discipline in managing the business,” which supported margins and cash flow.
First-quarter engagement and profitability
CFO Mark Livingston said results reflected engagement levels that were consistent with what the company had assumed when it issued guidance in February. He added that first-quarter revenue increased 1.4% year over year on a reported basis, and “more than 12%” excluding the contribution from a large former client that was under a transition-of-care agreement in the first quarter of 2025.
Livingston said gross margin benefited from efficiencies in care management and service delivery, as well as an anticipated decline in stock-based compensation expense. He also noted that first-quarter capital expenditures were $6.3 million, up $3.5 million from the prior-year period, as the company continues to ramp planned investments.
In response to an analyst question about strong non-GAAP gross margin, Livingston pointed to two primary drivers: reduced stock-based compensation expense “as some of the recognition period for older grants begins to expire,” and “recurring, regular efficiency” gains that he said should persist through the remainder of the year.
Cash flow, balance sheet, and share repurchases
Livingston said Progyny generated approximately $446 million in operating cash flow during the quarter. He added that the company has produced “over $200 million on a trailing 12-month basis,” a level it has maintained for five consecutive quarters. He also said days sales outstanding (DSO) improved, coming in 11 days lower than the first quarter a year ago, even with a typical sequential increase from the fourth quarter as the company established payment flows with newly launched clients.
As of March 31, Livingston said Progyny had working capital of about $266 million, including $225 million in cash, cash equivalents, and marketable securities. He also said the company had no borrowings under its $200 million revolving credit facility and “no debt of any kind.”
On capital return, Livingston said Progyny repurchased more than 5.5 million shares for about $160 million during the quarter under its most recent repurchase authorization, and that the company completed the $200 million program with total repurchases of approximately 8.8 million shares. Anevski added that the board is evaluating options for a new repurchase program, with a decision expected “around the end of May.”
Updated guidance for Q2 and full-year 2026
As the second quarter begins, Anevski said member engagement is tracking in line with typical seasonal patterns after the start of the year. Livingston said the company continues to incorporate the possibility of variability in engagement into its guidance ranges, even though the “unexpected variability” experienced previously has not recurred since 2024.
For the full year, Livingston said Progyny is maintaining its utilization assumption of 1.04% to 1.05%, and ART cycle consumption per female unique at 0.93 at the low end and 0.95 at the high end of guidance assumptions.
- Full-year 2026 revenue: $1.365 billion to $1.405 billion (growth of 5.9% to 9%). Livingston added that excluding $48.5 million of revenue in the first half of 2025 tied to the transition-of-care arrangement, revenue growth would be 10.1% to 13.3%.
- Full-year 2026 adjusted EBITDA: $232 million to $244 million.
- Full-year 2026 net income: $103.7 million to $112.3 million.
- Full-year 2026 diluted EPS: $1.23 to $1.34.
- Full-year 2026 adjusted EPS: $1.98 to $2.09, based on about 84 million fully diluted shares.
For the second quarter, Livingston guided to revenue of $342 million to $355 million (growth of 2.7% to 6.6%). Excluding $17.2 million of transition-of-care revenue from the year-ago quarter, he said the implied growth rate would be 8.3% to 12.4%.
- Q2 adjusted EBITDA: $58 million to $62 million.
- Q2 net income: $25.8 million to $28.7 million.
- Q2 diluted EPS: $0.31 to $0.35.
- Q2 adjusted EPS: $0.50 to $0.53, based on about 83 million fully diluted shares.
Livingston said that at the midpoints of guidance, the company expects a consistent adjusted EBITDA margin throughout the year at a level consistent with 2025, “even with the investments we’re making to grow the business.”
Sales pipeline, renewals, and partner channels
Anevski said market activity has been strong early in the selling and renewal season. He said overall pipeline and early pipeline build are “substantially favorable versus a year ago,” and that early commitments are pacing ahead of the same period last year. He added that on the renewal side, the company has “meaningfully de-risked the season” after receiving early favorable notifications from some of its largest clients.
Asked about the composition of early commitments, Anevski said a higher proportion typically comes from “not nows,” referring to prospects that previously delayed decisions, and that this year is “no different.” He also highlighted increased RFP activity from employers currently using standalone competitors, saying the activity has already outpaced what the company saw across all of last year.
Anevski also discussed traction with channel partners, including health plans. He said the company is seeing “good traction across our health plan partners overall and with Cigna in particular,” noting it is the first full season with Cigna as a partner and that opportunity flow has met expectations.
On Progyny Select, a product aimed at distribution through aggregators and other partners, Anevski said activity has been encouraging. He said the company is “signing up aggregators and distributors” and that market reception has been positive, though he does not expect meaningful “pull through” until later in the year, when smaller employers typically make buying and renewal decisions.
Client outcomes, utilization, and administrative updates
Anevski cited a client-presented study at the Business Group on Health Conference, where one of Progyny’s largest clients analyzed its own claims data warehouse over an eight-year period. Anevski said the client found that Progyny’s program increased fertility-related pregnancies per year, doubled pregnancy effectiveness per treatment, decreased multiples and miscarriage rates, and cut preterm delivery rates by more than half—results that the client said reduced average costs across fertility and related pregnancies, cost per baby, and NICU costs. Anevski added that other jumbo clients have conducted similar analyses and reached “similar conclusions.”
In Q&A, Anevski said utilization levels in the newer client cohort reflected a mix shift toward industries that tend to have higher utilization, rather than a change in behavior beyond expectations. He also addressed prior commentary about membership changes driven by administrative updates. Anevski said the company is working to obtain full eligibility files from clients, rather than relying primarily on numeric headcount updates. He said Progyny expects to have eligibility files from “the significant majority of our clients” by year-end, which management believes will help reduce future surprises.
Livingston said eligibility-related true-ups in the quarter were in line with typical patterns, with increases at some clients offset by decreases at others. He added that these adjustments have not changed the company’s expectations around revenue trends.
Separately, Livingston addressed first-quarter revenue per ART cycle, noting it is typically higher early in the year because more members are in initial consultation phases that generate revenue before ART cycles occur. He said the effect was less evident last year due to the mix of activity associated with the transition-of-care client arrangement.
About Progyny NASDAQ: PGNY
Progyny, Inc is a New York-based fertility benefits management company that partners with employers and health plans to design and administer comprehensive family-building programs. The company's digital health platform integrates clinical expertise, patient support tools and data analytics to help members navigate fertility treatments, from in vitro fertilization (IVF) and egg freezing to surrogacy and adoption. By focusing on outcomes-based care, Progyny aims to improve success rates while controlling costs for its clients.
The core of Progyny's offering is its proprietary Smart Cycle® benefit, which bundles clinical, emotional and logistical support into a single package.
Further Reading
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