Progyny (NASDAQ:PGNY) executives highlighted record financial results for 2025 and outlined expectations for 2026 during the company’s fourth-quarter earnings call, pointing to continued member engagement, strong client retention, and ongoing investment in product expansion and platform capabilities.
2025 results: record revenue, profitability, and cash flow
CEO Pete Anevski said 2025 was “an exceptionally strong year,” with record highs in revenue and adjusted EBITDA, both increasing at double-digit rates versus 2024. Progyny reported $1.29 billion in revenue and $222 million in adjusted EBITDA for 2025, which Anevski said were about $90 million and $28 million above the midpoint of the company’s original guidance, respectively. The company also generated a record $210 million in operating cash flow, up 17% from 2024.
Trends management emphasized: utilization, margin expansion, and cost containment
CFO Mark Livingston said fourth-quarter revenue grew 7% as reported, or 21% excluding the impact of a large former client that contributed in the year-ago period. For the full year, he said revenue grew 10% as reported, or 20% excluding the former client. The transition-of-care agreement related to that client ended June 30, 2025, and there was no contribution from that client in the fourth quarter or the second half of 2025.
Livingston said member engagement remained healthy, including utilization levels and ART Cycles per unique utilizer. Activity paced favorably versus assumptions embedded in guidance, and he said fourth-quarter revenue exceeded the top end of the company’s range by nearly $11 million.
On profitability, Livingston said Progyny delivered margin expansion in both the quarter and the full year. He noted nearly 200 basis points of expansion in full-year gross margin versus 2024, attributing it to continued efficiencies in care management and service delivery and increased leverage with third-party partners driven by scale.
Management also reiterated its emphasis on cost containment for clients. Livingston said Progyny has highlighted that U.S. employers have experienced a 27% compounded increase in overall medical costs since 2022, which he characterized as more than a 5x differential versus the compounded change in Progyny rates over the same period.
Balance sheet strength and share repurchases
Livingston said Progyny continues to convert a high percentage of adjusted EBITDA into cash, generating more than $50 million in operating cash flow for the third consecutive quarter. As of December 31, the company had approximately $350 million in working capital, including $310 million in cash equivalents and marketable securities. He said the company has no borrowings under its $200 million revolving credit facility and no debt.
During the quarter, Progyny repurchased more than 3.3 million shares for nearly $84 million under its most recent repurchase program (authorized for up to $200 million and initiated in November). Livingston added that, including activity since January 1, the company has repurchased about 6.5 million shares in total, with more than $40 million remaining under the authorization.
2026 outlook: covered lives update, guidance ranges, and stock-based comp reductions
For 2026, Livingston said the company is expecting 7.2 million covered lives, lower than previously estimated due to a net reduction in updated counts received from clients after open enrollment and other updates. In response to analyst questions, management said the changes relate to existing clients, not the new cohort, and appeared to be administrative updates rather than workforce reductions. Livingston emphasized that the company’s guidance is based on utilization it is seeing rather than total population counts, and he said Progyny is not expecting a negative impact to the total number of utilizers because the updates were largely from clients with lower-than-average utilization rates.
Livingston also addressed an executive departure disclosed previously: Michael Sturmer left his role as president at the end of 2025, which accelerated vesting of certain equity awards and led to an incremental $7.7 million in stock-based compensation expense in the fourth quarter and full year.
Progyny guided to 2026 revenue of $1.355 billion to $1.405 billion, representing growth of 5.1% to 9% as reported. Excluding $48.5 million of revenue tied to the former transitioned client in the first half of 2025, Livingston said projected full-year growth would be 9.3% to 13.3%.
Profitability guidance included adjusted EBITDA of $224 million to $239 million and net income of $95.4 million to $106.1 million. Livingston said earnings per diluted share are expected to be $1.19 to $1.22, with adjusted EPS of $1.83 to $1.95, based on approximately 87 million fully diluted shares. He noted the company’s assumptions do not include additional buyback activity beyond repurchases already completed due to timing uncertainty.
For the first quarter of 2026, Progyny guided to revenue of $319 million to $332 million (growth of -1.6% to +2.5% as reported). Excluding $31.3 million tied to the transitioned client in the year-ago quarter, Livingston said the first-quarter outlook implies growth of 9% to 13.4%. The company expects first-quarter adjusted EBITDA of $51 million to $55 million and net income of $20.8 million to $23.7 million, translating to diluted EPS of $0.24 to $0.27 and adjusted EPS of $0.42 to $0.45.
Livingston said guidance assumptions incorporate potential variability in activity and treatments, particularly at the low end of the ranges. He outlined utilization assumptions of 1.04% at the low end, with ART Cycles per unique utilizer in the first quarter assumed at 0.48% to 0.49%. For the year, consumption at the midpoint was described as consistent with the last two years, which he said is at the low end of the multi-year average.
Livingston also said the company expects a “significant reduction” in stock-based compensation in 2026—down about 35% from 2025—as prior large grants have fully vested. At the midpoint, he said stock-based compensation is expected to be about 6% of 2026 revenue versus more than 10% in 2025.
Product expansion: upsells, newer services, and Progyny Select
Anevski said 30% of Progyny’s client base expanded benefits for 2026 through upsells and service enhancements. With those expansions, he said more than 2.7 million members will have access to one or more newer services in pregnancy, postpartum, and menopause in 2026. In Q&A, management said these newer services are growing but are “not yet material” financially, characterizing them as value-adds that help strengthen relationships with clients.
Management also discussed “Progyny Select,” a fixed-premium product designed for smaller employers in the fully insured market. Anevski described it as a way to address cost predictability by pooling risk, using structures such as capped benefits and removing individual member opt-outs, with premiums applied to the entire covered population. He said 2026 will be the first year in market for Select, but the company does not anticipate any contribution to financial results until 2027.
In response to analyst questions on the scale needed for predictability, management said a pool in the “couple hundred thousand lives range” could begin to behave more predictably, and that any early variability would not be expected to meaningfully affect overall margins due to Progyny’s broader scale. Management also described guardrails for high-cost claimants, including a maximum dollar amount (a lifetime maximum) after which the employee would effectively become self-insured or cash pay.
Progyny also addressed questions about its pharmacy offering, Progyny Rx. Management said it has not seen employer pushback tied to broader marketplace developments and reiterated that its model includes rebates at point of sale, a structure it has used since introducing the pharmacy product in 2018. Executives said the fee structure could evolve, but they do not expect “net economics” to change given the value delivered through an integrated medical and pharmacy program.
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.
