Pulsenmore: Can FC become a real second commercial engine
Pulsenmore’s FC is no longer sitting only on clinical feasibility. After the Clalit study was completed and the commercial framework was updated, the question shifted from whether the product works medically to how it can actually become real commercial business.
The main article argued that Pulsenmore’s real test had moved away from one-off accounting relief and toward real commercialization. This follow-up isolates the FC channel, because at this point FC is no longer just an adjacent product to ES. It is becoming a separate commercialization track that could, at least in theory, open a second leg around IVF and fertility preservation.
What actually changed here? FC has already cleared one important gate. The commercial conditions with Clalit were confirmed as fulfilled, the study results were deemed satisfactory, and in January 2026 the parties signed an updated framework that moves the story from feasibility into a commercial pilot. That is real progress. But it is still not the same thing as a mature second engine, because the updated model also softens the economic floor: first an 18-month pilot, then a purchase framework, with a lower annual minimum, meaningful return rights, and direct sales by the company to patients that are deducted from Clalit’s minimum.
That is exactly why FC deserves its own continuation analysis. It has already moved beyond feasibility, but it has not yet passed the density test of commercialization. If the pilot proves demand, workflow fit, and repeat use, Pulsenmore could add a real second commercial engine within the same remote-care infrastructure. If not, FC will remain an interesting product with an attractive headline agreement but without enough economic weight to change the company-level picture.
What changed in FC
FC is designed for self-examination of follicle size and count and of endometrial thickness in women undergoing IVF or fertility preservation. The company presents it as a home-use product that does not require prior medical training, with either clinician-guided use or app-guided use. That matters, because what is being sold here is not just another small ultrasound probe. It is a way to move part of fertility monitoring out of the clinic and into the home.
The original December 2021 agreement with Clalit was already large relative to the company’s scale: a four-year purchase framework with an aggregate value of $10.8 million, subject to the Rabin Medical Center feasibility study meeting protocol criteria. That framework also gave Clalit the right to return up to half of the annual minimum. In other words, even the original agreement was never a hard industrial-style backlog. It was always conditioned both on clinical proof and on adoption quality.
The January 2026 update moves the process forward, but also changes its shape:
| Item | 2021 framework | January 2026 update | Economic meaning |
|---|---|---|---|
| Starting point | Conditional on feasibility results | Parties explicitly confirm the conditions were met and the results were satisfactory | The risk moved from study success to commercialization execution |
| Route to patient | Mainly through Clalit | The company may also sell directly to patients, with support through Beilinson NEXT | Pulsenmore gains a more active commercial channel, not just institutional supply |
| Annual minimum | 3,000 units | 2,000 units after the pilot | The commercial floor remains, but it is softer |
| Return right | Up to half of the annual minimum | Up to 1,000 units per year | Even after the update, Clalit keeps meaningful flexibility |
| Contract duration | 4 years | 18-month pilot, then 5 years | A longer track, but with the committed purchasing phase delayed in time |
The table and chart together tell the real story. Commercial clarity improved, but economic rigidity did not. Pulsenmore gained a more explicit commercialization route, while Clalit preserved a flexible structure around adoption, returns, and pacing.
Why this is already more than a feasibility story
To understand why FC should now be taken seriously as a possible second engine, the right way is to look at the full evidence chain rather than one presentation bullet. By year-end 2025, the company had already supplied 400 devices to Clalit under the agreement, of which 100 were used for the feasibility study. That is not mass commercialization, but it does show the product had already moved beyond the lab.
The clinical evidence also improved. During 2024, a single-center study at Rabin Medical Center examined whether patients could perform self-scans with FC for ovarian and endometrial monitoring. Forty-eight patients completed the study. No device-related or procedure-related serious adverse events were reported, and the company says follicle number and size and endometrial thickness measured by FC were comparable to standard in-clinic ultrasound. It also states that the scans could provide a reliable diagnosis for appropriate ovulation-trigger timing before oocyte retrieval, with high satisfaction reported by both patients and sonographers.
That is the moment when FC moves from a product that sounds logical to a product with operational clinical proof. The updated contract sharpens that point further: the parties explicitly state that the conditions precedent were fulfilled, including AMAR approval and completion of the study under Prof. Yoel Shufaro through Rabin Medical Center, and that the results met the trial protocol criteria. This is no longer vague language about what management believes. It is a formal statement that a gate was crossed.
The commercialization route matters too. Instead of waiting only for Clalit institutional orders, the updated framework allows the company to sell directly to patients, while Beilinson NEXT provides the healthcare and marketing layer. That is a smart choice, because fertility monitoring does not work exactly like the ES pregnancy model. It is built around frequent scans, clinic load, and a clear patient-value proposition in reducing visits and time burden. The March 2026 presentation makes that point explicitly: each IVF or fertility-preservation cycle requires 4 to 7 ultrasound scans, so home follicular monitoring should both relieve clinic burden and improve the patient experience.
That chart matters because it explains why FC now looks more credible and also slower. There is a launch path, but it is not an immediate jump into full institutional purchasing.
Why it is still not a full second commercial engine
The most important part of the story sits in the fine print. First, Clalit does not begin its minimum purchases immediately after signing. The pilot starts only one month after execution, and Clalit’s purchases begin only after 18 months of service through Beilinson NEXT. That means 2026, and likely much of 2027, are still pilot-model years rather than years of hard institutional volume.
Second, every unit that Pulsenmore sells directly to patients during the period is deducted from Clalit’s future annual minimum. That is a non-obvious clause. On one hand, it shows the company gained real commercial freedom. On the other hand, it means direct sales do not necessarily stack on top of Clalit purchases. They can replace part of them. So anyone looking for a second engine needs to be careful not to count the same success twice.
Third, the annual floor was reduced from 3,000 units to 2,000 units, while Clalit still retains the right to return up to 1,000 units per year. That is not a technical footnote. It is structural evidence that actual adoption remains uncertain enough that the framework could not be tightened. The wording that purchases will be made in stages and subject to coordination and mutual agreement leaves the pace of ramp-up open.
Fourth, the 2025 accounts already show that this model carries accounting caution. In the revenue note, the company explains that Clalit may return devices that were supplied but not sold or opened, and that end-customer returns are also possible under consumer-protection rules. As of December 31, 2025, the contract liability related to FC customer contracts stood at NIS 938 thousand. That is not a thesis-breaker, but it is a reminder that the move into recognized revenue already comes with return assumptions and commercial caution.
There is one more constraint the market could miss: FC does not yet diversify Pulsenmore’s customer base. It still sits on the same anchor customer that drives ES in Israel. The filing itself says the company is highly dependent on Clalit both for ongoing ES sales and for the future purchase of additional FC devices. So even if FC works, at least in the first phase it deepens the relationship with Clalit more than it broadens the commercial base.
What has to happen for FC to become a real second engine
The first test is demand proof inside the pilot. It is not enough that the study delivered good medical results. The next step is evidence that patients actually use the pathway, that the product fits into the Beilinson NEXT workflow, and that direct-to-patient sales do not remain a narrow launch event.
The second test is economic quality, not just activation. If most direct sales merely replace part of Clalit’s future minimum purchases, then FC will improve the commercialization narrative without necessarily creating as much incremental engine power as the slide suggests. What would indicate a real second engine is a combination of repeat usage, adoption pace, and proof that the route builds real economic mass rather than just reorganizing the same demand.
The third test is regulation outside Israel. The March 2026 presentation says “regulatory expansion expected in 2026.” By contrast, the 20-F still says the company plans to gain more real-world experience with FC before seeking approval in the United States and other territories. Those messages are not necessarily contradictory, but they do make one thing clear: regulatory expansion is not the same thing as actual commercial entry. Over the next 2 to 4 quarters, investors should be looking less for a growth slogan and more for concrete evidence of the next step.
There is also a framing gap worth calling out. The presentation condenses the FC story into one line, “$4.5M contract signed with Clalit HMO.” The annual filing tells a more complicated story: an older $10.8 million framework that depended on trial success, and a newer $9 million post-pilot structure with a reduced minimum, return rights, and direct sales that are deducted from that minimum. That does not cancel the thesis. It refines it. FC now looks like a real commercialization track, but still one that has to travel through far more than a single slide headline.
Bottom line
FC has already crossed the line between a clinical concept and a first commercialization framework. There is a completed study, a formal confirmation that the Clalit conditions were met, a pilot model, and a longer contractual track than before. That is enough to treat FC as a real candidate for a second commercial engine.
But a real candidate is still not a proven engine. For now, FC rests on the same anchor customer, a long pilot, a softer annual floor, and relatively high return rights. It can absolutely become Pulsenmore’s second leg, especially if the direct-sales route proves demand and the product begins to move beyond Israel. At this stage, though, the cleaner reading is a plausible second engine still in the proof-building phase, not a second engine solid enough to carry the full thesis already.
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