01The Challenge
A category most operators cannot run at all.
Fertility on Meta is a minefield. Ads get rejected for implying a personal condition, and the platform throttles health data, which blinds optimization and starves the algorithm of signal.
Most buyers simply cannot keep an account like this alive. The job was compliant ads that survive review and tracking that still works when the pixel is throttled.
02The Approach
Compliance as strategy, tracking rebuilt server-side.
- Write education-and-trust copy with no claims, so ads read as content, not violations.
- Run a VSL funnel optimized on watch time, so review systems saw engagement instead of policy triggers.
- Hand-build server-side tracking with GTM and CAPI at 8.3/10 match quality, so throttled pixels didn't blind budget.
- Treat compliance as the growth lever, not a constraint bolted on at the end.
03The Execution
A third of the target cost, about 7x.
The account stayed alive while competitors cycled through bans, and it did so profitably, not just safely.
Spend to sales, about 7xA$18.7K to ~A$133K
A$18,740 of spend produced 759 leads at A$24.69 and 203 booked consultations at A$92.32, roughly a third of the A$250 target, and about A$133K in sales at about 7x.
Honest scope: I ran Meta paid acquisition on a restricted Australian fertility offer; booked consultations were handled by the practice. Figures are from the account's own reporting, in AUD.