Femasys Inc.

11/12/2025 | Press release | Distributed by Public on 11/12/2025 16:24

Statement of Changes in Beneficial Ownership (Form 4)

FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden hours per response... 0.5
(Print or Type Responses)
1. Name and Address of Reporting Person *
Elefant Dov
2. Issuer Name and Ticker or Trading Symbol
FEMASYS INC [FEMY]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
__X__ Officer (give title below) _____ Other (specify below)
Chief Financial Officer
(Last) (First) (Middle)
C/O FEMASYS INC., 3950 JOHNS CREEK COURT, SUITE 100
3. Date of Earliest Transaction (Month/Day/Year)
11/07/2025
(Street)
SUWANEE, GA 30024
4. If Amendment, Date Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. SEC 1474 (9-02)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
(Month/Day/Year)
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Senior Secured Convertible Notes $0.73(1) 11/07/2025 I $25,000 11/07/2025 11/07/2035 Common stock, par value $0.001 per share 34,122(5) (7) $25,000 D
Series A-1 Warrants $0.81(2) 11/07/2025 I 34,122 11/07/2025 11/07/2035 Common stock, par value $0.001 per share 34,122(6) (7) 34,122 D
Series B-1 Warrants $0.92(3) 11/07/2025 I 34,122 11/07/2025 11/07/2035 Common stock, par value $0.001 per share 34,122(6) (7) 34,122 D
Series C-1 Warrants $1.10(4) 11/07/2025 I 34,122 11/07/2025 11/07/2035 Common stock, par value $0.001 per share 34,122(6) (7) 34,122 D

Reporting Owners

Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Elefant Dov
C/O FEMASYS INC.
3950 JOHNS CREEK COURT, SUITE 100
SUWANEE, GA 30024
Chief Financial Officer

Signatures

/s/ Kathy Lee-Sepsick, Attorney-in-fact 11/12/2025
**Signature of Reporting Person Date

Explanation of Responses:

* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
(1) Holder may, at its option, prior to maturity, convert all or any portion of the outstanding amount of Senior Secured Convertible Notes due 2035 (the "Convertible Notes"), including accrued paid in-kind interest thereon, subject to certain limitations, into shares of Common Stock, at an initial conversion price of $0.73 per share of Common Stock. The conversion rate is subject to adjustment in accordance with the terms of the Convertible Notes and will be subject to standard adjustments in the event of any stock split, stock dividend, stock combination, recapitalization or other similar transactions.
(2) Holder may, at its option, exercise the Series A-1 Warrants, subject to the terms and conditions thereof, at an initial exercise price of $0.81 per share of Common Stock. The exercise price is subject to adjustment in accordance with the terms of the Series A-1 Warrants and will be subject to standard adjustments in the event of any stock split, stock dividend, stock combination, recapitalization or other similar transactions.
(3) Holder may, at its option, exercise the Series B-1 Warrants, subject to the terms and conditions thereof, at an initial exercise price of $0.92 per share of Common Stock. The exercise price is subject to adjustment in accordance with the terms of the Series B-1 Warrants and will be subject to standard adjustments in the event of any stock split, stock dividend, stock combination, recapitalization or other similar transactions.
(4) Holder may, at its option, exercise the Series C-1 Warrants, subject to the terms and conditions thereof, at an initial exercise price of $1.10 per share of Common Stock. The exercise price is subject to adjustment in accordance with the terms of the Series C-1 Warrants and will be subject to standard adjustments in the event of any stock split, stock dividend, stock combination, recapitalization or other similar transactions.
(5) Represents the maximum number of shares of Common Stock issuable upon the voluntary conversion of the original stated amount of the Convertible Notes. The number of shares issuable upon conversion of the Convertible Notes is subject to increase in connection with the accrual of interest, which is payable in kind. The Holder's ability to convert the Convertible Notes to shares of Common Stock is subject to certain limitations, in accordance with rules of the Nasdaq Capital Market.
(6) The Holder's ability to exercise the subject Warrant for shares of Common Stock is subject to certain limitations, in accordance with rules of the Nasdaq Capital Market.
(7) The reported securities were purchased by the reporting person for an aggregate amount of $25,000.
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number.
Femasys Inc. published this content on November 12, 2025, and is solely responsible for the information contained herein. Distributed via Edgar on November 12, 2025 at 22:24 UTC. If you believe the information included in the content is inaccurate or outdated and requires editing or removal, please contact us at [email protected]