# EDGAR Filing Document

**Accession Number:** 0001339005
**File Stem:** 0001140361-25-042734
**Filing Date:** 2025-11
**Character Count:** 9001
**Document Hash:** e0303843761f149040858b40ca7a16f3
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001140361-25-042734.hdr.sgml**: 20251119

**ACCESSION NUMBER**: 0001140361-25-042734

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20251107

**FILED AS OF DATE**: 20251119

**DATE AS OF CHANGE**: 20251119

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Lee-Sepsick Kathy
- **CENTRAL INDEX KEY:** 0001857109

**ORGANIZATION NAME:**

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-40492
- **FILM NUMBER:** 251499372

**MAIL ADDRESS:**
- **STREET 1:** 3950 JOHNS CREEK COURT
- **STREET 2:** SUITE 100
- **CITY:** SUWANEE
- **STATE:** GA
- **ZIP:** 30024
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** FEMASYS INC
- **CENTRAL INDEX KEY:** 0001339005
- **STANDARD INDUSTRIAL CLASSIFICATION:** SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
- **ORGANIZATION NAME:** 08 Industrial Applications and Services
- **EIN:** 113713499
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 3950 JOHNS CREEK COURT
- **STREET 2:** SUITE 100
- **CITY:** SUWANEE
- **STATE:** GA
- **ZIP:** 30024
- **BUSINESS PHONE:** 770-500-3910

**MAIL ADDRESS:**
- **STREET 1:** 3950 JOHNS CREEK COURT
- **STREET 2:** SUITE 100
- **CITY:** SUWANEE
- **STATE:** GA
- **ZIP:** 30024

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 4

### STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

[ ] 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 for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>Lee-Sepsick Kathy<br><sub>(Last) (First) (Middle)</sub><br>C/O FEMASYS INC.<br>3950 JOHNS CREEK COURT, SUITE 100<br><sub>(Street)</sub><br>SUWANEE, GA 30024<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2025-11-07 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[X] Director [ ] 10% Owner<br>[X] Officer (give title below) [ ] Other (specify below)<br>_Chief Executive Officer_ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>FEMASYS INC [ FEMY ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
|  |  |  |  |  |  |  |  |  |  |  |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| Senior Secured Convertible Notes | 0.73<sup>(1)</sup> | 2025-11-07 |  | I |  |  |  | 2025-11-07 | 2035-11-07 | Common stock, par value $0.001 per share | 68244<sup>(5)</sup> | <sup>(7)</sup> |  | D |  |
| Series A-1 Warrants | 0.81<sup>(2)</sup> | 2025-11-07 |  | I |  | 68244 |  | 2025-11-07 | 2035-11-07 | Common stock, par value $0.001 per share | 68244<sup>(6)</sup> | <sup>(7)</sup> | 68244 | D |  |
| Series B-1 Warrants | 0.92<sup>(3)</sup> | 2025-11-07 |  | I |  | 68244 |  | 2025-11-07 | 2035-11-07 | Common stock, par value $0.001 per share | 68244<sup>(6)</sup> | <sup>(7)</sup> | 68244 | D |  |
| Series C-1 Warrants | 1.1<sup>(4)</sup> | 2025-11-07 |  | I |  | 68244 |  | 2025-11-07 | 2035-11-07 | Common stock, par value $0.001 per share | 68244<sup>(6)</sup> | <sup>(7)</sup> | 68244 | D |  |

---

### Footnotes:

(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 $50,000.

**Signature:** /s/ Kathy Lee-Sepsick  
**Date:** 2025-11-19

### Remarks:

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.

* 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).

Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.

**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 Number.**