Filling the Fertility Gap: Startups Drive Research in Ignored Field
WHY YOU SHOULD CARE
A growing number of fertility tech startups are funding and conducting their own research to help women.
By Molly Fosco
When Afton Vechery told her OB-GYN she wanted a fertility test, the doctor was puzzled. “Why would you want a fertility test if you’re not trying to get pregnant and you’re only 27?” she asked. Vechery wasn’t planning on having kids soon, but she still wanted to know whether her reproductive system was healthy. She ended up paying an infertility clinic more than $1,500 for the test, but she decided that there needed to be a better solution.
So in 2017, Vechery and her co-founder, Carly Leahy, launched Modern Fertility, an at-home test that can measure key fertility hormones — the same ones doctors test — for almost one-tenth the price: $159. But they didn’t stop there. Earlier this year, the startup conducted a detailed research project that showed how most American women don’t understand that a man’s age can also impact fertility. It’s just one of dozens of fertility tech companies that have emerged over the past five years that are now dominating the broader women’s health care technology market, a product category known as “femtech” — while also filling giant gaps in research that exist because of historical prejudices.
As of 2017, fertility tech startups had raised more than $548 million in funding, according to CB Insights. That’s compared to $20 million raised for menstrual health products, $28 million for sexual wellness technology and $228 million for pregnancy and nursing products. And there’s plenty of scope for expansion. Femtech firms received more than $400 million in funding in 2018 alone, according to PitchBook.
We can help be your fertility detectives.
Afton Vechery, Modern Fertility
The explosion in these fertility tech startups is spurred by a generation of couples who are waiting longer to have children. Modern Fertility, based in San Francisco, analyzes a small blood sample sent by mail for fertility hormones. The results provide details about fertility hormone levels and what they mean for ovarian reserve (egg count), egg freezing or in vitro fertilization. Since its launch, the startup has raised $7 million, and it gained more than $70,000 in preorder purchases within its first month.
Another company named Ava, meanwhile, offers the Ava bracelet. Worn at night, the bracelet measures different physiological signals in a woman’s body to accurately predict her ovulation window. In just two years, Ava has confirmed more than 19,000 pregnancies in women who tracked their ovulation using the bracelet. Mira, another firm, offers a registered medical device that measures fertility and tracks menstrual patterns. It claims 99 percent accuracy and has drawn thousands of users globally since releasing its product in September.
But these startups are at the cutting edge of more than just fertility tech. For most of the 20th century, the science community deemed women confounding test subjects for clinical trials due to their fluctuating hormone levels. It wasn’t until 1993 that U.S. Congress ruled women must be included in all National Institutes of Health clinical trials to account for physical differences between men and women.
These fertility tech companies are making up for the lost time by funding and conducting research on women’s reproductive health themselves. In the past three years, firms like Ava, Modern Fertility and Mira have all funded and carried out peer-reviewed studies that look beyond the efficacy of their immediate products, helping them with insights that could shape their future innovations — while also improving our broader understanding of women’s fertility and reproductive health.
“We can help be your fertility detectives,” says Vechery.
Lea von Bidder, who launched Ava in Zurich, Switzerland, in 2016 with three co-founders, wanted to better understand her body, though she wasn’t trying to get pregnant. Traditionally, most women used the “temperature method” to determine their fertile window: During ovulation, a woman’s body temperature slightly increases. But Ava — which now has offices in San Francisco, Hong Kong, Belgrade and Makati in the Philippines — published a study in April, along with University Hospital Zurich, that found that other factors besides body temperature indicate a woman’s fertile window, including heart rate, respiratory rate, heart rate variability and skin perfusion.
The Ava bracelet, which is regulated as a medical device by the FDA and costs $299, tracks these physiological parameters at night in real time, giving couples more time to try and conceive. “One of the reasons I’m here is to advance research,” says von Bidder. “If you want a free [menstrual] cycle tracking app, those exist,” she says, but fertility tech won’t grow without doing actual research. Ava puts 20 percent of the price of the Ava bracelet toward research and development in women’s health.
Vechery’s journey has been similar. Prior to launching Modern Fertility, she worked in health care private equity and noticed significant growth in products targeting couples experiencing infertility — which is one in every 8 American couples, according to the Centers for Disease Control and Prevention. “That experience really stuck with me,” Vechery says. Self-funded research by Modern Fertility earlier this year showed that while 86 percent of women understand that female fertility significantly declines between the ages of 35 and 39, only 28 percent know that a man’s age also impacts fertility. Now, filling that knowledge gap is part of the company’s endeavor, so people can make informed decisions about conceiving. Last year, the startup also published a clinical study in Obstetrics & Gynecology (“The Green Journal”), the official publication of the American College of Obstetricians and Gynecologists, that showed the results of its test are consistent with a traditional venous blood draw.
Mira, which costs $199, will be releasing an artificial intelligence-powered tool next year to monitor fetal health during pregnancy. Like Ava, Mira predicts ovulation as well. While neither of these devices are approved as contraceptives, the ability to accurately track ovulation also lets you know when you’re not ovulating. “Many women don’t want to take hormonal birth control pills anymore,” says Sylvia Kang, who co-founded Mira headquartered in the Bay Area and Hangzhou, China. The company published research in 2018 demonstrating its device can predict fertility as accurately as laboratory-grade readers. Another study is currently underway comparing the accuracy of Mira to the popular consumer fertility device Clearblue Fertility Monitor. “A lack of research on reproductive health is one of the things that drove us to do our own research,” says Yazan Amro, Mira’s chief marketing officer. “We’re also bringing a novel concept to the market — the first of its kind,” Amro says, which requires scientific evidence to back it up.
That the majority of recent fertility research is conducted and funded by these companies internally raises questions about just how much it can be trusted. Independent studies by universities and external research labs will be required to ensure these products are backed by unbiased scientific research. That’s something these companies recognize and are increasingly prioritizing. Ava has already teamed up with University Hospital Zurich. And Mira is working with the Marquette Institute of Natural Family planning at Marquette University on their current clinical trials.
For sure, it’s unlikely these tests will ever replace a doctor completely. Dr. Mark Trolice, director of fertility care at The IVF Center in Orlando, Florida, says he’s seen patients have trouble detecting ovulation with kits like Mira and Ava when they were in fact ovulating. “Home tests can be a guide to timed intercourse,” Trolice says. “But they do not, and will not, replace the knowledge, direction and experience of a fertility specialist.”
Still, the results speak for themselves. At Ava’s San Francisco office, the walls are covered with photos of babies born to mothers who used the firm’s bracelet. The next step, says von Bidder, will be improving actual infertility treatments — a market that is set to reach $2.2 billion globally by 2023.