Algorithm method: Women struggling to get pregnant turn to fertility apps
Fertility apps offer hope for women struggling to get pregnant
When Nicole and Christopher Roberts of North Stonington, Conn., decided to start a family in 2016, Nicole quickly became pregnant, but then miscarried three months later.
Getting pregnant a second time became far tougher than they expected. Nicole Roberts, 32, started taking neonatal vitamins, tracking her menstrual cycle carefully, taking over-the-counter ovulation tests, and even trying a few wacky internet suggestions, such as putting her legs up in the air after sex and not moving for half an hour.
“It didn’t work,” she said. “As the months dragged on, there was a feeling of desperation because we wanted it so badly.”
Then she saw an ad for Ava, a Fitbitlike device that’s worn on the wrist at night and uses sensors to identify the five fertile days in a woman’s monthly cycle to improve her odds of conception. “It almost felt too good to be true,” Roberts said. She started using the device in March 2017, was pregnant by June, and gave birth to Amelia on March 19.
Roberts is among a growing number of women who are seeking out fertility apps and wearable devices, like Ava, to help grow their families.
“We’re now living in a society where there is a cultural influence that everyone can get pregnant after five glasses of Tequila in one night. That’s what Hollywood shows us all the time,” said Lea von Bidder, co-founder and president of Ava. “But the reality is very different.”
Busy lifestyles have made it tougher for working couples to find the time to track menstrual cycles, take ovulation tests, measure their daily temperature, and then make that all-important physical connection at just the right time in the cycle to create a baby.
Also, many women, especially among Millennials, are focusing on careers and putting off marriage and
“As the months dragged on, there was a feeling of desperation.” Nicole Roberts, who tried to get pregnant, then finally found success with the Ava device
children until later, which poses additional challenges as conception rates are lower in older women. “For a 28-year-old woman, roughly 10 of the 12 eggs she releases each year are viable,” von Bidder said. “But for a 38-year old woman, perhaps only two of the 12 eggs will be viable.” So pinpointing those fertile days becomes even more critical.
The birthrate among women under 30 has been falling steadily since 2010 while the rate among women in their late 30s, 40s and 50s has been rising, according to National Center for Health statistics.
“In my mind, if you had (unprotected) sex, you got pregnant and that was it,” said Kate Campbell, a 32-year-old Nashville resident, who was measuring her body temperature and taking ovulation tests twice a day for months to try to conceive — without success. “I wasn’t getting any positives. I was really shocked. How do people get pregnant by accident?”
After purchasing an Ava bracelet in April 2017, she discovered she had been missing her fertility window by about a week because her cycles were longer than normal and regular period-tracking apps didn’t pick that up. By August, she was pregnant, and her son, Canaan James, was born on April 27.
The internet is filled with women on forums, Facebook and videos seeking fertility advice. They say the problem is highly misunderstood and deeply underestimated.
“For someone, especially a family member, to say, ‘Well, are you doing it right?’ or ‘Do you know what you’re doing?’ — I know they’re joking — but it’s not funny to me. It’s just rude,” said a woman who identifies herself as Jolene Grizzle in a YouTube video, as she described her struggle with fertility, which included using Ava. (It didn’t work for her.)
The Ava bracelet collects data on nine parameters, including skin temperature, resting pulse rate, breathing, sleep movement, and stress levels, while the woman sleeps. Once the bracelet is synced to the person’s phone in the morning, Ava’s proprietary algorithm achieves an 89 percent accuracy rate at detecting 5.3 fertile days each cycle, according to the company.
By measuring temperature and other variables, Ava is able to track changes in both progesterone and estrodial levels, von Bidder said.
“I didn’t have to worry about peeing on a stick and stressing out,” said Krystal Noon, a 30-year old New Jersey resident, who struggled for months to conceive before using Ava. “I would just put this bracelet on at night and it does all the work,” said Noon, who conceived two months after using Ava.
Since its introduction in 2016, von Bidder said, 10,000 Ava customers have become pregnant and at least 1,000 have given birth. Sales are on track to triple this year, she added.
But Ava isn’t for everyone. It’s limited to women with cycles between 24 and 35 days, and is not for those with PCOS, or polycystic ovary syndrome, who face hormone imbalances and highly irregular cycles.
And Ava has some competitors.
Some are free apps, like Glow, Clue, Period Tracker Lite, and Flo, which are generally period trackers that rely on a woman to input her cycle data, then estimate the fertile time based on a calendar or rhythm method.
There are also fertility monitors, like Kindara/ Wink and Daysy, that come with an app and thermometer. And there are a few wearables, like Bellabeat’s Leaf pendant, Duo Fertility’s sensor that’s worn under the arm, Yono’s in-ear sensor, and Tempdrop’s underarm sensor.
But none track all of the parameters that Ava does, von Bidder said. “Because we measure more physiological parameters than just temperature, we can actually detect the fertile window earlier and with a higher accuracy.”
One wearable, OvuSense, is worn like a tampon and measures temperature and other factors. Its readings are considered more accurate than those taken by external devices and can even predict ovulation days for people with PCOS. However, the device is more intrusive than wearing an Ava bracelet.
“I would be a little bit more leery of it because that sounds a little more invasive,” said Tara Perez, a 34-year-old Georgia resident who used the Ava bracelet to help conceive.
A big Ava perk is its Facebook groups, where 25,000 registered Ava users ask questions, share experiences and encourage one another. “That community of women is unlike any you’ve ever seen before,” said Perez, who credits the group with helping her through her fertility struggles. Perez said family members had told her she likely would never be able to have children because she was Type 1 diabetic. But the Ava community helped and encouraged her through the loss of one baby to heart failure at 34 weeks and another through a form of early miscarriage, or “chemical pregnancy,” at five weeks — before giving birth to a healthy baby girl, Selene, on May 30 this year.
Still, Ava has its skeptics. On Reddit, some questioned Ava’s efficacy, given that it had been tested on only 41 women in its original trial.
Then there’s Ava’s $249 price tag. “While it was expensive, it was a whole lot less expensive than trying to look into something like in vitro or trying to ovulate via medication,” Perez said.
Some critics noted that none of the fertility apps and devices have proven data that shows they significantly shorten the time it takes for a woman to become pregnant. “None of them have undergone time-to-pregnancy studies,” said Dr. Victoria Jennings, director of Georgetown University’s Institute for Reproductive Health. “But it won’t stop women from using them or the developers from promoting them.”
Ava has raised $42.3 million in financing.
And Pascal Koenig, chief executive and cofounder of Ava, said three studies are under way, including one with more than 430 participants, on expanding Ava’s use to include detecting infections during pregnancy, helping women with highly irregular cycles and helping perimenopausal women.
Dr. Zev Williams, chief of the Division of Reproductive Endocrinology & Infertility at Columbia University Medical Center, sees value in both fertility apps and wearables. Even a basic app can help a woman see if her cycles are seriously irregular and require medical attention, he said.
But he’s particularly interested in Ava.
“It seems pretty sophisticated,” said Williams, who is in talks with the company about doing a more extensive joint study on the device. “We have an overarching goal of trying to make fertility treatment easier for women and couples going through it, and if this worked out, it would have the potential to do that.”