The time-sensitive process of getting pregnant through in vitro fertilization (IVF) could not wait for stay-at-home orders to end. As the pandemic wanes, health tech companies are bringing the IVF process into the home while providing support to the patients who largely coordinate the process themselves.
“The onus of getting it right for a patient who is selected or elected to go forward with IVF treatment is very much on themselves,” Pixel Fertility Founder Adam Hait told Fierce Healthcare. “For the most part, as they progress through treatment, it's up to them to ensure they have the right medications at the right time, know how to store those medications and know how to administer those medications.”
The Centers for Disease Control and Prevention (CDC) reports that 1 in 5 heterosexual females ages 15 to 49 are unable to conceive on their own after a year of trying.
Currently, the in vitro fertilization clinic market is worth around $8 billion. Some estimates expect the industry to reach $41 billion by 2026. In the three-year period from 2019 to 2022, venture capital investment in fertility startups doubled. Many of these startups are looking at where fertility begins: in the home.
How tech can coordinate the siloed IVF process
Hait is a third-generation pharmacist and has spent three decades in “the world of fertility.” He created Pixel to function as a digital IVF sherpa to navigate the largely solitary space of trying to have a baby the new fashion way.
The Pixel app is currently in beta testing but is slated to launch within the next few months. Pixel gives fertility patients round-the-clock access to medication FAQs, live chats and on-demand video calls with healthcare professionals and how-to videos for administering treatment.
Patients are alerted when their medication is running low and can facilitate delivery while allowing for medication cost transparency. Through coordination with insurance, patients are also kept in the loop about their fertility benefits.
The precarious process can be disrupted at any point with mismanagement of a cocktail of drugs largely administered at home. Pixel provides guidance for both males and females. Half the time, male infertility is the issue, but the female cocktail of drugs is more complex, according to Hait.
“Every day in the fertility space, in the clinic as well as the pharmacy, unfortunately, is a fire drill,” Hait said. “Every single day, there are patients who do not have the medications that they need, when they need it.”
While patients can call their local pharmacist and presiding clinician during working hours, if the problem can’t be quickly remedied, the results can be expensive or even hazardous to the patient’s health.
For example, if a patient realizes too late that they don’t have enough gonadotropins, active drug forms of the FSH hormone responsible for follicle stimulation, ovarian hyperstimulation can take place. Mild cases of ovarian hyperstimulation can be treated with medications but severe cases can cause death.
At-home tech tools for determining the fertility journey
Before a digital sherpa can be conscripted, a path needs to be charted. Women's health company Proov provides an at-home ovulation testing kit and boasts the only FDA-cleared and CE-marked at-home ovulation diagnostic platform. The startup nabbed $9.7 million in series A funding in December 2021 to continue building out its product pipeline in women's health.
The at-home testing largely serves two purposes: acquiring preliminary information about patients’ fertility and determining if ovulation has taken place.
Proov offers four testing systems: “reserve” gives users an idea of the status of their ovarian reserve, “predict” determines the fertile window, “confirm” verifies ovulation took place and “complete” includes the insights of all the other packages.
All Proov tests are performed at home with urine strips that patients use each morning. Over a month-long period, patients record their results with the Proov app. The app then provides a cycle-long analysis and recommendations for patients looking to conceive or address hormone imbalances.
Founder and CEO Amy Beckley created the app after shelling out for IVF treatments that could have been addressed with simple supplements if only she had a clear picture of her fertility.
“If you go into a lab or send in a sample, you're getting like a snapshot in time, it is really hard to understand the cycle and how estrogen and progesterone fluctuate across it,” Beckley told Fierce Healthcare. A month of hormones tests, you can’t go to a clinic for that, Beckley said, that has to take place in the home.
Amy Zwanziger, CEO and founder of Turtle Health, told Fierce Healthcare that her company’s offering overlaps with Proov at some stages of the fertility journey, but she herself used Proov’s “confirm” package when on her own fertility journey.
Confirming that ovulation took place is an important part of determining fertility and for patients with mild fertility issues assessing hormone levels can be sufficient, Zwanziger said. For patients with structural fertility issues, Turtle Health exists.
“Proov is going to give a general fertility perspective,” Zwanziger said. “Turtle Health is going to show whether I have something structural like a huge fibroid, a huge cyst, a very small number of follicles that's likely to require a ton of intervention. If I look relatively normal, I can use Proov to actually confirm that I ovulated.”
Turtle Health bills itself as the first comprehensive at-home virtual fertility clinic geared towards both men and women. Patients are sent at-home semen analysis, blood work and health questionnaires. Blood is collected through an arm patch that Zwanziger says patients prefer to blood pricks.
Turtle Health plans to offer an at-home ultrasound that is still in the experimental stage.
For men, Zwanziger says at-home semen collection can be less anxiety-inducing. For women who experience vaginismus, in-clinic ultrasounds may not even be an option.
“There's a lot of different patient populations who might have sexual assault history, who might have medical trauma,” Zwanziger said. “There's a lot of different scenarios that we see it's definitely a huge advantage to do this at home.”
Turtle Health seeded $5 million in funding this past December, bringing total funding to $5.4 million. The company’s at-home ultrasound tool showed comparable efficacy with in-clinic transvaginal ultrasonography ovarian reserve assessments, according to a recent study. With the importance of the tool in fertility diagnosis, Zwanziger hopes to soon have full authorization.