Fertility trackers are hot right now. Reports of major investment in fertility applications abound, and as other applications and wearable devices report faltering engagement statistics or a fall-off rate that suggests tremendous need for improvement, fertility application consumers are addicted. Ovuline investor Bill Pescatello of Lightbank states in a TechCrunch article that Ovuline numbers are “almost like Candy Crush.” Paris Wallace, Ovuline’s co-founder and CEO supports this claim, telling us that of all who download the Ovia Fertility application, 50% either report pregnancy and go on to download their Ovia Pregnancy app, or are continued monthly users.
Engagement levels certainly drive the hype (and investment) around fertility applications. But tracking monthly cycles is hardly something new for women. In fact, we would argue women were the first quantified-selfers in history, tracking their monthly physiological symptoms against lunar cycles for family planning. It’s clear the desire to have (or NOT to have) a baby rather than getting fit, managing symptoms of medications, tracking pain, steps, or heart rate drives motivation much more.
Smartphone applications like Ovuline and Glow enhance this natural motivation by providing immediate, personalized feedback to users. The more data users feed the applications, the more relevant insights they receive. Ovuline receives nearly 200 million data points each month between its two applications. The information they are collecting is manually-entered and include everything from manually-entered mood, physical symptoms, intercourse had, cervical mucous and positioning, blood pressure, amount of sleep you had, weight, medications taken things eaten, and more. With every bit of information entered over time, the machine-learning technology creates “a virtual conversation cycle that encourages people to come back,” says Paris of Ovuline.
What’s the big deal?
Fertility tracking applications clearly illustrate technology’s potential to drive down cost and improve outcomes as a direct result of high user engagement and adherence.
This figure shows the probability of women with regular or irregular cycles and their fertile windows. In red, the distribution of fertile days is represented by ovulation days. Overall, an estimated 17% were in their fertile window by the seventh day of their cycle (based on 213 women). This percentage peaked on days 12 and 13, when 54% of women were in their fertile window. If ovulation was delayed (in blue), women reached their fertile window much later and at variable times, resulting in their fertile days being spread more broadly across their cycles. 16% of women had reported that their cycles were “irregular.”
A virtual cycle of data input and feedback helps women identify patterns throughout the month that indicate fertile windows. Where this is most valuable is in women with irregular cycles, many of whom are deemedclinically “infertile.” In a recent interview Glow stated one of their biggest insights has been that 50% of women are missing their fertile window by nearly four days.
In just over a year from its launch, Glow has helped over 20,000 women conceive naturally. Ovuline has helped 150,000 women conceive naturally. Of these, 20% showed signs and symptoms of infertility. A recent report stated that of 7,280 women aged 28-36, 18.6% reported infertility, and of that number, “40% can achieve births without using treatment, indicating they are subfertile rather than infertile (this means that people needed help in tracking their irregular ovulation cycles, rather than needing to go through costly IVF treatments).”
Costs of IVF treatments per cycle
As of 2000, countries that provide public funding for IVF costs include Australia, Austria, Denmark, Finland, France, Germany, Iceland, The Netherlands, Norway, and Sweden. The US was added to the list from WebMD.com. In the US, the average cost of an IVF cycle is $12,400, nearly three times the cost in France or Germany.
The CDC reports 176,247 Assisted Reproductive Technology (ART) cycles were performed at 456 clinics in the US during 2012, resulting in 65,160 live born infants, or in other words, a 4% success rate for total attempts against total outcomes. In the US, infertility is an estimated $5 billion annual industry, where cost per IVF cycle or other fertility procedure varies tremendously from clinic to clinic. Significantly, there are onlyfifteen states that mandate insurance coverage for treatment, including IVF cycles, leaving thousands of families to cover costs themselves.
Though they are not diagnostic, both companies’ algorithms suggest to users when infertility might be a problem. Glow democratizes access and aids in the preparation needed to handle the unpredictability of costs associated with infertility with Glow First. A bit like insurance, Glow First is a nonprofit that serves Glow users by providing them with an option to invest ($50 per month for 10 months) in a financing pool should eventual infertility issues arise. Ovuline also partners with infertility doctors throughout the country and provides a resource-rich area on their website for families wanting more information on infertility. Glow also partners with the Pacific Fertility Center and Shady Grove Fertility in San Francisco.
One of Ovuline’s goal is to move their Ovia Fertility users (and all their data) to their Ovia Pregnancy application. Glow also recently announced Glow Nurture, a pregnancy application to help the women they helped conceive through their pregnancy.
When asked whether the data collected with their applications was used by outside sources, Paris made it very clear that they keep their data private. Ovuline has amassed the world’s largest database of women trying to conceive ever. With it they hope to answer some of the lingering “I don’t knows” in pregnancy and conception, like accurately calculating someone’s due date. “Ultimately the greatest good,” says Paris, “is to be able to take the information collected in the database and answer some of these bigger questions about fertility and infertility.”
User engagement and a resulting 200 million data points are what any tracking device or smartphone health and fitness application aim for, and with it is the much touted outcome of lowering cost while improving quality and access to health. But promising a bundle of baby joy at the end of continued and consistent tracking is pretty difficult to imitate.
Written with Ben Maximilian Heubl, a tech blogger, data journalist, digital health geek and technology advocate and speaker. Ben founded a European chapter of the non-for profit organization Health 2.0 and runs the business development department at Zesty, which has the mission to improve online health access in Europe. He has written for TechCrunch, Forbes, and WIRED UK. Follow Ben on Twitter at @benheubl
This article was originally published in The Digital Health Post.