Sex Talk With mHealth: (In)Fertility, Big Data, Personalized Medicine

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Issues:

I have been following a recent series featured in the New York Times Motherlode blog by Amy Klein that depicts often heart-wrenching conveyances of Klein’s journey through the mirky waters of infertility. Klein openly tracks the process, along with the bumps and dips she experiences in accessing accurate medical or financial information about her choices.

“There is a dearth of readily accessible, personalized information available.”

Due to many preferring not to speak about their difficulties in conceiving, online infertility communities have blossomed. On some of these sites emoticons stand in for potential children, sometimes with smiles of success, other times with blinking halos and wings: a miscarriage. Stories shared also reveal critical information about infertility lingo, cycle length, and drug and treatment options.

The desire to understand the science behind all stages of pregnancy also drives women and men to fertility sites like BabyCenter, where pregnancy symptoms, cramping issues, or dietary concerns are discussed in disconnected streams and are often ladled with uninformed bits. Most information is general with only partial relevance to one’s personal situation.

Even in birthing, a small revolution to reclaim power over the birthing process is underway, as films like The Business of Being Born illustrate. It’s no longer enough to be run through a general treatment protocol when everyone’s body and pregnancy is so unique.

Solutions:

To quell women and men’s frustrations of being lumped into generic diagnoses and treatments, new reproductive health companies are harnessing the potential of big data. Ovuline is a fertility application that seeks to empower users by giving them control to positively engage in their own fertility experience. The company has two components: Ovia Fertility, a tracker using big data and machine learning to assess fertility, “helping her and her partner get pregnant up to 3 times faster than the national average;” and Ovia Pregnancy, a tracker built to monitor a pregnant woman’s health metrics during pregnancy.” Ovuline has over 40 million data points, and 250,000 global users. Its applications are built for the fertility market, a market that is, as CEO Paris Wallace (founder of Good Start Genetics) describes, primarily patient-directed and patient-payed, and where emotional stakes are drastically different than say, losing weight or reducing one’s cholesterol levels.

Ovuline’s dependency on big data and machine learning promises personalized approaches to reproductive health that includes sharing what others experience while also paying attention to the unique symptoms of the patient. For each Ovia Fertility and Ovia Pregnancy, the more information entered into the app, the more personalized and accurate results the user receives. Further, partnering with MyFitnessPal, Fitbit, and Withings provides users the opportunity to easily upload health and fitness information. Feedback from this data input, therefore, is comprehensive, multi-dimensional, and continuously evolving.

Though not diagnostic, Ovia Fertility will suggest, depending on information provided, whether infertility issues are at hand. Infertility is something affecting more people than is commonly known. 10% of Americans are infertile, where 40% is male-factor, 40% is female-factor, and 10% is unexplained. Indeed, as Ovuline’s Paris Wallace describes, “Infertility is one of the largest undiscussed public health issues.”

Indeed, before slamming up against the reality of infertility for yourself, the idea of not being able to easily have a baby – romantically and magically – exists for most of us in a peripheral part of our collective consciousness. Infertility is something that happens to other people. And yet, it doesn’t. It happens to all sorts of women and men, and as most find, there are feelings of despair, shame, helplessness, and desperation in discovering infertility issues.

Glow, another fertility app, has a contingency plan built into the application to safeguard against infertility costs. The company describes itself as “a data science company that is redesigning health insurance.” It spun out of Max Levchin’s HVF (Hard Valuable Fun), a project that focuses on employing the data collected through inexpensive and nearly ubiquitous technologies to reveal invaluable insights and efficiencies to meaningfully improve lives. Levchin also founded PayPal, helped launch Yelp, and recently, became a board member of Yahoo. By employing big data analytics, the founders of Glow, all of whom have strong backgrounds in data science and patterns, were inspired to create the company to improve women’s reproductive health, and to empower them throughout the fertility process.

The app requires a similar process as Ovuline, where tracking everyday health, mood, and activity feed an ever-adapting data set. Glow’s machine-learning capability creates personalized insights for each user.  It also partners with MyFitnessPal. In addition, to date there is no large scale study on women’s ovulation cycles. Glow hopes the data collected through their app might provide insight into women’s overall reproductive health.

Costs: Baby-making isn’t cheap

According to Glow, “The infertility market is a $5 billion market and growing, and one in three women ages 35-39 will not be pregnant a year after trying (the time period recommended by doctors to attempt conception before seeking fertility help).”

Glow First is a nonprofit that is democratizing access to fertility treatment. Returning to Amy Klein’s series, the cost of even a single IVF cycle can cripple the average American family, and as these procedures are largely considered “elective”, they are not covered by most insurance companies. Even an Intra Uterine Injection, where sperm are washed and inserted into an ovulating woman (romantic, yes) can cost about $3,000 per cycle. The way Glow First works is to suggest Glow app users pay $50 per month for 10 months. To offset the cost of fertility treatments,  the contribution pool is divided equally amongst participants who have been unsuccessful in conceiving. Payment is sent directly to the user’s clinic of choice. Max Levchin personally contributed $1 million to this program. Glow also partners with Pacific Fertility Center and Shady Grove Fertility in San Francisco.

There’s nothing exciting or romantic about tracking the thickness of your cervical mucous or taking your temperature daily to help pinpoint the exact days of the month you should procreate. Yet the gamble that is infertility treatment, and the emotional and financial pain it inflicts on couples might be lessened with the help of advanced big data analytics. By pumping information into the backend of applications, we go full-circle back to nature. We can see our natural rhythms and cycles more comprehensively, and make decisions about our health appropriately. And yet there’s still unavoidable uncertainty inherent in genetics and fertility in which everyone, regardless of the sort of information one is armed with, is at the mercy.

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Susan E. Williams (@estherswilliams) explores experiments at the intersection of health care and technology, particularly around how mobile apps, games and sensory apparatus change the way we pay attention, understand, and make decisions about our bodies, emotions, and behavior. Susan received her BA in cultural anthropology from Columbia University and her MA in East Asian Culture, with an emphasis on Japan, from New York University. She is on the board of Health 2.0 Seattle, and works (and believes) in social media communications for health care and science.

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