6 ms·

Modern Fertility (YC S17) is a proactive way to test fertility at home

67 points by aaffttoonn 8y ago

pg_bot 8y ago
Given that you are dealing with medical data that falls outside of HIPAA what are you doing to ensure that PHI remains secure?
- aaffttoonn 8y ago
  Great question! All of our data is securely stored and we take privacy very seriously. Modern Fertility employees can only access user data via an internal administrative portal to which access is strictly controlled and monitored and two-factor authentication is required. Access is reviewed on a regular basis. Data is stored in a de-identified manor. All Modern Fertility employees who handle PHI are required to complete a HIPAA training hosted by HHS.gov.
jontas 8y ago
Any plans for a male version?
- aaffttoonn 8y ago
  Male factor is 50% of the equation and it is really important for both women and men to understand that from an education perspective. We are customers ourselves for our female fertility test and understand the female market well, but are interested in learning more about if males would proactively test / store their sperm.
  - tvanantwerp 8y ago
    As a man, I would certainly buy it. If my wife and I can't have kids, then it could be either of us with an issue. And I'm no more inclined to go to and pay for a lab test than she is, I imagine.
  - shouldifakeit 8y ago
    Happy to chat with you about this. I've been through 4 IVFs and have severe male factor infertility, so sadly I know this space all too well. Mens market is trickier - the existing method for home testing for men is too clunky. You need to produce a sperm sample into.. a test tube. Then put it in warm water. Then wait. This is too dirty and too much work. There is a roundabout way to do this without a sperm sample. Pen prick, blood in a container, ship it out to a lab and then do a karyotype test on it. That'll pick up around 50% of infertility cases. To cover the rest, you'll need to do a sperm test. Also, the 'hook' that gets men in has to be more than just 'check your sperm count'. Men mostly couldn't care less about their sperm count. Something like 'check if you're at risk of passing on a rare blood disease' is a much better hook.
- Thiez 8y ago
  As far as I'm aware male fertility decreases a bit with age, but there's no such thing as menopause and ovulation for men. So I doubt there is as much of a market for a male version. Besides, our male egos are way too fragile to risk learning we have fertility problems ;-) Also your hormones may be fine, but your sperm can still be bad, e.g. your testicles can't get too warm.
  - daxorid 8y ago
    > So I doubt there is as much of a market for a male version Sperm count has been cut in half in the last 40 years in the West. Sperm motility and morphology has also seen precipitous declines, along with increasing DNA fragmentation issues. Male factor infertility is definitely a problem, but even attempting to discuss environmental estrogens is "men's rights activism" so we ignore it. To the extreme psychological detriment of women who tend to accept blame for fertility failures. There is a problem in developed countries - that goes far beyond warm testicles - that we are ignoring. For reasons.
    - seehafer 8y ago
      There’s a reason the alt-righters have gotten so far with using the term “soy” as an insult.
gataca 8y ago
This is a great idea. I work in clinical diagnostics at a large academic health care center and the prices billed to patients are absurd once you see the actual costs of the testing. What’s your strategy to decrease the testing cost compared to reproductive endocrinology clinics? Is it simply a lower markup?
- aaffttoonn 8y ago
  Thanks! Totally agree- this was my exact experience (billed $1500). Today, women typically get these tests when they are having issues and we are making them available to women before they start trying to conceive. There are only ~500 infertility clinics in the US so when you think about the volume of testing they do vs. a general healthy population being able to access these tests, we get different economies of scale and can pass on these savings. We have invested a lot in our processes to support this scale.
evrydayhustling 8y ago
Markets have been really bad at coming with solutions (a) for chronically vulnerable groups, (b) for problems which develop over too long a time period to become urgent, and (c) by replacing reactive efforts with proactive efforts. MF seems to check all three of those boxes, while making sense as a business. Cool. Can you say anything about how you expect these kinds of proactive diagnostics to interact with the existing insurance ecosystem, which tends to pay for diagnosis but varies a lot on treatment?
- aaffttoonn 8y ago
  Thanks for the kind words! Infertility is not federally reimbursed and if a company happens to cover infertility as a benefit, women have to wait until they are having issues (and "try" for 9-12 months) before these types of tests are covered. We started Modern Fertility to bring these tests to women earlier in life at a much more accessible price point. Some HSA/FSA plans cover Modern Fertility.
  - deleted 8y ago
    [deleted]
vedtopkar 8y ago
Congrats on the launch! I'm a big fan of the candid and fair discussion of fertility literature on your site. More healthcare startups should be doing exactly that.
robbiemitchell 8y ago
How are you thinking about the increased growth of egg freezing? Is this something that is going to tell more women to freeze their eggs? From what I'm told by doctor family members, it's expensive and not necessarily a guarantee.
- aaffttoonn 8y ago
  I believe egg freezing is not the right decision for everyone. It is not a guarantee/ insurance policy, but it does help with the odds. We (women) should be understanding our bodies as a first step and hormone levels combined with other factors (finances, emotional state, family planning goals etc) should be included in the decision to freeze or not to freeze. We started Modern Fertility to help women navigate these decisions.
- Alex3917 8y ago
  > How are you thinking about the increased growth of egg freezing The actual number of babies that have been born worldwide from frozen eggs is only around 2,000, and most of those were done either to prove out the concept or else due to some specific medical condition (e.g. about to get chemo). Despite the fact that you read about it in the news all the time and it feels like everyone is doing it, the number of babies born to women who decided to just pre-emptively freeze their eggs is probably only a couple hundred, accounting for literally 0.00% of babies born each year.
  - shouldifakeit 8y ago
    Nonsense. Where are you getting your stats from?
replicatorblog 8y ago
An excellent, important product — and stellar branding! While this product is a massive technical improvement, its biggest value might be getting couples to think about fertility earlier. I admit as a career-minded professional, I underestimated how quickly the reproductive window closes biologically and how much higher the risks are for Mom and baby as the years pass. My wife and I went through IVF and learned quite a bit, e.g.: You may have to wait a year before an insurer will begin to cover treatments or you may have to scrounge for cash to pay for them. Once you find a clinic, there's a multi-month process to get started. Maybe you miss a dose of the IVF drugs due to an illness and have to postpone for a cycle or two. In the case of IVF, you may not get viable embryos or they may not implant. If they do implant, there's a scarily high risk of miscarriage. And if you want to have more than one child you need to factor in the 40 weeks of pregnancy, recovery, and adjusting to sleep deprivation before you get to start the whole process again. On their own, these are small delays, but compounded they can take up years, and if you're starting in your mid-30s and working with a five-year window, they can make the difference. It took my wife and me two years of financially and emotionally draining treatments before we had success. Our second run was smoother, but our first child was diagnosed with Leukemia (she's good now) at the start of my wife's 2nd trimester. Had we waited another quarter, it's very likely we would only have had one child. I can say unequivocally in my career there has been no bonus, promotion, or professional recognition that comes close to matching that value. Despite our challenges, we were lucky. We met a couple that struggled with infertility. Turned out after a lot of testing, the husband was sterile. The wife wanted to carry a child from an egg of hers fertilized by a donor. The man didn't want to raise a child that wasn't his biological offspring, so they split and she had to renter the partner market in her mid-30s under extreme time pressure. Apologies for the overly personal PSA, but I wish I had this information in my twenties. If you want children, you need to treat the process with all the seriousness you treat your career. This product is a great tool to do so.
- irrational 8y ago
  Also, if you or your partner have ever had a STD/STI please be aware that this can affect your fertility. I was recently talking to a OB/GYN and he was telling me that one of the saddest things he has to do is inform a person that they are sterile due to an untreated STD/STI from their younger years when thoughts about fertility were the the furthest thing from their mind.
shouldifakeit 8y ago
Its a good idea, but I wonder how accurate your results will be. HCG tests (done via blood samples) are notoriously bad as a predictor for how many eggs are actually in the ovaries. Its a very broad indicator yes, but nothing more than that. This is really quite different from say testing a mens sperm where you can accurately count the exact number to the nearest million. Have you compared your accuracy with an HCG test? What is the delta between your home test results and an HCG test?
- aaffttoonn 8y ago
  Hi! Are you referring to human chorionic gonadotropin (hcg)? If so, HCG is used in pregnancy tests not an ovarian reserve test. We do not test for HCG.
faitswulff 8y ago
Quick note: "Millenial women" should be "Millennial women" (note the missing "n")
narenst 8y ago
Great product! Are you talking to companies who might want to offer this as a benefit to their employees?
- aaffttoonn 8y ago
  Yes! We are already working with a few companies who are offering Modern Fertility as a wellness benefit. If you are interested you can email info@modernfertility.com and we will schedule a quick demo and get you setup in <20 minutes. Thanks so much for asking.
dabbledash 8y ago
It just needs to be made clear to people that no matter how much else may have changed, 35 is not the new 25 when it comes to having kids. The only message I got when I was in my early 20s was “you have plenty of time! Make sure you’re established first!” Now it’s very unlikely that I’ll have as many children as I would like, and if I do they’ll have to come in much more rapid succession than I would prefer.
- deleted 8y ago
  [deleted]
souprock 8y ago
The age range of 21 to 40 needs to be expanded greatly in both directions. Well, really the limit should go away. This fall my wife goes over the limit. She might be pregnant with a 12th kid already though, so she'd be excluded. We'd like an estimate of how many more kids we'll end up with. A histogram would be great, for example: 17% chance of no more, 40% chance of 1 more, 23% chance of 2 more, 11% chance of 3 more, 4% chance of 4 more, 3% chance of 5 more, 2% chance of at least 6 more...
- aaffttoonn 8y ago
  We are working on it! No matter what age you are, the tests are the same. We worked super hard to have age specific content for the range of 21-40 but are excited to expand this. Women need information about fertility through their entire lives because it impacts so many aspects of health and wellbeing. Our next step is to expand our age range to over 40.
garrettlangley 8y ago
congrats guys :)

67 points by aaffttoonn 8y ago

Given that you are dealing with medical data that falls outside of HIPAA what are you doing to ensure that PHI remains secure?

aaffttoonn 8y ago
Great question! All of our data is securely stored and we take privacy very seriously. Modern Fertility employees can only access user data via an internal administrative portal to which access is strictly controlled and monitored and two-factor authentication is required. Access is reviewed on a regular basis. Data is stored in a de-identified manor. All Modern Fertility employees who handle PHI are required to complete a HIPAA training hosted by HHS.gov.

jontas 8y ago

Any plans for a male version?

aaffttoonn 8y ago
Male factor is 50% of the equation and it is really important for both women and men to understand that from an education perspective. We are customers ourselves for our female fertility test and understand the female market well, but are interested in learning more about if males would proactively test / store their sperm.
- tvanantwerp 8y ago
  As a man, I would certainly buy it. If my wife and I can't have kids, then it could be either of us with an issue. And I'm no more inclined to go to and pay for a lab test than she is, I imagine.
- shouldifakeit 8y ago
  Happy to chat with you about this. I've been through 4 IVFs and have severe male factor infertility, so sadly I know this space all too well. Mens market is trickier - the existing method for home testing for men is too clunky. You need to produce a sperm sample into.. a test tube. Then put it in warm water. Then wait. This is too dirty and too much work. There is a roundabout way to do this without a sperm sample. Pen prick, blood in a container, ship it out to a lab and then do a karyotype test on it. That'll pick up around 50% of infertility cases. To cover the rest, you'll need to do a sperm test. Also, the 'hook' that gets men in has to be more than just 'check your sperm count'. Men mostly couldn't care less about their sperm count. Something like 'check if you're at risk of passing on a rare blood disease' is a much better hook.
Thiez 8y ago
As far as I'm aware male fertility decreases a bit with age, but there's no such thing as menopause and ovulation for men. So I doubt there is as much of a market for a male version. Besides, our male egos are way too fragile to risk learning we have fertility problems ;-) Also your hormones may be fine, but your sperm can still be bad, e.g. your testicles can't get too warm.
- daxorid 8y ago
  > So I doubt there is as much of a market for a male version Sperm count has been cut in half in the last 40 years in the West. Sperm motility and morphology has also seen precipitous declines, along with increasing DNA fragmentation issues. Male factor infertility is definitely a problem, but even attempting to discuss environmental estrogens is "men's rights activism" so we ignore it. To the extreme psychological detriment of women who tend to accept blame for fertility failures. There is a problem in developed countries - that goes far beyond warm testicles - that we are ignoring. For reasons.
  - seehafer 8y ago
    There’s a reason the alt-righters have gotten so far with using the term “soy” as an insult.

gataca 8y ago

This is a great idea. I work in clinical diagnostics at a large academic health care center and the prices billed to patients are absurd once you see the actual costs of the testing. What’s your strategy to decrease the testing cost compared to reproductive endocrinology clinics? Is it simply a lower markup?

aaffttoonn 8y ago
Thanks! Totally agree- this was my exact experience (billed $1500). Today, women typically get these tests when they are having issues and we are making them available to women before they start trying to conceive. There are only ~500 infertility clinics in the US so when you think about the volume of testing they do vs. a general healthy population being able to access these tests, we get different economies of scale and can pass on these savings. We have invested a lot in our processes to support this scale.

evrydayhustling 8y ago

Markets have been really bad at coming with solutions (a) for chronically vulnerable groups, (b) for problems which develop over too long a time period to become urgent, and (c) by replacing reactive efforts with proactive efforts. MF seems to check all three of those boxes, while making sense as a business. Cool. Can you say anything about how you expect these kinds of proactive diagnostics to interact with the existing insurance ecosystem, which tends to pay for diagnosis but varies a lot on treatment?

aaffttoonn 8y ago
Thanks for the kind words! Infertility is not federally reimbursed and if a company happens to cover infertility as a benefit, women have to wait until they are having issues (and "try" for 9-12 months) before these types of tests are covered. We started Modern Fertility to bring these tests to women earlier in life at a much more accessible price point. Some HSA/FSA plans cover Modern Fertility.
- deleted 8y ago
  [deleted]

vedtopkar 8y ago

Congrats on the launch! I'm a big fan of the candid and fair discussion of fertility literature on your site. More healthcare startups should be doing exactly that.

robbiemitchell 8y ago

How are you thinking about the increased growth of egg freezing? Is this something that is going to tell more women to freeze their eggs? From what I'm told by doctor family members, it's expensive and not necessarily a guarantee.

aaffttoonn 8y ago
I believe egg freezing is not the right decision for everyone. It is not a guarantee/ insurance policy, but it does help with the odds. We (women) should be understanding our bodies as a first step and hormone levels combined with other factors (finances, emotional state, family planning goals etc) should be included in the decision to freeze or not to freeze. We started Modern Fertility to help women navigate these decisions.
Alex3917 8y ago
> How are you thinking about the increased growth of egg freezing The actual number of babies that have been born worldwide from frozen eggs is only around 2,000, and most of those were done either to prove out the concept or else due to some specific medical condition (e.g. about to get chemo). Despite the fact that you read about it in the news all the time and it feels like everyone is doing it, the number of babies born to women who decided to just pre-emptively freeze their eggs is probably only a couple hundred, accounting for literally 0.00% of babies born each year.
- shouldifakeit 8y ago
  Nonsense. Where are you getting your stats from?

replicatorblog 8y ago

An excellent, important product — and stellar branding! While this product is a massive technical improvement, its biggest value might be getting couples to think about fertility earlier. I admit as a career-minded professional, I underestimated how quickly the reproductive window closes biologically and how much higher the risks are for Mom and baby as the years pass. My wife and I went through IVF and learned quite a bit, e.g.: You may have to wait a year before an insurer will begin to cover treatments or you may have to scrounge for cash to pay for them. Once you find a clinic, there's a multi-month process to get started. Maybe you miss a dose of the IVF drugs due to an illness and have to postpone for a cycle or two. In the case of IVF, you may not get viable embryos or they may not implant. If they do implant, there's a scarily high risk of miscarriage. And if you want to have more than one child you need to factor in the 40 weeks of pregnancy, recovery, and adjusting to sleep deprivation before you get to start the whole process again. On their own, these are small delays, but compounded they can take up years, and if you're starting in your mid-30s and working with a five-year window, they can make the difference. It took my wife and me two years of financially and emotionally draining treatments before we had success. Our second run was smoother, but our first child was diagnosed with Leukemia (she's good now) at the start of my wife's 2nd trimester. Had we waited another quarter, it's very likely we would only have had one child. I can say unequivocally in my career there has been no bonus, promotion, or professional recognition that comes close to matching that value. Despite our challenges, we were lucky. We met a couple that struggled with infertility. Turned out after a lot of testing, the husband was sterile. The wife wanted to carry a child from an egg of hers fertilized by a donor. The man didn't want to raise a child that wasn't his biological offspring, so they split and she had to renter the partner market in her mid-30s under extreme time pressure. Apologies for the overly personal PSA, but I wish I had this information in my twenties. If you want children, you need to treat the process with all the seriousness you treat your career. This product is a great tool to do so.

irrational 8y ago
Also, if you or your partner have ever had a STD/STI please be aware that this can affect your fertility. I was recently talking to a OB/GYN and he was telling me that one of the saddest things he has to do is inform a person that they are sterile due to an untreated STD/STI from their younger years when thoughts about fertility were the the furthest thing from their mind.

shouldifakeit 8y ago

Its a good idea, but I wonder how accurate your results will be. HCG tests (done via blood samples) are notoriously bad as a predictor for how many eggs are actually in the ovaries. Its a very broad indicator yes, but nothing more than that. This is really quite different from say testing a mens sperm where you can accurately count the exact number to the nearest million. Have you compared your accuracy with an HCG test? What is the delta between your home test results and an HCG test?

aaffttoonn 8y ago
Hi! Are you referring to human chorionic gonadotropin (hcg)? If so, HCG is used in pregnancy tests not an ovarian reserve test. We do not test for HCG.

faitswulff 8y ago

Quick note: "Millenial women" should be "Millennial women" (note the missing "n")

narenst 8y ago

Great product! Are you talking to companies who might want to offer this as a benefit to their employees?

aaffttoonn 8y ago
Yes! We are already working with a few companies who are offering Modern Fertility as a wellness benefit. If you are interested you can email info@modernfertility.com and we will schedule a quick demo and get you setup in <20 minutes. Thanks so much for asking.

dabbledash 8y ago

It just needs to be made clear to people that no matter how much else may have changed, 35 is not the new 25 when it comes to having kids. The only message I got when I was in my early 20s was “you have plenty of time! Make sure you’re established first!” Now it’s very unlikely that I’ll have as many children as I would like, and if I do they’ll have to come in much more rapid succession than I would prefer.

deleted 8y ago
[deleted]

souprock 8y ago

The age range of 21 to 40 needs to be expanded greatly in both directions. Well, really the limit should go away. This fall my wife goes over the limit. She might be pregnant with a 12th kid already though, so she'd be excluded. We'd like an estimate of how many more kids we'll end up with. A histogram would be great, for example: 17% chance of no more, 40% chance of 1 more, 23% chance of 2 more, 11% chance of 3 more, 4% chance of 4 more, 3% chance of 5 more, 2% chance of at least 6 more...

aaffttoonn 8y ago
We are working on it! No matter what age you are, the tests are the same. We worked super hard to have age specific content for the range of 21-40 but are excited to expand this. Women need information about fertility through their entire lives because it impacts so many aspects of health and wellbeing. Our next step is to expand our age range to over 40.

garrettlangley 8y ago

congrats guys :)