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Congrats, It's an App! Family Planning with Your Smartphone

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http://www.kqed.org/.stream/anon/radio/science/2013/09/2013-09-02-science.mp3

More and more people are tracking sexual activity on their smartphones. We’re not talking about watching X-rated videos. Rather, we mean fertility apps for getting pregnant, the newest high-tech trend in helping people conceive.

At Natural Resources, a baby store in San Francisco’s Mission district, it’s not hard to find couples who track their sexual activity online. Lorraine Acosta is 15 weeks pregnant and attending her first pre-natal class. While the 30-year-old wants to give birth the old-fashioned way, she got pregnant with the help of an app called OvuView. “I’m an Android user,” Acosta says, “so I like this app for Android.”

OvuView has more than 18,000 reviews in the app store, and gets mostly five out of five stars.

When a woman is ovulating, her body temperature at rest goes up a degree or so. The app asks you to log that temperature before getting out of bed every morning.

“It synched with my alarm,” Acosta says. “So everyday when my alarm went on, the app also showed a notification.”

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The app also asks women to describe, on a daily basis, the quality of the mucus coming from their cervix. As the mucus goes from creamy and thick to clear like an egg white, a woman is getting more fertile.

While many women would feel anxious logging so much personal information, Acosta says the app made her feel more in control. The very month she and her husband Andres Ornelas wanted to conceive, she got pregnant.

Acosta says the app did not dictate when she and her husband should have sex. “It just told me when I was more fertile.”

Dozens of self-tracking apps have popped up on the market in the last few years to help women find their fertility window. One new high-profile app called Glow is going a step further, and asking some very personal questions about sexual activity—questions like: Was the woman’s position on the bottom, in front, on top, other? Was there a female orgasm? Was there emotional discomfort? Sad, angry, or stressed?

Acosta laughs when she reads through the list. “Is it for fertility or sexual preferences,” she said, “I don’t know!”

Ornelas raises his eyebrows. “I’m kind of curious what it does with the answers that you give it,” he says. “Those seem like questions that I’ve never seen related to fertility.”

He’s mostly right.

Fertility specialists say there’s no consensus on how stress can impact pregnancy. Studies show female orgasm has little to no effect on pregnancy. As to the impact of sexual positions on fertility—there’s not much serious research there, either.

Glow Founder Max Levchin says he's asking personal questions because his start-up is a science experiment.
Glow Founder Max Levchin says he’s asking personal questions because his start-up is a science experiment.

Glow is based in San Francisco. The founder, Max Levchin, is a computer scientist, and Levchin says his company is running a science experiment. “Part of our responsibility here,” he said, “is to actually gather enough data to run a study and say, ‘You know what? People conceived faster if they tried it on their back.’ Or not.”

Levchin is the same Big Data scientist who helped launch PayPal in 1999. The payment service looks at what people buy online to try to predict what they want next. Glow wants to use crowdsourcing to figure out if certain myths about pregnancy are actually facts.

“As soon as we have a couple hundred thousand data points,” Levchin says, “we’ll probably have the single largest study correlating sexual position to speed of conception.”

Glow stores all its data on the cloud. Sexual position is arguably more sensitive data than a credit card number, and this app does not strip people’s names from their responses. Levchin says that’s a service, if a Glow app user needs to visit a fertility doctor.

“You actually want to show up with a log that that person can understand,” Levchin says. “They can look at and say, ‘Oh, you’ve been tracking your data. Let me tell you what your options are.'”

Doctor Marcelle Cedars is a fertility specialist at the University of California San Francisco. She is skeptical of the medical value of fertility tracking apps.

Cedars says she tries to make things as simple and low stress as possible for couples early in the process. “The more sort of boxes you put around their sexuality, to me, tends to increase stress.”

Cedars points out the data that Glow is collecting may not end up being useful for science: the women who choose to use Glow may not represent women in general. And these women may not tell the truth about their sexual activity.

Cedars also says fertility apps have to be crystal clear about whom they cannot help. These apps assume a woman is ovulating regularly. “But if you’re having periods every two to three months,” she says, “you may not be ovulating at all. There need to be some windows saying, ‘maybe you should talk to your doctor.’”

The Glow app is free.  Founder Max Levchin says he’s not worried about making money just yet. He’s focused on getting new users.

Levchin put a million dollars of his own money into Glow First, a non-profit fund offered as a premium service for app users who need to see a fertility specialist.

“That’s a strong way to drive adoption so people use the app,” says Andrew Farquharson, Managing Director of InCube Ventures, “but over time that approach isn’t going to be sustainable.”

Farquharson is a venture capitalist who invests in life science apps, but he says fertility apps are not ripe for investment because they don’t improve medical outcomes. With diabetes and heart patients, monitors that track blood sugar and heart rate “are better than going to a doctor once a day because they operate continuously.”

He’s waiting for products like Glow to integrate sensors. “When women don’t have to pee on a stick to know if they’re pregnant, I’ll reconsider.”

Levchin is toying with other ways to make his app profitable. Currently Glow has a companion edition for the partner of the woman trying to conceive. Using data about her mood and ovulation, Levchin says, Glow makes suggestions like, “This might be an excellent time to send a bouquet of flowers or book a spa trip.”

Levchin says he’s not yet planning to integrate such features with commercial websites like flowers.com or hotels.com. “But since I am on Yelp’s board,” he says, “I know exactly where to look for the best florists and spa. And we actually talked about it when we were designing this thing.”

Andres Ornelas, the father-to-be from the baby store, calls that idea “kind of creepy.”

Ornelas is a fan of self-tracking, but doesn’t want an app that intrudes on his marriage. “If an app told me, ‘Oh it’s that time of the month to buy flowers for your wife,’ then I feel like I’m not giving them the flowers. I feel like the app is doing it for me, so it’s pointless.”

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But the guy who always forgets to buy flowers might just like that feature. Fertility apps are still seeking their niche. After all, they’re only in their infancy. The start-up Glow hasn’t even reached its first trimester.

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