This medtech wants to bring assisted reproduction technology to your home.
Infertility: before IVF
Hello and welcome to Careviser, the weekly newsletter that cuts through the healthcare noise with a single focus: productization of the latest research and tech breakthroughs.
A few months ago, I wrote about how AI startups are working on improving the outcomes of assisted reproduction procedures. But subfertility does not necessarily involve invasive procedures such as IVF.
Carson SA, Kallen AN. Diagnosis and Management of Infertility: A Review. JAMA. 2021;326(1):65–76.
🗝️ Why it matters: About 1 in 8 women of reproductive age (in a heterosexual relationship) does not get pregnant after a year and seeks treatment. Everyone is aware of IVF, but it actually should be the last resort treatment in many cases.
🔎 The study is a review of all 71 articles published in English between 2015 and 2020 related to infertility.
✅ Findings: There are various categories of infertility that call for different treatment options.
Lack of ovulation (anovulation) or ovulatory dysfunction: women with super short, super long, or super irregular periods, or women who have no period at all. Accounts for 25% of diagnosis. The main treatment should be either hormone treatments or ovulation induction through meds to resume a standard cycle. This should be combined with what the authors call “timed intercourse”(a sexy term meaning that patients should have sex when the woman ovulated and is the most likely to conceive).
Tubal infertility: blocked tubes or inability of the tubes to pick up an oocyte. Account for 11 to 67% of diagnosis (yes I know it’s a wide range). Depending on the patient, the main treatment should be either a surgical repair procedure or IVF.
Endometriosis: I think we are all aware of what it is now. 25% to 50% of women suffering from infertility have endometriosis. Most of the women can be treated first with ovulation induction, then IVF if unsuccessful.
Low ovarian reserve: women have fewer follicles as they age but also as they are exposed to chemotherapy or radiation therapy.
Uterine and cervical factors: abnormalities in the uterine cavity, abnormalities that prevent the sperm from making its way into the uterus. Can be treated with hysteroscopic removal.
Male factor (because yes it’s not always the woman’s fault): either low testosterone concentrations or low sperm count. They occur in 35% of infertile couples (can be combined with other infertility factors). Can be treated through Intrauterine insemination or IVF.
Unexplained infertility affects about 15% of couples who seek treatment.
🚀 Opportunities ahead: Lifestyle factors have a significant impact on fertility such as the weight of the woman trying to get pregnant, whether she or her male partner do drugs, smoke, drink alcohol, or eat a healthy diet. Whether patients should delay treatments and diagnosis while they change their lifestyle is still up for debate.
Selectivity is a fascinating early-stage medtech. Founded in 2019 in Argentina, they want to bring assisted reproduction technology procedures to your home. They have developed two devices so far:
A sperm selection device
An assistive device for intrauterine insemination to enable women to do it at home with the remote help of a physician
🤯 The problem: assisted reproduction is insanely expensive and not reimbursed in many countries so making cost-friendly devices is great. Additionally, there is a lot of shame felt by people who are unable to conceive naturally, so they would feel way more comfortable at home.
📈 The traction: Selectivity has a pending patent for their device. They now need to build a device that can be industrialized and go through all the medical device approval processes. Learn more about their vision here.
Meditrina is another exciting medtech company. Founded in 2016 in San Jose, they developed a new type of hysteroscopy system called Aveta. It is an “all-in-one tissue removal solution for intrauterine pathology” with a small footprint that can fit any procedure room. It’s a differentiated solution as it enables physicians to perform procedures with single-use devices which reduce the odds of developing an infection. They raised a $10m round last summer when they received the FDA approval for their device.
That’s a wrap for today! Don’t hesitate to reply to this email with comments, I read and answer all emails :)
Marie