The Future of Women's Health: Exploring Oova's Hormone Monitoring Technology

[00:00:00] Hi, welcome to Beyond The Paper Gown where we explore the factors that impact on our health,

[00:00:19] including innovations like the one we're going to hear about today. I'm your host, Dr. Mitzi

[00:00:25] Krockover. On today's episode, we'll learn how Dr. Amy Diveraniya's own fertility struggles

[00:00:31] led her to pivot from a career in data science to launching Uva with the mission to empower women

[00:00:37] with actionable data about their bodies through hormone monitoring. You'll hear about how Uva can

[00:00:43] be used to monitor hormones throughout a woman's cycle. The AI-powered test was developed to specifically

[00:00:49] answer questions about fertility, parry menopause and even if the two are overlapping. However,

[00:00:56] Uva can also be used to monitor conditions like PCOS or polycystic ovarian syndrome

[00:01:01] and doctors can use Uva to remotely monitor their patients undergoing infertility treatments.

[00:01:07] You'll also get a peak at a future that goes beyond our current one size fits all approach to medicine,

[00:01:13] especially when it comes to women and hormones. It's a future where treatments are as unique as

[00:01:19] those seeking them and why personalized healthcare matters. It's about improving lives, one unique

[00:01:26] individual at a time. So whether you're intrigued by how you can monitor your own hormone levels

[00:01:32] to understand your body, know when you're about to ovulate or if you're in the midst of parry menopause

[00:01:38] or what the potentials are for this new innovation, you've landed in the right place.

[00:01:43] And just a reminder that our podcast is for educational and informational purposes only.

[00:01:49] We highly encourage you to share this information with your healthcare provider

[00:01:53] and any personal questions you might have about your healthcare needs.

[00:01:57] And finally, companies and products highlighted here should not be considered an endorsement by

[00:02:02] beyond the paper gown or me.

[00:02:14] It's my pleasure to introduce Dr. Amy DeVeronia, who is the CEO and founder of Uva.

[00:02:22] How did someone with your background end up starting this company and what does Uva do?

[00:02:30] Thank you so much for having me. My background is pretty heavy on the science side.

[00:02:34] I have a PhD in biomedical sciences focusing on genetics and genomics,

[00:02:38] but I'm actually a trained data scientist who worked in industry for about seven years before

[00:02:43] pivoting to start my own company. You know, it's funny because I never foresaw myself being an

[00:02:49] entrepreneur. It wasn't a goal of mine. I never wanted to be my own boss. It just wasn't this

[00:02:55] which I needed to scratch. But what ended up happening was towards the end of my PhD,

[00:03:02] my husband and I started trying to have a baby. And it just wasn't happening for us.

[00:03:08] I've always had irregular cycles my entire life. And I realized very quickly that all the tools

[00:03:14] that were available for women were designed for a woman with a 28-day cycle or who had a regular

[00:03:19] hormone pattern. And that just wasn't me. I would assume that that's not very many people at all.

[00:03:25] Actually. There was a study that came out showing that only that 87% of women did not have a 28-day

[00:03:33] cycle. And when we look at our Uva users, it's about 5% that actually do. So it's a really big

[00:03:39] disservice for women that we assume that the 28-day cycle is normal. But it really highlighted

[00:03:47] a few issues for me. One that our medical system is incredibly broken. And second, women just

[00:03:54] aren't given the data they need to truly advocate for their own health. And I realized I

[00:03:58] couldn't solve the medical system problem on my own very quickly, but I could solve giving women

[00:04:03] data. And so I decided to start Uva. We are a women's health platform that provides women with

[00:04:10] actual hormone levels by monitoring their urine on a daily basis. And we seamlessly share that data

[00:04:16] with our doctor if they're working with one. We believe that women should have access to this data.

[00:04:20] So they can understand what's going on with their bodies. Education is very critical for our

[00:04:25] platform. And it's not to school a woman. It's really to shed light on the fact that we're not

[00:04:31] taught the basics about our bodies, and yet we're taught the complete opposite. But if you have sex,

[00:04:36] you're going to get pregnant. That's absolutely not the case. We're really trying to shatter

[00:04:40] a lot of these myths that we think are true about. Women's health and our bodies overall.

[00:04:46] Take us through how someone would use this and what the information that they receive

[00:04:53] means, and how they would take action on it. Absolutely. So let me kick it off with we actually have

[00:05:01] two products that are available right now. So we have this trying to conceive product which is

[00:05:05] quite easy to understand. We identify when a woman's most fertile. We confirm this is released

[00:05:10] in agronaut and we provide that data to her. The second product that we have is actually helping

[00:05:16] a woman navigate the transition of pariamenapause. And that is a really dark period for a lot of

[00:05:22] women because we don't know what's going on. We just know something is off. And that's really

[00:05:28] hard to come to terms with when you keep getting more and more off, and you start accepting this

[00:05:32] to be normal when you're just really tired all the time. We're feeling sick all the time. I

[00:05:38] actually saw this billboard on the train ride into the city today. I was by city MD saying

[00:05:44] when you're sick and tired, a feeling sick and tired, that's when you have a problem.

[00:05:49] And I feel like that's what pariamenapause is. You're just always feeling off. So the way that our

[00:05:55] product works, and it works the same for both platforms but I know it's a podcast so you can't

[00:06:00] see this but I'll show it to you and I'll prescribe it. But our kit comes with the holder, a handle,

[00:06:06] and then 30 disposable cartridges that look like this. So 15 measure, loot nice and hormone

[00:06:11] in a progesterone and 15 measure estrogen. Every one of our cartridges has a QR code on it.

[00:06:17] So what you do is we're so long-satisfying as Marathon app. You download the app, you enter all

[00:06:21] of your information in the app and we figure out what days need to scan. On a scanning day,

[00:06:27] you'll provide a urine sample on our cartridge. You then scan it with your phone. Very simple. I

[00:06:32] mean, everyone knows how to scan a QR code. Thanks to COVID now. And we basically give you your

[00:06:38] result within seconds. And I should just say to our audience, it looks like a fancy pregnancy test.

[00:06:46] Absolutely. So we did that by design because what we realized during early user testing and this

[00:06:51] was quite a funny moment in like Ovens history, I bought a bunch of ovulation and pregnancy tests

[00:06:56] and I was still in my PhD. So I dumped it on the table, I called a bunch of my lab mates and I was like,

[00:07:02] what do you feel about this stuff? Just interactive it. And there's a bunch of men and a few women.

[00:07:08] The guys open up the boxes first thing they do is pull out that massive insert and start reading the

[00:07:12] instructions. Women grab the test and went to the bathroom. They knew exactly what to do. So I see

[00:07:17] what you're saying. Okay. Yeah, because usually men don't read their instructions. But I,

[00:07:21] they don't, this is the one area that they did. That's great. Let me ask you a question really quickly.

[00:07:27] How does your product and let's focus on the fertility piece just for a moment?

[00:07:33] Differ from those ovulation kits. So there's a lot of products in the market today for fertility

[00:07:41] and ovulation parking, right? But when I was using these products, there was a lot of gaps

[00:07:46] that identified very quickly. One, they shoehorned me into a 28-day cycle.

[00:07:51] Who doesn't do that? We're a completely personalized test. You learn every nuance about your body and

[00:07:56] guide you through that phase of life. So what's going on with your cycle? Are you in your fertile

[00:08:01] window or not? It's different for every woman. It's not that on cycle day 14, you're going to ovulate.

[00:08:06] We're not robots. Are you different in that you because you do check every day and the other ones

[00:08:12] don't? Well, some of them do check every day but they're not quantitative tests. They're qualitative.

[00:08:18] So you're getting a binary yes or no. Okay. And in layman's terms explain what you just said.

[00:08:25] Yeah, sure. So it's think of a pregnancy test, right? You either see two lines or you don't.

[00:08:30] You see one line or two lines. One line means you're not pregnant. Two line means you are.

[00:08:35] It doesn't matter how dark that second line is. If it's even kind of there, you're pregnant.

[00:08:40] You can't be 25% pregnant. But with Ufa, we give you an actual value, a hormone measurement for

[00:08:47] all three hormones every day that you test. So I'm telling you that your delutinizing hormone is 11.27.

[00:08:55] Your progesterone is 1.46 nanograms per mil and micro.

[00:09:00] So, milli-iupil later on my grant now. milli-iupil later for L.A.

[00:09:07] And so we're really trying to be mindful of understanding what every woman's unique baseline levels are

[00:09:13] and then detecting fluctuations by comparing to that because our surges, our peaks, are not the same

[00:09:18] from one woman to the other and Ufa learns those nuances to navigate a woman through those phases.

[00:09:24] So it sounds like it's much more personalized? Absolutely. That's one of our core pillars

[00:09:29] to be a personalized asset to a woman. How is it working? Do you have any outcomes data?

[00:09:36] I mean we have a ton. We've been in markets since 2020. We have over 10,000 cycles that we've

[00:09:41] monitored across those years and the stories that we hear are just so amazing. I'll give you

[00:09:50] one example. Like a lot of these fertility companies are going to talk about like oh we have a 90%

[00:09:55] success rate of getting women pregnant. On average our users get pregnant within three months.

[00:10:00] Like yes we have those stats too but what I find really encouraging and exciting is how educated

[00:10:07] women are walking away from our platform and I'll give you a really good example. So we do these

[00:10:12] consults with our users because oftentimes they'll have questions about like can you explain what

[00:10:16] might Ufa data means or I saw this weird behavior or can you help me understand it? So I take these

[00:10:21] consults often and I was talking to one woman and she was talking about like some nuances she

[00:10:27] saw in her cycle and she's like when I ovulate from my right side I have a 27 day cycle and when

[00:10:32] I ovulate from my left it's a 32 day cycle. So she can feel the ovulation? She feels the ovulation

[00:10:39] because we took away that stress point of am I ovulating or not? She became so much more

[00:10:46] in tune with her body that she was noticing what side the pain was coming from. Interesting. And

[00:10:51] she had monitored for so many months that she saw that pattern and it's critical to know this right?

[00:10:56] Like if you're trying to get pregnant and you're assuming that you're ovulating at the 50%

[00:11:01] mark of your cycle which is also not true we can debunk that later on in the conversation but

[00:11:06] like if your cycle is not equal one cycle to the next you could be completely off assuming that it is.

[00:11:16] Before we go further it might be useful to go through a review of the menstrual cycle and I'll

[00:11:24] try not to get too technical. There are four phases to the menstrual cycle and there is a communication

[00:11:30] system between the uterus and ovaries and parts of the brain that act as the control center

[00:11:37] which receives and sends signals to the uterus and ovaries. It's a very intricate system but for

[00:11:44] our purposes here these are the cliff notes. The first phase is considered the menstrual phase

[00:11:50] if there is not a pregnancy estrogen and progesterone levels are low and that results in shedding

[00:11:56] the lining of the uterus that's the menstrual period. During this time that control center in your

[00:12:02] brain notices that it's time to start over and sends a signal in the form of FSH or follicle

[00:12:09] stimulating hormone to prepare new eggs. The control center keeps sending the FSH signal to make

[00:12:16] sure the eggs are getting ready for one of them to break from the follicle. This is called the

[00:12:20] follicular phase and follicles are the small fluid filled sacs in the ovary each one contains

[00:12:27] one immature egg during each cycle a dominant egg emerges and sends out its own estrogen so FSH is

[00:12:36] rising and now so is estrogen. When the estrogen signal gets really strong it tells the control

[00:12:43] center that a dominant egg is ready. The control center then sends out a super strong signal

[00:12:51] this is the LH surge or the luteinizing hormone that tells the egg it's time to leave the ovary

[00:12:58] and start the journey down the fallopian tube toward the uterus. This is called ovulation

[00:13:05] and the prime time for fertilization with sperm. After the egg is on its way, the empty follicle

[00:13:12] starts making its own signals with progesterone and a little estrogen to further build up that

[00:13:17] uterine lining to make it friendly to a fertilized egg should there be one. This also tells the

[00:13:23] brain that it doesn't need to send out any more of its signals and that LH and FSH levels will start

[00:13:30] falling. If the egg and sperm meet and therefore a pregnancy occurs, the uterus continues to send

[00:13:37] out progesterone and estrogen making it more conducive for that fertilized egg to implant in the uterus.

[00:13:44] If there's no fertilization, the hormone levels decrease and the cycles start again.

[00:13:51] So for someone who's looking to get pregnant for example they're going to want to know when the

[00:13:55] LH surges or better yet when it's about to surge is that will be the most fertile time.

[00:14:02] Now we'll go back to the discussion. I asked Dr. Diverania about any data she had

[00:14:07] with respect to results for women who use the test

[00:14:16] and going back what are your numbers in terms of statistics?

[00:14:21] So we talk about success regarding pregnancy or I mean it's so we on average our users are

[00:14:29] getting pregnant within three months and then we I mean I don't want to give you a percentage

[00:14:33] of success on pregnancy because it's just that's not the only reason women are using us.

[00:14:39] So it's a bit different but not an ovulation test. We're really a hormone monitoring device

[00:14:44] and so I'll give you another example here but we have women that conceive with the lab

[00:14:52] and what happens is while we're not a pregnancy test monitor we are able to detect a pregnancy

[00:14:58] really early on because luteinizing hormone and beta HCG are very similar in structure.

[00:15:06] They only vary off of one antibody site so our luteinizing hormone antibody actually binds

[00:15:12] to the beta HCG so we have that non-specific binding happening on our test. It's not a problem

[00:15:17] because that hormone is not present unless if you're pregnant right but what we'll start to see

[00:15:23] is that the woman has her LH search and then she starts to see her progesterone rinsed

[00:15:27] and the LH starts to come back down right as it's supposed to but then in a couple of days

[00:15:32] the LH will start to pick back up and the progesterone is also staying elevated.

[00:15:36] So that like we get flagged when we see that pattern because we're like oh something's

[00:15:40] up with this patient's test so sometimes we'll reach out and we're like hey you may want to go get

[00:15:45] a pregnancy test and we find out oh no I am pregnant, Uva got me pregnant but I've had a

[00:15:51] struggle with reoccurring this carriage and I want to make sure that the pregnancy gets through

[00:15:56] the first trimester. So they continue using Uva to just get that piece of mind that their progesterone

[00:16:02] is staying elevated and their LH is staying up. Is that as good a test or how does that compare

[00:16:10] with doing a beta HCG level? You would absolutely want to do a beta HCG level because your levels

[00:16:16] for beta HCG both progesterone and beta HCG are going to be way over what Uva can monitor

[00:16:24] and in fact they're breaking our test because the die from the control line is being pulled

[00:16:29] into the LH and the progesterone reading so the test is not even reading properly like they're getting

[00:16:35] an error but they're getting that piece of mind that my levels are still high and I'm not miscarrying

[00:16:40] right now. We're not trying to replace like what getting a beta HCG or a normal blood test

[00:16:46] from doing the right things but it speaks to how scared women are on this journey and how much

[00:16:51] they're hungry for some some solace and we're providing that. And just to explain to our audience

[00:16:59] when there is a question about miscarrying or the early pregnancy,

[00:17:05] a blood test that looks at the basically the pregnancy hormone you can actually

[00:17:11] do levels of it to see if it's increasing in the right amount and so that's what we're talking

[00:17:17] about. Yeah that's absolutely correct and I'll reiterate that Uva is not designed to

[00:17:23] confirm or deny that a miscarriage is happening it's just a nice tool to get some soft

[00:17:28] confirmation it's never meant to replace any sort of medical advice. Thank you. Does anyone ever

[00:17:34] use it for contraception? We like to say that it's for off label use, it's an off label use

[00:17:41] of the product because with everything that we put out there for Uva,

[00:17:46] we have done studies to confirm that our results are accurate. We have not done sufficient studies

[00:17:51] to say that were an effective contraception. And before we jump over to the parimenopause

[00:17:59] information with what with everything going on with dogs, there has been a real focus on

[00:18:08] privacy, especially with these reproductive health apps because even if they are

[00:18:15] hypocompliant which is the law that protects patient privacy. Many of them are not I don't know

[00:18:20] if yours as you'll tell me but even when they're when they are if there was a government entity

[00:18:30] that wanted to file a criminal offense then they would have access to that data. So tell

[00:18:40] us about your approach to privacy. All right so let's go back to when dogs was overturned.

[00:18:48] It happened on a Friday and if you remember that weekend it was a frenzy on social media with all

[00:18:55] these companies putting on announcements that we are working to ensure your data is secure

[00:19:00] and I remember looking at those messages and I was like wow you guys really suck. How much data

[00:19:07] how much data are you holding on to that you've just kind of been biting time, not ensuring that it

[00:19:11] was secure and women didn't think to ask even I'm guilty of that like I didn't think to ask

[00:19:17] the app that I was tracking on if my data was secure so like we had a moment there where I was

[00:19:24] either we joined this conversation or we stay silent because OVA didn't have to do anything.

[00:19:30] We haven't hit a compliant and secure from the very beginning it's like it was a foundation my

[00:19:34] PhD work used a lot of EHR records so it was just like when you're building a database you have to

[00:19:39] ensure right it was dealing with medical records so I was like when you create a database you need

[00:19:45] to ensure it's secure so that's what we did it was it wasn't an afterthought for us and so we

[00:19:53] stayed quiet during that frenzy and we were getting a lot of messages from potential customers

[00:19:58] and current customers is my data secure can you delete my account I'm no longer using it

[00:20:02] and I was like I'm happy to do whatever you need but I can ensure you that your data is secure

[00:20:07] and then regarding the subpoenas that you could possibly get when you're using a fertility

[00:20:10] tracking app. The reason I can't necessarily tell you what our absolute success rate is is because

[00:20:16] we don't we don't keep record of whether a woman conceived or not in our system. We do that by

[00:20:22] design because we again are not an ovulation test. We are a hormone monitoring platform

[00:20:28] and so what I care about are what the hormone levels are and like fine we have what your health

[00:20:33] goal may be but it's not tied to a specific person it's completely deidentified

[00:20:39] and that key that maps everything is underlogged and key so I can't map it for anyone

[00:20:45] so if someone and I don't want to get too much in the weeds out this but if there was a subpoena

[00:20:51] for patient A you can't go into her file to see what her hormone levels have been. Depends on how deep

[00:21:00] that subpoenas but just if I was is there like I need the medical records of so-and-so it would be

[00:21:04] a huge lift for us to be able to map that out and then what are you getting you are getting a bunch

[00:21:09] of hormone levels. Okay I don't have anything on whether the woman conceived or not I don't have

[00:21:14] anything about whether the pregnancy was terminated we don't track we don't keep record of any of that

[00:21:20] and given what we just talked about even if they might have conceived it would be an indirect measure

[00:21:26] so it doesn't you know unless somebody was really sophisticated they may not be able to know

[00:21:30] okay it's a shame that we have to be having this conversation but unfortunately it's certainly

[00:21:37] something that's very important and to remind our listeners that when they're giving their data

[00:21:43] you know they really need to know how it's being protected and if it's being protected. I agree with

[00:21:49] you like I think it's unfortunate that we have to have that conversation but in a way it's

[00:21:53] the expected to a positive two right I think women's health has always been kind of this cursory

[00:21:58] thing that women's health is all periotracking and like fine that's the easiest app because it's so

[00:22:02] predictable but it's really not it's still health-dated and for these companies to be under fire now

[00:22:09] have the bars that you need to be hip-hop compliant I think that's a fantastic step forward for

[00:22:13] women's health and like we don't want to make this a political discussion but I think the positive

[00:22:18] that came out of this is that now even periotracking apps are being treated like health platforms

[00:22:24] that's that's a huge step for us. And to the end that you are collecting large amounts of data

[00:22:31] that really paint some more detailed picture of what is and isn't normal you know most of the

[00:22:40] of what we consider not normal is actually normal. How do you contribute to the data out there so

[00:22:49] that scientist and others can benefit from it and ultimately you know women in general can benefit

[00:22:57] from it? Absolutely it's one of our massive pillars because while we're trying to inform a woman

[00:23:03] about her body we're also trying to myth-bust a lot of these assumptions that we have around women's

[00:23:08] health. It is horrible that we all think that the 28-day cycle is normal, it's not. That was a

[00:23:14] marketing point that became basic healthcare. I think that's like that's just how a lot of women's

[00:23:20] health has been handled and so what we do is yes we have an amazing data set and I can talk about

[00:23:26] that data set a bit more. But with over 10,000 cycles what we do is actually release

[00:23:32] the publish and we present at some believing medical conferences about the data that we're collecting

[00:23:38] because it's not it's not necessarily just for the consumer it's also for the medical community to

[00:23:44] understand that we now have actual hormonal data over time to understand the nuances of every

[00:23:50] woman because the dynamic has drastically changed. Women are not in their early 20s getting pregnant

[00:23:56] anymore. The age of pregnancy first pregnancy is drastically increasing and if you look at our

[00:24:02] users 46% are above the age of 35, almost half of our users and this is just for the trying to

[00:24:08] conceit demographic are over the age of 35. That says a lot right? We can't compare that woman

[00:24:17] to an 18 year old who has a typical cycle. A lot has happened in those years that will impact

[00:24:24] her cycle so we're really trying to educate both the consumer and the medical community about what

[00:24:30] normal looks like and we work with REIs or re-bredital immunokinologist quite a lot they're very aware

[00:24:36] of the abnormalities in women and they embrace it because those are the cases that they see most often

[00:24:43] OBGYNs I think are in need of data but the only way to get that data is that a patient come in

[00:24:48] every day for blood work and unless if you're going through IVF you're not going into the clinic every day.

[00:24:54] And to that point can you use this modality with IVF or instead of having to go each day to

[00:25:06] getting your blood drawn? To being used across IVF I'm going to honestly say no not at the moment

[00:25:12] because our estrogen test doesn't reach the levels that women are typically going to see when

[00:25:19] they're going through an IVF cycle so I don't want to mislead anyone there but what we can be used

[00:25:24] for are any non-gonetic tropin cycles so that could be a natural FET or natural frozen embryo

[00:25:30] transfer a natural cycle an IUY trigger shot monitoring there's a whole slew thing that you

[00:25:37] can use OVA for today and it is being used in that way we're actually kicking off a study with

[00:25:42] mass general and the next few weeks looking at using OVA for frozen I'm sorry looking at OVA for

[00:25:48] trigger shot monitoring and what it should be really exciting sure so when you're going through

[00:25:52] an IVF cycle and you're you give yourself think about who's going through an IVF cycle right it's not

[00:25:58] really it's not always a woman who's in medically trained and they're they have to give themselves

[00:26:03] injections and medications it's a very scary thing especially cycle one but one of the first steps

[00:26:09] that a lot of clinics make their patients do is give themselves or self-administer a trigger shot

[00:26:15] which is often a BDHCG shot and that's to induce ovulation so what they're trying to do with an

[00:26:21] IVF cycle is override or natural cycle and put you into a predicted like a controlled and predicted

[00:26:28] cycle so the trigger shot is meant to induce ovulation so that when you come in for a retrieval

[00:26:34] of your egg you have ovulated and they can extract the egg so they can create the embryo outside

[00:26:39] and then do a transfer at some other date well the problem is that a lot of women who are self-administering

[00:26:45] that trigger shot don't know if they're doing it right and in many cases the clinic won't know

[00:26:51] that the shot was an administered right until the patient comes in for a retrieval and now if

[00:26:57] that shot shot was an administered correctly they have to let cycles waste okay so you're basically

[00:27:04] being able by a hormonal level to see if they had done it correctly correct yeah so you get a

[00:27:11] baseline you monitor the day of the shot and the day after the shot to ensure that the test was

[00:27:15] done properly and the beauty is that your doctor gets your data in real time through our HIPAA

[00:27:21] compliant dashboard so you don't need to send screenshots or images to your doctor they can see

[00:27:27] it all in real time and the nurse can call you the next day's incase he doesn't look like the shot

[00:27:31] was administered right come in and we can still we can do it and you're still in cycle so obviously

[00:27:37] you're a consumer product but when it's used in this way is it paid for by insurance

[00:27:44] not at the moment we're working on it okay let's switch a little bit and talk about

[00:27:51] how you might use this for or if you have a different kind of measurement for someone who thinks

[00:27:59] they might be in parimenopause sure so what's happening in parimenopause the bottom line is that there's

[00:28:05] a hormonal imbalance that's happening which is causing all of these symptoms the problem is we don't

[00:28:11] understand that hormonal imbalance we don't even understand the symptoms we just know that they

[00:28:16] exist and we don't know if when we're experiencing those symptoms if they're for parimenopause or

[00:28:21] because I'm feeling sick or I'm coming down with something or I just didn't get enough sleep

[00:28:26] it's very ambiguous so what we're trying to do here is forget I don't say forget the symptoms but

[00:28:32] put less emphasis on the subjective piece of it and let's get to the objective component which

[00:28:37] is the hormone hormone balance let's monitor your hormones across 15 or 30 days depending on what

[00:28:43] your where you are in your cycle and figure out if there is a hormonal imbalance happening or not

[00:28:49] is your estrogen behaving the way it should is your progesterone staying super elevated is being

[00:28:54] brought down what is going on because there's a reason it's called a menstrual cycle these hormones

[00:29:00] work in unison and in harmony together so if something is off it's going to cause a downstream

[00:29:06] effect and that is what leads to those symptoms so the way that we're using uva for parimenopause

[00:29:12] understanding that hormonal imbalance and then we also allow women to track their symptoms to

[00:29:17] layer that information on top of that hormone imbalance to figure out what the causal nature is

[00:29:23] the phd work was done in Bayesian networks so it's all about causality with for like

[00:29:28] that's where my head always goes so we're trying to see what that hormone pattern is that's causing

[00:29:33] you to experience certain symptoms and then start shedding light on that one of the questions

[00:29:38] that women typically ask us is am I in parimenopause that is a very tricky and multifaceted question

[00:29:45] to answer i don't want to say that we can absolutely 100% answer that today but what we can do

[00:29:51] is give you information to start teasing out what is happening on a day-to-day basis

[00:29:56] and that control is what i believe what we're seeing women are really hungry for today

[00:30:02] you know it's interesting because if you look at guidelines for clinicians

[00:30:08] if you talk to a clinician they'll say you don't need any hormone test we're going to treat you

[00:30:16] or you have the option to be treated if you have symptoms what do you think it's going to take

[00:30:21] for a test like yours to be included as part of the diagnostic process and what do you say to those

[00:30:33] clinicians who say we really don't need that kind of monitoring i mean we'd have this conversation

[00:30:41] every day with clinicians right because it's about changing a behavior that is the hardest thing

[00:30:46] to do right humans don't want to change and they don't they don't welcome change but my challenge is

[00:30:54] i understand you don't look at hormone data and blood work right now but why is that

[00:31:00] is it because you don't need it or is it because you don't have it

[00:31:05] and the answer is that they don't have it what do you mean when they say don't have it because we can

[00:31:10] take estrogen levels but what i was always taught is you really can't correlate those levels

[00:31:15] with what's going on in any kind of well concrete way are you getting those levels daily or are

[00:31:21] you getting that no it's a spot check exactly that's exactly it these hormones are not they're not

[00:31:28] stagnant hormones they're fluctuating every single day and every hour so being able to see your

[00:31:35] hormone trends over time is the true value of our platform and that is information that a clinician

[00:31:41] hasn't had because like i said earlier a woman is not going into the doctor every day for blood work

[00:31:46] unless if she's going through a really invasive treatment like what i'm excited about is this

[00:31:52] this new technique of being able to get daily hormone measurements can actually start supporting

[00:31:58] clinicians and women to get the right dosage and treatment for home and replacement therapy

[00:32:03] right now it's like this blanket no don't do it because i'm going to get cancer

[00:32:07] but why is that it's because the dosage isn't right and the monitoring isn't done correctly because

[00:32:12] women don't clinicians and women don't want to get blood drawn draws all the time

[00:32:17] but if i can provide you with that data daily by just using a urine test wouldn't you prefer that

[00:32:24] just to be clear though we don't have guidelines for that we don't

[00:32:28] you know we don't have data for that and all of that but what i'm hearing you say is that's the

[00:32:33] holy grail that's you know the the goal that's the next step yeah absolutely of course and that's in

[00:32:38] the way for change like the way that treatment is done we don't have enough data for it yet but that's

[00:32:43] one of our what we're trying to do here who about we're trying to collect that data to have those

[00:32:47] meaningful conversations with clinicians and how do we do that by publishing research by showing

[00:32:52] our findings not coming up with arbitrary like gimmicky scores or something some marketing material

[00:32:59] we're really trying to move science the medical field forward and the only way that i know what

[00:33:03] i do is that it's with data absolutely and so just uh again if i'm hearing you correctly or if i'm

[00:33:11] understanding correctly a woman who might be experiencing some symptoms but doesn't want

[00:33:19] isn't ready to go to the doctor yet or just really wants to have a little bit more information

[00:33:23] this is the kind of person that might use your test and get some more data if it is looking like

[00:33:31] you know it's pariamine-apause then they can come in with that dad and say you know hey i need to

[00:33:36] have that conversation or if it's not then they obviously need to go further to see what

[00:33:42] wide some of their symptoms are occurring is that a fear assessment that's a completely fair

[00:33:46] assessment and i mean just think about the change in mentality between those two women right

[00:33:52] one who's able to get the answers as she needs from our test great she's walking away confident

[00:33:56] another woman who has to walk into her doctor's office because she doesn't necessarily have the answers

[00:34:00] or to her questions but she has data to walk in with them being like can you explain

[00:34:05] what's going on to me for something is clearly off you're not walking in lost and um yeah i'll leave it

[00:34:13] and given that it's not reimbursed right now is it fsa or hsa uh eligible yes it is okay so

[00:34:21] that's one way that people can help afford it so here's my question you just said earlier that

[00:34:31] you've got a big percentage of people that are 35 and over trying to get pregnant

[00:34:38] and that's hard because you know for all the reasons we know as we get older becomes more hard

[00:34:45] to concede and more difficult to conceive and you're now kind of in that space especially if

[00:34:51] you're 40 and above maybe getting into parimenopause and for anybody who's heard my um podcast they've

[00:34:58] heard me say you know i was in parimenopause but i had my or i think i slid into it after my second baby

[00:35:05] at the age of 41 and so talk a little bit about are you using both tests or how would you suggest

[00:35:14] someone who is in that um kind of gray area and having difficulty if they're trying to conceive

[00:35:23] how would you approach that that is a great question and you know it's funny because i

[00:35:29] i got this like pushback early on when i was sharing with investors and potential investors like what

[00:35:38] my goal was for the company that we aren't like don't look at me as an ovulation test or

[00:35:43] fertility fatten tech company or a fertility test because we're scaling across other women's

[00:35:48] health areas and the pushback that i got from potential investors was how are you like you're

[00:35:55] talking about two very different consumers like you're talking about a young woman who's trying to

[00:35:58] get pregnant and an elderly person is going through parimenopause. How would you person?

[00:36:04] yes yes exactly i have a problem with that but okay thank you thank you yes i did too which is

[00:36:10] why they were potential investors and i've heard um i i really did too and i've walked away from a lot

[00:36:16] of tables because of that sentiment because i'm like you're just so disconnected with the reality

[00:36:20] and it's okay i'd like to read a quote from a woman i did a consult with her and she made a statement

[00:36:25] to me um she said i love how uva acknowledges and supports both the trying to conceive and parimenopause

[00:36:31] journeys recognizing the challenges women face uva is highlighting the continuity of these experiences

[00:36:37] rather than viewing them as separate paths and like that when she said that to me it resonated so

[00:36:44] deep because i'm like yes our average woman who's trying to get pregnant is over the age of 35

[00:36:49] and when you look at the average age of a woman who is going through parimenopause or you buying

[00:36:53] our test just 41 this is not an old woman exactly right i loved it when i was 36 and had my first

[00:37:02] child and i was considered a geriatric you know pregnancy yeah even the way that we talk about it

[00:37:08] that's another whole study that we actually presented about like what advanced maternal age

[00:37:12] action needs and looks like um so it's well it's a little bit about that

[00:37:18] because so we actually did is we did a study because we assume that if you're in an advanced

[00:37:23] maternal age you're going to have trouble getting pregnant or more difficult to getting pregnant right

[00:37:26] 35 is that magic pivoting age and there's absolutely some signs to this right that like the rates

[00:37:33] of infertility increase as you're getting older um and it gets more difficult to get pregnant but

[00:37:38] what we started looking at is what are the actual hormone patterns in the younger age group versus

[00:37:43] the older and there's not that much difference like these women are still cycling it's just

[00:37:51] slightly more irregular and it's not it's coming off as infertility because they're using these over

[00:37:57] the counter tests that are designed for a 20 year old woman but if you look at their actual hormone

[00:38:02] levels they are still cycling you just need to understand that woman do you know if you are

[00:38:12] more effective because of that i believe so i mean we're we have all the success stories and all

[00:38:20] of that like most other companies but what i think is amazing is we're able to provide that individualized

[00:38:27] care and it's not we're not dumping you into or trying to shove you into this like cookie cutter mold

[00:38:33] we're really embracing your individuality so this is really what the what spearheaded us

[00:38:38] we'll be launching a perimenopause sooner than we thought we had so many women that were telling

[00:38:43] us that we're trying to conceive but then also telling us that they had perimenopause i was like

[00:38:49] you're 37 like why do you like whatever let's just go with it and they were being told that

[00:38:53] they were in perimenopause because they were a little bit older and they had an irregular cycle

[00:38:59] that's not perimenopause right so that that end happened and on the flip side we have women who are

[00:39:06] like 41-42 who are still trying to have a baby there's nothing wrong you're still cycling but they're

[00:39:12] using our perimenopause test to see if they're cycling or not so the beauty of our platform is

[00:39:19] a woman basically goes into our app and selects what her health goal is and then the entire app

[00:39:24] experience changes based off of that the data is the same it's a quantitative test so your estrogen

[00:39:31] level your progesterone those are all the same whether you're using an anesthetical fertility or

[00:39:36] perimenopause kit but the interpretation is very different sure what did you have to go through any

[00:39:44] kind of regulatory approval for your product and i would assume if you did for the claims that

[00:39:50] you're providing yeah sure so we fall into our class one exempt device so we have registered

[00:39:55] with the FDA we've done all the things that we need to do on that front and we're really conscious

[00:39:59] about the claims that we make so it's a bit hard for us because we can detect signs of like

[00:40:04] polycystic ovarian syndrome but we can't tell a woman that she's experienced she has that what we

[00:40:09] can do is provide that insight to her physician or her clinician if she's working with one of our

[00:40:14] providers who can then use uva's recommendation to do a workout on her but we don't prescribe

[00:40:21] or diagnose a patient based off of any of our data okay how do you get to that physician

[00:40:30] we have a clinician dashboard that clinicians can log into to view their patient's data and

[00:40:36] so we have a network of over a hundred clinics that have partnered with us they range from

[00:40:40] natural pads to obi julians to fertility centers and basically what happens is when you have a

[00:40:46] patient that's using uva they can go into their app and select what clinics they want to have

[00:40:51] access to their data so the patient drives all of it once they select the clinic the clinic will be

[00:40:57] able to view that patient's data and their dashboard the patient the doctor is also able to add a

[00:41:02] patient but the patient has to opt into it of course though again the patient controls access to

[00:41:07] whoever sees their data terrific what do you see for the near future with uva oh my gosh it's so

[00:41:16] exciting right now i mean we we launched our parent mental pads product never expected it to take

[00:41:21] off the way it did it just really reinvigorated our entire team and reminded us of how

[00:41:27] important the work that we're doing is and how hungry people are for this information so

[00:41:32] we've really like kind of hit the ground running thinking about like what's next

[00:41:36] we are not limiting ourselves to just these two phases the goal has always been to scale across

[00:41:42] all different phases of women's lives um we like to think of our platform as uva for life so regardless

[00:41:49] of where you are in your life journey we will have a platform available to you to help navigate that

[00:41:55] and as we're wrapping up what did i not ask you that you wanted to make sure that we discussed

[00:42:03] one thing that i think we should definitely address is the feeling the women have about medical

[00:42:08] gas lighting and i mean i've experienced it myself as well like going to my clinician at um

[00:42:15] thirty how old was i i was 27 and i was just starting my PhD and i was like i have a regular

[00:42:22] cycle i don't want to get pregnant now but what can i do to optimize my chance of getting pregnant

[00:42:27] she glint looked me up and down once and was like come back to me at 30 if you're not pregnant

[00:42:33] i was like well i'm asking how to be proactive and you're literally not giving me anything when

[00:42:38] i know i'm gonna have trouble which i did have trouble um i never went back to that obi again but

[00:42:43] there's this sentiment that women don't aren't taken seriously when they walk into their

[00:42:48] clinicians office and i just want to interrupt for just a second because you just

[00:42:53] it's very interesting i think most of us when we think about this issue we think about a male

[00:42:58] physician but you just gave us an example of a female physician so yeah it's potentially gender

[00:43:04] neutral right? a great it is and exactly you would hope that a female clinician be older more

[00:43:10] sympathetic and understanding but like i understand the medical side of a tune obi has seven

[00:43:14] minutes with you she wants you in and out so if she can get you out in six minutes she gets a minute

[00:43:18] to breathe so i get that but as a patient it's really it's not the best experience

[00:43:26] so if you take a couple of steps back from that that journey of me actually walking to the doctor's

[00:43:30] office what are to take me to get into that office? if my son has a cough we're going to the pediatrician

[00:43:38] if my husband says that his shoulder hurts i'm making him an appointment with the PT

[00:43:42] i can have be going through so much stuff but until it becomes debilitating i'm not walking into

[00:43:47] that doctor's office because there's so much other stuff i'm monitoring on a day-to-day basis

[00:43:52] i'm always a last priority so if i drag myself to a clinician's office because something with

[00:43:56] bothering you so much to have to go to a doctor and then i get feedback like this

[00:44:02] that's incredibly disheartening so i took that feeling and i was like how do i build that into a

[00:44:09] product that women never have to experience that again and so what we've done with uva is

[00:44:15] everything as i've been saying is based on hormone levels so if i can give you a report to take

[00:44:20] to your doctor where they say okay xyz is wrong with you you can be like okay great i hear you

[00:44:27] but how does that relate to my hormone trends let me speak your language and now all of us and

[00:44:32] you we've opened up a two-way conversation with your doctor it's not one sided anymore

[00:44:37] and you're being heard but that's like really the ultimate goal of our of our platform here

[00:44:43] powerful statement you mentioned that your son so i assume that you were ultimately successful

[00:44:51] i was yes i had a beautiful baby boy who was so good that during my

[00:44:57] matley whatever you consider founders matley to be i was bored because he was so good and we ended

[00:45:05] doing a beta test and the feedback that i got then was just amazing like it built uva to what

[00:45:12] it is today and he has been really a core component of this company and to the point where like

[00:45:21] i mean as a mom and as a founder like there's a lot of guilt that you're kind of juggling on both

[00:45:25] sides right because both things are your babies um and so there's this one moment that we had where

[00:45:31] my friend asked him so what do you do like what does your mom do for work and this is definitely like

[00:45:38] during covid like where he's seen me on computers all day i thought my little three or all

[00:45:43] at the time was gonna say something like oh my mom sits on the computer is on zoom all day

[00:45:48] and he paused and he says my mom helps other families have babies

[00:45:56] and so it's i roll yet too

[00:46:00] oh my god that's a great story it just warmed my heart so much and i was like man i'm doing

[00:46:06] something right absolutely look what you have i'm raising a son who thinks it's appropriate for

[00:46:13] his mom to work this hard and to make a difference in the world oh that is a terrific story thank you

[00:46:19] for sharing that with us what's his name his name is arian arian i love that well dr. Amy divaraniya

[00:46:28] thank you so much for sharing your time and your expertise and your innovative spirit i think

[00:46:35] that this um was really educational and empowering so thank you so much for being with us

[00:46:42] and we'll look forward to following the company as well thank you so much for having me it's great chatting

[00:46:48] with you

[00:46:55] as we wrap up today's enlightening conversation with dr. Amy divaraniya it's clear we're standing on

[00:47:01] the threshold of a new era in women's health the work being done at uva tracking a woman's daily

[00:47:07] hormone levels opens up a world of possibilities not just for women interested in fertility or navigating

[00:47:14] parimenopause but for anyone who dreams of a health care system that sees and treats them as an

[00:47:20] individual this conversation doesn't have to end here so i hope you'll share this episode with

[00:47:26] friends and family spark your own discussions and keep the dialogue going please comment on our

[00:47:31] social media or drop us a line at info at womancentred.com or on our forum at beyondthepapergown.com

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[00:47:58] for sharing your time with us and for being part of this important conversation until next time take

[00:48:05] good care

[00:48:17] our episode was produced by Patrick Shambayati and me and our associate producer is Kyla McMillian