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Women’s health testing can be improved with more and better data. Dr. Amy Divaraniya, CEO and founder of OOVA, shares how her struggles with fertility sparked the idea for OOVA, a new way to measure and monitor female fertility at home.
During this episode you’ll learn about:
Resources to topics mentioned in this episode:
Products mentioned in this episode: Fertility Test, Stress Test, Menopause Test, Ovarian Care
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Subscribe to the show wherever you listen to podcasts so you never miss an episode. You can also learn more about the topics in the episode by checking out the latest news, videos, and stories on Thorne’s Take 5 Daily blog.
During this episode you’ll learn about:
Resources to topics mentioned in this episode:
Products mentioned in this episode: Fertility Test, Stress Test, Menopause Test, Ovarian Care
Subscribe to More Content
Subscribe to the show wherever you listen to podcasts so you never miss an episode. You can also learn more about the topics in the episode by checking out the latest news, videos, and stories on Thorne’s Take 5 Daily blog.
Dr. Robert Rountree
This is The Thorne Podcast, the show that navigates the complex world of wellness and explores the latest science behind diet supplements and lifestyle approaches to good health. I'm Dr. Robert Rountree, chief medical advisor at Thorne and Functional Medicine Doctor. As a reminder, the recommendations made in this podcast are the recommendations of the individuals who express them and not the recommendations of Thorne. Statements in this podcast have not been evaluated by the Food and Drug Administration. Any products mentioned are not intended to diagnose, treat, cure, or prevent any disease.
Dr. Robert Rountree
Hi everyone, and welcome to The Thorne Podcast. This is Dr. Bob Rountree, back with you again. This week we're going to be speaking to Dr. Amy Divaraniya. She's an entrepreneur and a scientist. She has a PhD in genetics and genomic sciences, which she's going to talk about with us, and we're going to talk about solving challenges in the field of fertility and women's health through her company, OOVA. Am I right on that – “oova” or “ova”? Because I'm tempted to say “ova.” She's the CEO and founder, so welcome to the show, Amy.
Dr. Amy Divaraniya
So thank you so much for having me. I'm glad you got that little pun, with it being “oova” or “ova.” We do pronounce it “oova,” but there is the intent of having the word “ova” in there, obviously.
Dr. Robert Rountree
Right. And it's spelled O-O-V-A, just for our listeners out there –
Dr. Amy Divaraniya
Correct.
Dr. Robert Rountree
– because they can't see it on the screen. So, Amy, why don't you tell us a little bit about your origin story, as the saying goes. Like, why get a PhD in genetics and genomics? And, you know, what does that have to do with your own personal journey?
Dr. Amy Divaraniya
Yeah, I mean, if you had asked me when I was 5 years old, if I would have a PhD in genetics and genomics, I probably would have said, “No way.” My dream was to be a cardiologist. So all of my stuffed animals have a cut down their little chests, and I was always doing surgery on them. That's what I envisioned for my life. And I kind of had that trajectory all through college. It's funny because I was so hell-bent on being a cardiologist that I avoided any class that did not circulate around that arena. So no business classes, nothing on entrepreneurship, nothing. And when it came time to apply to med school, for some reason, I could never hit send on my med school application.
Dr. Robert Rountree
Your hand was frozen.
Dr. Amy Divaraniya
Yeah, it was such a weird thing because I'm so Type A. Like I always do everything with intention and I took my MCATs. I had all the recommendations. I did all the volunteer work. But I could never hit send, and it happened to me twice in my young adult career. And I was like, you know what? Maybe med school is just not for me right now. Let's go get a master's in bioinformatics. And the reason I did that was because genetics was something that was really up and coming at that time. And I always had this ability to code well. I love building sites. I love doing anything that was programmatic online and I put those two worlds together to do bioinformatics. While I was finishing up my master's degree. I got a job at Roche as a data scientist, and I was like, OK, well, that's kind of cool. I got to use all my statistics and like support a bunch of disease areas, I got involved in a lot of really cool projects. I was there for five years, and then what was really interesting was I hit a glass ceiling, and I've been so fortunate to be surrounded with the best mentors. So my boss took me out to lunch one day. He's like, “Amy, look, I want to give you a promotion, but I can't. You either need 10 years of experience or you need a PhD.”
Dr. Robert Rountree
Oh!
Dr. Amy Divaraniya
And I was only at five. So I was like, “Well, that's not fair.” And he's like, “Exactly. Invest in yourself. Go get a PhD. And then wherever you go, I'm coming.” And so I left. I did my PhD. I love this field of genetics and genomics, and I actually had two idols that I used to kind of stalk at conferences. But what's really funny is my boss that gave me this advice is actually an investor in OOVA today.
Dr. Robert Rountree
Oh, wow.
Dr. Amy Divaraniya
So he did follow me.
Dr. Robert Rountree
When you did the degree had they mapped the genome at the time? Wasn’t that before we even really knew?
Dr. Amy Divaraniya
It had been mapped, but it was an early version of it. There was still a lot of work being done. So a lot of students in my class were working on segments of the human genome to decode those regions. So it wasn't fully mapped, but there was a draft out. But the two idols that I kind of stalked through conferences were Eric Shot and Joel Dudley.
Robert Rountree
Oh, yes.
Dr. Amy Divaraniya
Both of them were at Mount Sinai. And so like I said, I do everything with intention. So I went to Mount Sinai and I was like, look, I want to do my PhD, but I want Eric and Joel to be my advisors. I want to do this project and I want to do it in three years. And they both looked at me and wrote, “Project sounds good. You can definitely be our student. You want three years, let's do it in two and a half.” And that's what we did. So it was super fun. I mean, the reason I follow those two, because they're such visionaries, honestly, their slides, their presentations were like, you were sitting there in awe. The way they were able to visualize what's going on inside of our body was just so enlightening for me. I was like, I want to do that.
Dr. Robert Rountree
I want to do that.
Dr. Amy Divaraniya
Yeah, that's what I did and my PhD… I love looking at my dissertation because the graphics are just so beautiful, and they're these like gorgeous networks of genes and pathways. And it's really interesting, but that has nothing to do with where I am today.
Dr. Robert Rountree
Uh-huh? That was just a springboard.
Dr. Amy Divaraniya
That was a springboard. Yeah. A big lesson I learned is you always want to surround yourself with folks that are smarter than you and more experienced than you, because that kind of sets that platform significantly higher for where you can go. So the reason that we're where we are today is because, like I've been saying, I'm so Type A, so I actually schedule my dissertation and then I planned when I was going to get pregnant. So I want to get pregnant or I want to deliver in nine months. We got to get pregnant now.
Dr. Robert Rountree
You had it down to the day.
Dr. Amy Divaraniya
I had it down to the day. Water needs to break on my dissertation day so I don’t have to defend. And unfortunately, that didn't happen, so we weren't able to conceive very easily. It was a pretty heartbreaking journey for us. It took us 18 months to conceive my little guy, who is the best thing that came out of our entire journey. But what it did really open up my eyes to, is just how broken the women’s health space is. I realized very quickly that for women who have irregular cycles like me, there are barely any solutions outside of invasive treatment available to them. And if you look at the fine print on any of these ovulation sticks or pregnancy tests or any of these fertility trackers, apps, whatever it may be, they always have this fine print saying that if you have irregular cycles or reproductive disorders, our results are not reliable for you.
Dr. Robert Rountree
Well, that discounts a lot of results.
Dr. Amy Divaraniya
Exactly. So I was like, well, that's great. It's like I have nothing to go off of except chance or spending $20,000 on fertility treatment. And that wasn't an avenue that I was willing to proceed. My husband and I had agreed that we did not want to go down the invasive route because of previous health issues. And I just had a really deep mistrust of the medical community. So we were like –
Dr. Robert Rountree
By invasive you mean IVF or things along those lines?
Dr. Amy Divaraniya
IUI, IVF. Any medicated treatment, I just didn't want to go through any sort of assisted reproductive treatment.
Dr. Robert Rountree
You don't want to say Clomid or those kind of drugs. Yes.
Dr. Amy Divaraniya
Yeah, I didn’t. I can tell you why. So I've always had irregular cycles. When I came out of college, my mom was like, “OK, Amy, one day you're going to want to get pregnant, get this checked out because you're going to have trouble.” And so I went to an OB and… Like, mind you I was pre-med in undergrad, so when I came out, it was right after finals. I'd been living in a library for like two-and-a-half months. I had gained the college 10, 15 pounds. I had a little bit of adult acne, and then I’m Indian. So I had dark facial hair. I didn't have time to get my eyebrows done during finals. So the doctor looked at me and basically diagnosed me with PCOS, didn't do any sort of blood work, didn’t do any sort of ultrasound or anything to see if there was anything going on internally, and put me on metformin and on birth control pills.
Dr. Robert Rountree
So he basically said, “You've got hair, irregular cycles, maybe a little visceral fat. Irregular cycles means you've got PCOS and we don't need to do any kind of testing at all. I want to put a big emphasis on that. I can look at you and tell.” Yeah. And so that assumes that all women with PCOS are the same.
Dr. Amy Divaraniya
Exactly. So we know that PCOS is so multifaceted, but the problem is there's no standard way of diagnosing. So there's basically a checklist of three things. And if you check off two, you're considered to have PCOS.
Dr. Robert Rountree
Polycystic ovary syndrome, for our readers. Yes. So you were not happy with that state of affairs?
Dr. Amy Divaraniya
I was not. But what did I know at that time? So I trusted my doctor, and I went on the metformin, and I went on the birth control pills. The birth control pills made me bleed so much that I became anemic and I didn't even have the energy to get out of bed. For someone like me who is so happy and positive, all of a sudden I was in a state of depression, and I couldn't get out of bed. My mom was so concerned. But this was my life for about three years. And I finally, like three years later, I became myself, right, I lost the weight, my face cleared up, I got my eyebrows done. I was back to my normal self and I went to a new OB, and at my intake, I said I’m on metformin I’m on this birth control, and I have PCOS. She was fantastic and did blood work on me and was like, “Why do you think you have PCOS? You don't. Your hormones are just fine.”
Dr. Robert Rountree
“I've been taking drugs for three years…”
Dr. Amy Divaraniya
Right. And they're not light drugs. Metformin can really imbalance a lot of different processes of your body. It can have a drastic impact on your overall health if you don't need it.
Dr. Robert Rountree
Especially for a young woman who's not diabetic.
Dr. Amy Divaraniya
Exactly. Right there, I developed such a mistrust for doctors who treat this part of me. And I was like, I don't want anyone to tell me how to have a baby because if my body can't do it on its own, it's not meant for me. That's kind of where my head got, and my husband was on board with it, luckily. So we started doing everything right. I was peeing on everything. I was using every app. I was just using anything I could get my hands on to understand what was going on in my cycle. And keep in mind, I'm a data scientist, so I'm literally tracking everything.
Dr. Robert Rountree
You love data!
Dr. Amy Divaraniya
I am tracking everything. And it was like incredibly devastating, not learning anything cycle after cycle, but getting negative pregnancy tests every month. And on top of that, I wasn't even getting highs or peaks on my ovulation sticks. So I was like, well, I can't not be ovulating if I'm having periods somewhat regularly. Like it's not like in 18 months, I didn't have any periods. How is it that I'm not ovulating at all? That couldn’t be right.
Dr. Robert Rountree
Just to point that out. That's how we're trained in medical school. If there's irregular cycles, that means by definition, you're not ovulating, right? Because your cycles are irregular because, you know, the ovaries are making the hormones that they make and there's no egg in there, no corpus luteum, nothing to regulate, you know? So it means you don't have enough progesterone. And so that's the end of the story. We'll just put you on synthetic progestins and you're good.
Dr. Amy Divaraniya
Exactly.
Dr. Robert Rountree
So a lot of missing pieces in that.
Dr. Amy Divaraniya
There's so many missing pieces. And on top of that, the tests I'm using are all qualitative, so they're waiting for my hormone levels to get above some arbitrary threshold to give me that positive you are ovulating or you're in your fertile window. So I just wasn't getting those positives.
Dr. Robert Rountree
And the whole cervical mucus thing, like you're going to measure how thick it is. And somehow that tells you.
Dr. Amy Divaraniya
I mean, I did it.
Dr. Robert Rountree
You did it all.
Dr. Amy Divaraniya
I did it all. And it's not fun to do that at 4 in the morning.
Dr. Robert Rountree
Yeah.
Dr. Amy Divaraniya
The mania that is associated with this, I used to travel a lot. I could forget my underwear, but I would not forget my thermometer. My thermometer had to be in my bag. And it had to be that thermometer.
Dr. Robert Rountree
The thermometer with like very small increments?
Dr. Amy Divaraniya
Correct. So I could get my basal body temperature at 4:00 in the morning every single day. So it's just incredibly mania driving this whole journey of trying to get pregnant. But then really, what happened was I was so frustrated because there was a day, it was nine months and everything with OOVA happens in nine month increments somehow. It was nine months in, and I got another negative pregnancy test. I was sobbing on my bathroom floor trying to understand like why this was negative. And I saw my reflection in my shower door, and I was like, this cannot be real life. I'm literally using my dad's 30-year-old magnifying glass, trying to find a ghost line on a test and then going to work to create these, like, amazing high-tech models to figure out what inflammatory diseases people are getting. How is this real life? I went into the lab that day and literally ranted to anyone that would listen. Why can't we use some technology to improve women's health and actually make it personalized and give women the data they need? And Joel [Dudley], who is who he is very entrepreneurial, very innovative, was like Amy, you build that. He's like, That's a good idea. You build that.
Dr. Robert Rountree
Yeah.
Dr. Amy Divaraniya
And that's really where the idea for OOVA was born.
Dr. Robert Rountree
And what was missing was the ability to do testing at home.
Dr. Amy Divaraniya
There was so many things.
Dr. Robert Rountree
Tell us what was missing.
Dr. Amy Divaraniya
There's so many things missing. There was no quantitative test, right? When I'm saying, I'm ovulating or not, I’m literally letting a blinking smiley face indicate that to me.
Dr. Robert Rountree
Yeah, or frowny face.
Dr. Amy Divaraniya
Well, no, it's either a blank circle or a smiley face or it's blinking. Yeah. So I was like that. That's the level of, like, gradations you get right? There was nothing quantitative. There was nothing personalized. So like I said, like there was this threshold that you had to hit to get a positive result. What if my hormones are imbalanced or I have irregular cycles and my hormones are completely above or always below that number? I'm going to get false positives or false negatives. I also didn't know what any of this stuff meant. So how do I put this in the context of a woman who is not medically trained, has no idea of what's going on with her body, but she should understand this process, right?
Dr. Robert Rountree
So some way to get feedback to the consumer, to the actual person for whom it matters the most.
Dr. Amy Divaraniya
Right, like, what does this mean? I got a smiley face. What do I do? Like, there's just no follow up of like what does this mean for me? And then, yes, all of it being done at home, because the only way to get that data was to go to the clinic every day for bloodwork. Who wants to do that?
Dr. Robert Rountree
Nobody.
Dr. Amy Divaraniya
Right. So you're already in this like, headspace of, like, kind of a psychosis, I want to say, because everything is just how do I get pregnant? And now you want to go to a clinic every day on top of that, no one wants to do that.
Dr. Robert Rountree
Yeah, the time, the drive, etc.
Dr. Amy Divaraniya
Exactly. There's just so many extraneous costs associated with that. And so I wanted to bring all of that in, and the most important thing was how do I get a clinician to trust those results?
Dr. Robert Rountree
Because they got to be validated. Yeah.
Dr. Amy Divaraniya
Yeah.
Dr. Robert Rountree
Because you don't want to do test and then take it in to your fertility specialist who says, Oh, I don't know, this stuff is out of left field. I don't really trust it.
Dr. Amy Divaraniya
Exactly. Yeah, exactly.
Dr. Robert Rountree
So how did that evolve?
Dr. Amy Divaraniya
Well I mean it started with a concept, so it really had all of those five components that we had to hit. And then I started building. I started asking people to help me. I started talking to doctors like, What do you need to see? What do I need to do as somebody who's trying to build a new technology in order to give you a result that you will be like, OK, I see this. This is what I'm going to do next, not push it to the side. And so it took me three years to develop OOVA and build the technology. But in those three years, I must have talked to close to 200 doctors of all different specialties because the vision for OOVA is not to just stop here. It's to really go across all the phases of a woman's life and then even beyond. So I talked to any doctor that would give me the time of day and after three years we have the technology. It took us a while to be here, but doctors are using us. We have consumers that are not working with doctors yet, using the data, getting pregnant. It's been pretty rewarding to say the least.
Dr. Robert Rountree
So if someone's going to use your testing, do they have to have a doctor involved or, you know, there's an interesting concept, I want to get pregnant, therefore I need to see a doctor.
Dr. Amy Divaraniya
Right? So they don't they don't have to have a doctor. That's the beauty of it, because we do synthesize information and let you know exactly what it means. We guide you through the process. So if you're working, if you're not working with a doctor, you can use OOVA as a standalone. But if you are, what we also allow the doctor to do is layer on their protocols and their treatments on top of our platform. So we're not creating noise for them. We’re really embedding ourselves into their standard of care.
Dr. Robert Rountree
And I should add that this is on top of a revolution in self-testing. You're in this specific arena of fertility testing, but at the same time, people are testing their adrenal function at home. People are testing to see if they've got heavy metals. People are testing to see if they've got thyroid or high cholesterol, and people are getting sleep trackers, you know, to see how well they're sleeping or what their heart rate is or the EKG. So all of a sudden, testing is consumer-centered, it's patient-centered or client-centered.
Dr. Amy Divaraniya
Agreed. And I think what all that really sheds light to is how hungry the consumer is for data and understanding their bodies. It's not having a mistrust or inability or want to talk to their doctors. It's being able to go into that doctor's office and have a two-way conversation, because typically it's you going in, you're silent, you report a couple of things. The doctor tells you this is what's wrong, this is what you have to do and you walk out.
Dr. Robert Rountree
They write you a script. Here's your Clovin.
Dr. Amy Divaraniya
Right. Like what if you can have that two-way conversation, where it's like, OK, I've been monitoring hormones for the past two months and it looks like my progesterone is not going up why do you think that is? You're asking open-ended questions versus “What's wrong with me?” And I think it's that empowerment that patients are looking for now. It's not that they don’t trust their doctors. They just want to be able to walk out of that office, not having to record everything that the doctor is saying because they have some basic understanding.
Dr. Robert Rountree
So can you give us some like general examples? You don't have to talk about specific patients, but like what might a typical person's presentation look like, and what would you find that's typically wrong that you could do an intervention for?
Dr. Amy Divaraniya
Absolutely. So I guess let's talk about the first one, who's a typical person using this? Currently, it's really any woman who's trying to understand her cycle. And if you think about it like I had irregular cycles my whole life, but I didn't really care about it until I tried to get pregnant. So by default, I think the women are trying to get pregnant. That's what they get all the more diligent but understanding what's going on. So that's predominately our user base right now. What we've been able to detect with our test. So currently we quantitatively measure LH – luteinizing hormone – and progesterone, so we can identify a woman's fertile window and then confirm if she actually released an egg that cycle.
What's been really informative for a lot of our clinicians and patients is two things. One, especially like with a patient like me, I didn't get very many positive results on ovulation sticks over the counter, but when I started using OOVA, I learned my LH surge is just on the lower side. Totally normal for my body, but not normal according to the standard that was defined by the 20-some-year-olds that are at their peak fertility, which is what all these tests are based on. So that's number one. The second thing is we've been able to detect a lot of luteal phase defects, with OOVA. So what happens here is if a woman has an LH surge and her progesterone doesn't rise effectively, it'll go up and it might come back down. It zig-zags a bit we call this the zig-zag pattern. She has ovulated, but it's just not the corpus luteum isn't forming strong enough to release enough progesterone in the steady stream. So by giving her that progesterone supplementation, we can actually carry that pregnancy at least through that risky period until the body can kind of kickstart and start creating its own progesterone. We've had so many successful pregnancies from that. Just being able to flag that within one or two days of the progesterone zigzagging.
Dr. Robert Rountree
So you're seeing a pretty good success rate, in other words.
Dr. Amy Divaraniya
Yes, we are.
Dr. Robert Rountree
Yeah, that isn’t a data-driven question. But just as a general rule, the feedback you're getting is, “Hey, you got me pregnant.”
Dr. Amy Divaraniya
Yes. I mean, those are the best cancellation emails that we get.
Dr. Robert Rountree
Yeah, “I'm not coming back. I'm having a baby.”
Dr. Amy Divaraniya
It's like, yeah, it's the best thing because we're not in it for like… And I know, like, everyone could say that they’re being altruistic, but I'm not in this for the money. I care to make sure that women don't go to the same pain that I went through and that sense of loss that I had to go through.
Dr. Robert Rountree
Oh, yeah, tough it’s tough.
Dr. Amy Divaraniya
It is.
Dr. Robert Rountree
Before we do a break, just one last question. How are these hormones collected? Is a urine, spit, blood? What does a woman do?
Dr. Amy Divaraniya
It's all urine. So it's a urine-based test, she pees on it, and scans it with her phone.
Dr. Robert Rountree
How convenient. No fingersticks.
Dr. Amy Divaraniya
No fingersticks. So you would think that urine is a really messy fluid. It's actually really hard to mess with the composition of your urine. So it's pretty predictable. We're so sensitive and we get to 97-percent sensitivity of being able to measure these two hormones. And it's so easy, like I know we're on of a podcast, but I can show you quickly.
Dr. Robert Rountree
Oh yeah, that's cool looking.
Dr. Amy Divaraniya
Yeah, there's the pee-stick, there’s a QR code, and then a window where the lines show up, and you basically align the QR code on the window with your phone. It's just like doing a mobile deposit and within seconds you get your results in your app.
Dr. Robert Rountree
So you know, you don't have to like wait for somebody to tell you how you're doing.
Dr. Amy Divaraniya
No, no.
Dr. Robert Rountree
You know yourself. Wow.
Dr. Amy Divaraniya
Yes, it's all within seconds.
Dr. Robert Rountree
Just want to point out one thing is, I know a lot of doctors that would take a woman like you've described and do one or two blood tests for progesterone. Maybe you could quickly say why urine is something you believe to be preferable to those progesterone blood tests.
Dr. Amy Divaraniya
It goes back to the convenience right. Like if you ask a doctor, they would love to have daily hormone levels and that monitoring, but having a patient come in every day for that blood work is not feasible. So if I could give you as a clinician that data noninvasively where you don’t have to deal with samples, you won’t have to mail anything out, and you can have results in real time, wouldn’t you prefer that?
Dr. Robert Rountree
Yes, so really convenient. Which is again, the whole reason behind this revolution in self-testing.
Dr. Amy Divaraniya
Right. And then the other link that we connect is once the woman gets her results in her app, if she's working with the provider, they get the results in their HIPAA compliant dashboard as well. So it's all in real-time and seamless.
Dr. Robert Rountree
Wow. Well, this is all pretty darn impressive. I have to say. I'm not a fertility specialist by any means, but on the periphery of that, certainly seen a lot of patients struggle with this. And even have to point out that I just read a book called Song of the Cell by Siddhartha Mukherjee, which is an amazing book about cell biology, and he has a whole section on fertility and how it hasn't really been taken seriously as a problem. Right. And so you're saying, well, we really need to take this seriously and let's get out there and collect some data. Yeah, terrific. Well, let's take a short break, and then when we come back we've got some questions from our community that should prod your brain a little bit and give you some interesting opportunities to talk about your understanding of this whole field.
Dr. Amy Divaraniya
Sure sounds great.
Dr. Robert Rountree
Hello, this is Dr. Robert Rountree, your host of The Thorne Podcast. Do you have a health topic you want covered or a question you want answered on the show? Then reach out to us on Instagram, and we'll try and cover it in a future episode. Also, don't forget to subscribe to the show through your favorite podcast app. Subscribing to the show enables you to stay up to date on the latest in medical research, follow the next big ideas in health and technology, and get insights from experts on common health concerns. Subscribe today through the podcast app of your choice. Thanks for listening. Now let's get back to the show.
And we're back. So now it's time to answer some questions that have come in from our community. I should say thank you all for doing that. Our first question this week comes from a listener who asked, was OOVA a startup? I'm not sure exactly what they're asking. I think they're just kind of wondering, how did you do it? How did you make it happen?
Dr. Amy Divaraniya
Well, I guess overall, yes, OOVA is a startup, this isn't a company that I generated out of work I did on my PhD or previously. It was literally an idea that I had, you could say on a napkin, as is traditionally said, And then I turned it into something tangible. Not an easy road, but I think if you're really persistent and focused on what you're trying to achieve, then you’ll hit those milestones and start seeing progress very quickly.
Dr. Robert Rountree
You make this all sound easy. Why isn't this technology more broadly used and are there other things that we can use this technology for by peeing on cartridges at home and looking for changes? So what doors are we going to see opening as a result of this kind of technology?
Dr. Amy Divaraniya
Well, I think one of the perks of being a startup is that you could pivot very quickly. But one of the drawbacks of being a startup is you have to be laser focused on one thing. See, that become a huge success and figure out how you're going to scale vertically and horizontally. So yes, like right now we started with fertility, a space that was very near and dear to my heart. I wanted to solve that problem. But where we're going is really addressing all the different phases of a woman's life. What our technology has done is we figured out how to measure biomarkers from whatever body fluid. It could be, urine, it could be spit, it could be blood, whatever it may be. And then you could scan it with your phone and get your results within seconds on the app. Now, you can apply that recipe to any biomarker that you care about. So while we're addressing fertility now, our next product is actually going to perimenopause. And we have plans to to scale into like the other phases, like the first period to last all the way to beyond, and then also start addressing men’s health, infant health, and chronic disease.
Dr. Robert Rountree
I can't you know, I'm a little bit overwhelmed by that concept of perimenopause because I cannot tell you how many thousands of women I've seen over the years that say, “Am I in perimenopause or not?” Well, you've got this definition: “Have you had a period in the last year?” I mean, that's it. You stopped having periods for a year. Now you're in menopause. Before that, you're in perimenopause, but you don't know until then. So, boy, if you can open that door by specific testing, I just think that's going to be overwhelming.
Dr. Amy Divaraniya
And that's where we’re going next.
Dr. Robert Rountree
Wow. That's great. So the next listener says, How important is it to track my cycle?
Dr. Amy Divaraniya
Well, it's kind of what you just said right now. Like, have you had a period in the past year? And that will dictate if you're in menopause or not. Tracking your cycle… It's a critical thing for women to understand. It's not always associated with trying to get pregnant. It is a critical point of your health, and it gives you a good picture of how your overall health is going. If your cycle is irregular, that might be normal for you. But there is an imbalance that is happening somewhere. Depending on what that is, you may want to get that resolved, but your cycle being irregular is the first clue that something is off. Like, I want to just be clear that tracking your cycle is not essential for just trying to get pregnant. It's critical for understanding your overall health.
Dr. Robert Rountree
Wow. So it doesn't mean if your cycles are off, it doesn't mean you have a disease, but it does mean something is not in balance.
Dr. Amy Divaraniya
Right. Like you could be very stressed out. What we see in our data is that on the holiday times, women's cycles are all over the place. Holidays are stressful. But that's an indicator, right, that your cycle is not going, not what you’re used to something is off.
Dr. Robert Rountree
I got to say. Given our current lifestyle. It's amazing that irregular cycles are not the norm.
Dr. Amy Divaraniya
But that's the thing. They actually are. So 87 percent of women have an irregular cycle
Dr. Robert Rountree
Wow. Then that is kind of the norm to be irregular. Wow. Well, that kind of feeds into the next question, which is what role did diet and exercise play in fertility testing? I would say, what role do diet and exercise and even stress play in regular cycles, right? So the two are interrelated.
Dr. Amy Divaraniya
They play a huge role. So now if we're talking about fertility specifically, if your body is battling something, right, like let's say it's very stressed or you have a high BMI and it's not healthy for your body or you have an insulin resistance, it's not going to prioritize getting pregnant. It's going to prioritize getting those factors in check before it opens up the door for you to get pregnant. So being in the best health of your that you can be in prior to getting pregnant is critical for successful pregnancy.
Dr. Robert Rountree
Would you say most fertility specialists acknowledge all this, or most of them are just focused on, say, just, but they know their main focus is what drug you know, giving you metformin and progesterone or Clomid or whatever?
Dr. Amy Divaraniya
I think it depends on your doctor. Right. Like there are so many clinicians that do look at women holistically and are like, “Look like we need to get your BMI in check in order for this round of IVF to be successful,” or like, “OK, look, everything was done properly on the medical side. Here are some lifestyle changes that we can make to help optimize that same medical protocol.” I think there's a lot more acceptance of being a little bit more holistic in treatment, but I will say it's not the same across the board. So if you are going down that road of fertility treatments, definitely find a doctor that aligns with you. So this is important to you that you should definitely find a doctor that accepts this as something that's viable in your treatment plan.
Dr. Robert Rountree
Great piece of advice. I think if a woman starts to use your tests and then brings it to the doctor and the doctor says, I don't want to hear it, then you find another doctor, right? Because this is solid. This is legitimate science and solid science. So, you know, that shouldn't be an issue for any doctor.
Dr. Amy Divaraniya
Correct.
Dr. Robert Rountree
So what areas of “femtech,” I guess, technology oriented towards women, what areas need to see the most growth? What's missing now?
Dr. Amy Divaraniya
So if you do look at things like maps of companies in the femtech space, like the fertility space is like super crowded, but they're just crowded with brands, not solutions. And if you look at that map and you look at all the different players, there's a lot of communities, there's a lot of brands, but there's very few solutions. And I think what's really missing is the data. Understanding who a woman is and what is unique about her and being able to treat her – not a population or a market – treat the patient. So what we're really prioritizing at OOVA is getting accurate and solid data to be able to create these models, to provide insights to women overall and being able to segment them out by demographic and give them the insights that they need to really achieve whatever their health goal is.
Dr. Robert Rountree
So a big part of that data is making it convenient and easy to collect that data right?
Dr. Amy Divaraniya
Correct. I mean, it's funny because I come from it, but that's exactly it. I come from a genomics background where I used to seeing sparse data. You'd never have a full data set when your dealing with genomics, but with OOVA this is a dream data set to work with because you're never going to find a more diligent woman to use a product correctly than someone who is trying to get pregnant.
Dr. Robert Rountree
She's motivated.
Dr. Amy Divaraniya
The insights that we're gleaning from our data is they're just so fantastic, and I’m excited for what we can do in other spaces like perimenopause and a lot of underserved areas of women's health.
Dr. Robert Rountree
You know, you've already kind of mentioned this or alluded to it in passing, but do you have advice for new entrepreneurs that are looking to make products targeted at helping women? I assume that's products like a dietary supplement or timers, little reminders. “You need to have sex today." You know, if you want to have a baby, time for a romantic evening.” So what kind of advice would you have?
Dr. Amy Divaraniya
The biggest piece of advice that I would give, because I found this to be the most helpful on my side is to be a sponge, talk to people like don't have walls up, be very receptive and open to feedback and new ideas because you never know what shiny nugget someone's going to say that's going to take your idea to the next level. I go to the point of I'm actually answering customer support tickets to understand what their pain points are so we can make sure we're building something that women want. So I think it's really important to be a sponge and don't walk in with an ego saying like, “OK, my solution is the best one in the room.” You need to figure out how to make it work for you. No, figure out how to make your solution work for the majority of people in the room.
Dr. Robert Rountree
Great. That's wonderful advice. And you've offered us some amazing insights over this podcast. So that's all the time we have this week. So, Dr. Amy, thanks so much for coming on the podcast. If people want to follow your work, you know, I guess if they want to find out about OOVA for sure, then where do they go? What's the link?
Dr. Amy Divaraniya
They could go to our website, which is www.oova.life. That's O-O-V-A dot L-I-F-E. Or you can follow us on all social channels @oovalife.
Dr. Robert Rountree
So that's the best way to keep track of what's happening next. All right. Thank you, everyone, as always. Until next time, we will have another podcast that expands this topic. So, stay tuned.
Thanks for listening to The Thorne Podcast. Make sure to never miss an episode by subscribing to the show on your podcast app of choice. If you've got a health or wellness question you'd like answered, simply follow our Instagram and shoot a message to @thornehealth. You can also learn more about the topics we discussed by visiting Thorne.com and checking out the latest news, videos and stories on Thorne’s Take 5 Daily blog. Once again, thanks for tuning in and don't forget to join us next time for another episode of The Thorne Podcast.
Dr. Robert Rountree
This is The Thorne Podcast, the show that navigates the complex world of wellness and explores the latest science behind diet supplements and lifestyle approaches to good health. I'm Dr. Robert Rountree, chief medical advisor at Thorne and Functional Medicine Doctor. As a reminder, the recommendations made in this podcast are the recommendations of the individuals who express them and not the recommendations of Thorne. Statements in this podcast have not been evaluated by the Food and Drug Administration. Any products mentioned are not intended to diagnose, treat, cure, or prevent any disease.
Dr. Robert Rountree
Hi everyone, and welcome to The Thorne Podcast. This is Dr. Bob Rountree, back with you again. This week we're going to be speaking to Dr. Amy Divaraniya. She's an entrepreneur and a scientist. She has a PhD in genetics and genomic sciences, which she's going to talk about with us, and we're going to talk about solving challenges in the field of fertility and women's health through her company, OOVA. Am I right on that – “oova” or “ova”? Because I'm tempted to say “ova.” She's the CEO and founder, so welcome to the show, Amy.
Dr. Amy Divaraniya
So thank you so much for having me. I'm glad you got that little pun, with it being “oova” or “ova.” We do pronounce it “oova,” but there is the intent of having the word “ova” in there, obviously.
Dr. Robert Rountree
Right. And it's spelled O-O-V-A, just for our listeners out there –
Dr. Amy Divaraniya
Correct.
Dr. Robert Rountree
– because they can't see it on the screen. So, Amy, why don't you tell us a little bit about your origin story, as the saying goes. Like, why get a PhD in genetics and genomics? And, you know, what does that have to do with your own personal journey?
Dr. Amy Divaraniya
Yeah, I mean, if you had asked me when I was 5 years old, if I would have a PhD in genetics and genomics, I probably would have said, “No way.” My dream was to be a cardiologist. So all of my stuffed animals have a cut down their little chests, and I was always doing surgery on them. That's what I envisioned for my life. And I kind of had that trajectory all through college. It's funny because I was so hell-bent on being a cardiologist that I avoided any class that did not circulate around that arena. So no business classes, nothing on entrepreneurship, nothing. And when it came time to apply to med school, for some reason, I could never hit send on my med school application.
Dr. Robert Rountree
Your hand was frozen.
Dr. Amy Divaraniya
Yeah, it was such a weird thing because I'm so Type A. Like I always do everything with intention and I took my MCATs. I had all the recommendations. I did all the volunteer work. But I could never hit send, and it happened to me twice in my young adult career. And I was like, you know what? Maybe med school is just not for me right now. Let's go get a master's in bioinformatics. And the reason I did that was because genetics was something that was really up and coming at that time. And I always had this ability to code well. I love building sites. I love doing anything that was programmatic online and I put those two worlds together to do bioinformatics. While I was finishing up my master's degree. I got a job at Roche as a data scientist, and I was like, OK, well, that's kind of cool. I got to use all my statistics and like support a bunch of disease areas, I got involved in a lot of really cool projects. I was there for five years, and then what was really interesting was I hit a glass ceiling, and I've been so fortunate to be surrounded with the best mentors. So my boss took me out to lunch one day. He's like, “Amy, look, I want to give you a promotion, but I can't. You either need 10 years of experience or you need a PhD.”
Dr. Robert Rountree
Oh!
Dr. Amy Divaraniya
And I was only at five. So I was like, “Well, that's not fair.” And he's like, “Exactly. Invest in yourself. Go get a PhD. And then wherever you go, I'm coming.” And so I left. I did my PhD. I love this field of genetics and genomics, and I actually had two idols that I used to kind of stalk at conferences. But what's really funny is my boss that gave me this advice is actually an investor in OOVA today.
Dr. Robert Rountree
Oh, wow.
Dr. Amy Divaraniya
So he did follow me.
Dr. Robert Rountree
When you did the degree had they mapped the genome at the time? Wasn’t that before we even really knew?
Dr. Amy Divaraniya
It had been mapped, but it was an early version of it. There was still a lot of work being done. So a lot of students in my class were working on segments of the human genome to decode those regions. So it wasn't fully mapped, but there was a draft out. But the two idols that I kind of stalked through conferences were Eric Shot and Joel Dudley.
Robert Rountree
Oh, yes.
Dr. Amy Divaraniya
Both of them were at Mount Sinai. And so like I said, I do everything with intention. So I went to Mount Sinai and I was like, look, I want to do my PhD, but I want Eric and Joel to be my advisors. I want to do this project and I want to do it in three years. And they both looked at me and wrote, “Project sounds good. You can definitely be our student. You want three years, let's do it in two and a half.” And that's what we did. So it was super fun. I mean, the reason I follow those two, because they're such visionaries, honestly, their slides, their presentations were like, you were sitting there in awe. The way they were able to visualize what's going on inside of our body was just so enlightening for me. I was like, I want to do that.
Dr. Robert Rountree
I want to do that.
Dr. Amy Divaraniya
Yeah, that's what I did and my PhD… I love looking at my dissertation because the graphics are just so beautiful, and they're these like gorgeous networks of genes and pathways. And it's really interesting, but that has nothing to do with where I am today.
Dr. Robert Rountree
Uh-huh? That was just a springboard.
Dr. Amy Divaraniya
That was a springboard. Yeah. A big lesson I learned is you always want to surround yourself with folks that are smarter than you and more experienced than you, because that kind of sets that platform significantly higher for where you can go. So the reason that we're where we are today is because, like I've been saying, I'm so Type A, so I actually schedule my dissertation and then I planned when I was going to get pregnant. So I want to get pregnant or I want to deliver in nine months. We got to get pregnant now.
Dr. Robert Rountree
You had it down to the day.
Dr. Amy Divaraniya
I had it down to the day. Water needs to break on my dissertation day so I don’t have to defend. And unfortunately, that didn't happen, so we weren't able to conceive very easily. It was a pretty heartbreaking journey for us. It took us 18 months to conceive my little guy, who is the best thing that came out of our entire journey. But what it did really open up my eyes to, is just how broken the women’s health space is. I realized very quickly that for women who have irregular cycles like me, there are barely any solutions outside of invasive treatment available to them. And if you look at the fine print on any of these ovulation sticks or pregnancy tests or any of these fertility trackers, apps, whatever it may be, they always have this fine print saying that if you have irregular cycles or reproductive disorders, our results are not reliable for you.
Dr. Robert Rountree
Well, that discounts a lot of results.
Dr. Amy Divaraniya
Exactly. So I was like, well, that's great. It's like I have nothing to go off of except chance or spending $20,000 on fertility treatment. And that wasn't an avenue that I was willing to proceed. My husband and I had agreed that we did not want to go down the invasive route because of previous health issues. And I just had a really deep mistrust of the medical community. So we were like –
Dr. Robert Rountree
By invasive you mean IVF or things along those lines?
Dr. Amy Divaraniya
IUI, IVF. Any medicated treatment, I just didn't want to go through any sort of assisted reproductive treatment.
Dr. Robert Rountree
You don't want to say Clomid or those kind of drugs. Yes.
Dr. Amy Divaraniya
Yeah, I didn’t. I can tell you why. So I've always had irregular cycles. When I came out of college, my mom was like, “OK, Amy, one day you're going to want to get pregnant, get this checked out because you're going to have trouble.” And so I went to an OB and… Like, mind you I was pre-med in undergrad, so when I came out, it was right after finals. I'd been living in a library for like two-and-a-half months. I had gained the college 10, 15 pounds. I had a little bit of adult acne, and then I’m Indian. So I had dark facial hair. I didn't have time to get my eyebrows done during finals. So the doctor looked at me and basically diagnosed me with PCOS, didn't do any sort of blood work, didn’t do any sort of ultrasound or anything to see if there was anything going on internally, and put me on metformin and on birth control pills.
Dr. Robert Rountree
So he basically said, “You've got hair, irregular cycles, maybe a little visceral fat. Irregular cycles means you've got PCOS and we don't need to do any kind of testing at all. I want to put a big emphasis on that. I can look at you and tell.” Yeah. And so that assumes that all women with PCOS are the same.
Dr. Amy Divaraniya
Exactly. So we know that PCOS is so multifaceted, but the problem is there's no standard way of diagnosing. So there's basically a checklist of three things. And if you check off two, you're considered to have PCOS.
Dr. Robert Rountree
Polycystic ovary syndrome, for our readers. Yes. So you were not happy with that state of affairs?
Dr. Amy Divaraniya
I was not. But what did I know at that time? So I trusted my doctor, and I went on the metformin, and I went on the birth control pills. The birth control pills made me bleed so much that I became anemic and I didn't even have the energy to get out of bed. For someone like me who is so happy and positive, all of a sudden I was in a state of depression, and I couldn't get out of bed. My mom was so concerned. But this was my life for about three years. And I finally, like three years later, I became myself, right, I lost the weight, my face cleared up, I got my eyebrows done. I was back to my normal self and I went to a new OB, and at my intake, I said I’m on metformin I’m on this birth control, and I have PCOS. She was fantastic and did blood work on me and was like, “Why do you think you have PCOS? You don't. Your hormones are just fine.”
Dr. Robert Rountree
“I've been taking drugs for three years…”
Dr. Amy Divaraniya
Right. And they're not light drugs. Metformin can really imbalance a lot of different processes of your body. It can have a drastic impact on your overall health if you don't need it.
Dr. Robert Rountree
Especially for a young woman who's not diabetic.
Dr. Amy Divaraniya
Exactly. Right there, I developed such a mistrust for doctors who treat this part of me. And I was like, I don't want anyone to tell me how to have a baby because if my body can't do it on its own, it's not meant for me. That's kind of where my head got, and my husband was on board with it, luckily. So we started doing everything right. I was peeing on everything. I was using every app. I was just using anything I could get my hands on to understand what was going on in my cycle. And keep in mind, I'm a data scientist, so I'm literally tracking everything.
Dr. Robert Rountree
You love data!
Dr. Amy Divaraniya
I am tracking everything. And it was like incredibly devastating, not learning anything cycle after cycle, but getting negative pregnancy tests every month. And on top of that, I wasn't even getting highs or peaks on my ovulation sticks. So I was like, well, I can't not be ovulating if I'm having periods somewhat regularly. Like it's not like in 18 months, I didn't have any periods. How is it that I'm not ovulating at all? That couldn’t be right.
Dr. Robert Rountree
Just to point that out. That's how we're trained in medical school. If there's irregular cycles, that means by definition, you're not ovulating, right? Because your cycles are irregular because, you know, the ovaries are making the hormones that they make and there's no egg in there, no corpus luteum, nothing to regulate, you know? So it means you don't have enough progesterone. And so that's the end of the story. We'll just put you on synthetic progestins and you're good.
Dr. Amy Divaraniya
Exactly.
Dr. Robert Rountree
So a lot of missing pieces in that.
Dr. Amy Divaraniya
There's so many missing pieces. And on top of that, the tests I'm using are all qualitative, so they're waiting for my hormone levels to get above some arbitrary threshold to give me that positive you are ovulating or you're in your fertile window. So I just wasn't getting those positives.
Dr. Robert Rountree
And the whole cervical mucus thing, like you're going to measure how thick it is. And somehow that tells you.
Dr. Amy Divaraniya
I mean, I did it.
Dr. Robert Rountree
You did it all.
Dr. Amy Divaraniya
I did it all. And it's not fun to do that at 4 in the morning.
Dr. Robert Rountree
Yeah.
Dr. Amy Divaraniya
The mania that is associated with this, I used to travel a lot. I could forget my underwear, but I would not forget my thermometer. My thermometer had to be in my bag. And it had to be that thermometer.
Dr. Robert Rountree
The thermometer with like very small increments?
Dr. Amy Divaraniya
Correct. So I could get my basal body temperature at 4:00 in the morning every single day. So it's just incredibly mania driving this whole journey of trying to get pregnant. But then really, what happened was I was so frustrated because there was a day, it was nine months and everything with OOVA happens in nine month increments somehow. It was nine months in, and I got another negative pregnancy test. I was sobbing on my bathroom floor trying to understand like why this was negative. And I saw my reflection in my shower door, and I was like, this cannot be real life. I'm literally using my dad's 30-year-old magnifying glass, trying to find a ghost line on a test and then going to work to create these, like, amazing high-tech models to figure out what inflammatory diseases people are getting. How is this real life? I went into the lab that day and literally ranted to anyone that would listen. Why can't we use some technology to improve women's health and actually make it personalized and give women the data they need? And Joel [Dudley], who is who he is very entrepreneurial, very innovative, was like Amy, you build that. He's like, That's a good idea. You build that.
Dr. Robert Rountree
Yeah.
Dr. Amy Divaraniya
And that's really where the idea for OOVA was born.
Dr. Robert Rountree
And what was missing was the ability to do testing at home.
Dr. Amy Divaraniya
There was so many things.
Dr. Robert Rountree
Tell us what was missing.
Dr. Amy Divaraniya
There's so many things missing. There was no quantitative test, right? When I'm saying, I'm ovulating or not, I’m literally letting a blinking smiley face indicate that to me.
Dr. Robert Rountree
Yeah, or frowny face.
Dr. Amy Divaraniya
Well, no, it's either a blank circle or a smiley face or it's blinking. Yeah. So I was like that. That's the level of, like, gradations you get right? There was nothing quantitative. There was nothing personalized. So like I said, like there was this threshold that you had to hit to get a positive result. What if my hormones are imbalanced or I have irregular cycles and my hormones are completely above or always below that number? I'm going to get false positives or false negatives. I also didn't know what any of this stuff meant. So how do I put this in the context of a woman who is not medically trained, has no idea of what's going on with her body, but she should understand this process, right?
Dr. Robert Rountree
So some way to get feedback to the consumer, to the actual person for whom it matters the most.
Dr. Amy Divaraniya
Right, like, what does this mean? I got a smiley face. What do I do? Like, there's just no follow up of like what does this mean for me? And then, yes, all of it being done at home, because the only way to get that data was to go to the clinic every day for bloodwork. Who wants to do that?
Dr. Robert Rountree
Nobody.
Dr. Amy Divaraniya
Right. So you're already in this like, headspace of, like, kind of a psychosis, I want to say, because everything is just how do I get pregnant? And now you want to go to a clinic every day on top of that, no one wants to do that.
Dr. Robert Rountree
Yeah, the time, the drive, etc.
Dr. Amy Divaraniya
Exactly. There's just so many extraneous costs associated with that. And so I wanted to bring all of that in, and the most important thing was how do I get a clinician to trust those results?
Dr. Robert Rountree
Because they got to be validated. Yeah.
Dr. Amy Divaraniya
Yeah.
Dr. Robert Rountree
Because you don't want to do test and then take it in to your fertility specialist who says, Oh, I don't know, this stuff is out of left field. I don't really trust it.
Dr. Amy Divaraniya
Exactly. Yeah, exactly.
Dr. Robert Rountree
So how did that evolve?
Dr. Amy Divaraniya
Well I mean it started with a concept, so it really had all of those five components that we had to hit. And then I started building. I started asking people to help me. I started talking to doctors like, What do you need to see? What do I need to do as somebody who's trying to build a new technology in order to give you a result that you will be like, OK, I see this. This is what I'm going to do next, not push it to the side. And so it took me three years to develop OOVA and build the technology. But in those three years, I must have talked to close to 200 doctors of all different specialties because the vision for OOVA is not to just stop here. It's to really go across all the phases of a woman's life and then even beyond. So I talked to any doctor that would give me the time of day and after three years we have the technology. It took us a while to be here, but doctors are using us. We have consumers that are not working with doctors yet, using the data, getting pregnant. It's been pretty rewarding to say the least.
Dr. Robert Rountree
So if someone's going to use your testing, do they have to have a doctor involved or, you know, there's an interesting concept, I want to get pregnant, therefore I need to see a doctor.
Dr. Amy Divaraniya
Right? So they don't they don't have to have a doctor. That's the beauty of it, because we do synthesize information and let you know exactly what it means. We guide you through the process. So if you're working, if you're not working with a doctor, you can use OOVA as a standalone. But if you are, what we also allow the doctor to do is layer on their protocols and their treatments on top of our platform. So we're not creating noise for them. We’re really embedding ourselves into their standard of care.
Dr. Robert Rountree
And I should add that this is on top of a revolution in self-testing. You're in this specific arena of fertility testing, but at the same time, people are testing their adrenal function at home. People are testing to see if they've got heavy metals. People are testing to see if they've got thyroid or high cholesterol, and people are getting sleep trackers, you know, to see how well they're sleeping or what their heart rate is or the EKG. So all of a sudden, testing is consumer-centered, it's patient-centered or client-centered.
Dr. Amy Divaraniya
Agreed. And I think what all that really sheds light to is how hungry the consumer is for data and understanding their bodies. It's not having a mistrust or inability or want to talk to their doctors. It's being able to go into that doctor's office and have a two-way conversation, because typically it's you going in, you're silent, you report a couple of things. The doctor tells you this is what's wrong, this is what you have to do and you walk out.
Dr. Robert Rountree
They write you a script. Here's your Clovin.
Dr. Amy Divaraniya
Right. Like what if you can have that two-way conversation, where it's like, OK, I've been monitoring hormones for the past two months and it looks like my progesterone is not going up why do you think that is? You're asking open-ended questions versus “What's wrong with me?” And I think it's that empowerment that patients are looking for now. It's not that they don’t trust their doctors. They just want to be able to walk out of that office, not having to record everything that the doctor is saying because they have some basic understanding.
Dr. Robert Rountree
So can you give us some like general examples? You don't have to talk about specific patients, but like what might a typical person's presentation look like, and what would you find that's typically wrong that you could do an intervention for?
Dr. Amy Divaraniya
Absolutely. So I guess let's talk about the first one, who's a typical person using this? Currently, it's really any woman who's trying to understand her cycle. And if you think about it like I had irregular cycles my whole life, but I didn't really care about it until I tried to get pregnant. So by default, I think the women are trying to get pregnant. That's what they get all the more diligent but understanding what's going on. So that's predominately our user base right now. What we've been able to detect with our test. So currently we quantitatively measure LH – luteinizing hormone – and progesterone, so we can identify a woman's fertile window and then confirm if she actually released an egg that cycle.
What's been really informative for a lot of our clinicians and patients is two things. One, especially like with a patient like me, I didn't get very many positive results on ovulation sticks over the counter, but when I started using OOVA, I learned my LH surge is just on the lower side. Totally normal for my body, but not normal according to the standard that was defined by the 20-some-year-olds that are at their peak fertility, which is what all these tests are based on. So that's number one. The second thing is we've been able to detect a lot of luteal phase defects, with OOVA. So what happens here is if a woman has an LH surge and her progesterone doesn't rise effectively, it'll go up and it might come back down. It zig-zags a bit we call this the zig-zag pattern. She has ovulated, but it's just not the corpus luteum isn't forming strong enough to release enough progesterone in the steady stream. So by giving her that progesterone supplementation, we can actually carry that pregnancy at least through that risky period until the body can kind of kickstart and start creating its own progesterone. We've had so many successful pregnancies from that. Just being able to flag that within one or two days of the progesterone zigzagging.
Dr. Robert Rountree
So you're seeing a pretty good success rate, in other words.
Dr. Amy Divaraniya
Yes, we are.
Dr. Robert Rountree
Yeah, that isn’t a data-driven question. But just as a general rule, the feedback you're getting is, “Hey, you got me pregnant.”
Dr. Amy Divaraniya
Yes. I mean, those are the best cancellation emails that we get.
Dr. Robert Rountree
Yeah, “I'm not coming back. I'm having a baby.”
Dr. Amy Divaraniya
It's like, yeah, it's the best thing because we're not in it for like… And I know, like, everyone could say that they’re being altruistic, but I'm not in this for the money. I care to make sure that women don't go to the same pain that I went through and that sense of loss that I had to go through.
Dr. Robert Rountree
Oh, yeah, tough it’s tough.
Dr. Amy Divaraniya
It is.
Dr. Robert Rountree
Before we do a break, just one last question. How are these hormones collected? Is a urine, spit, blood? What does a woman do?
Dr. Amy Divaraniya
It's all urine. So it's a urine-based test, she pees on it, and scans it with her phone.
Dr. Robert Rountree
How convenient. No fingersticks.
Dr. Amy Divaraniya
No fingersticks. So you would think that urine is a really messy fluid. It's actually really hard to mess with the composition of your urine. So it's pretty predictable. We're so sensitive and we get to 97-percent sensitivity of being able to measure these two hormones. And it's so easy, like I know we're on of a podcast, but I can show you quickly.
Dr. Robert Rountree
Oh yeah, that's cool looking.
Dr. Amy Divaraniya
Yeah, there's the pee-stick, there’s a QR code, and then a window where the lines show up, and you basically align the QR code on the window with your phone. It's just like doing a mobile deposit and within seconds you get your results in your app.
Dr. Robert Rountree
So you know, you don't have to like wait for somebody to tell you how you're doing.
Dr. Amy Divaraniya
No, no.
Dr. Robert Rountree
You know yourself. Wow.
Dr. Amy Divaraniya
Yes, it's all within seconds.
Dr. Robert Rountree
Just want to point out one thing is, I know a lot of doctors that would take a woman like you've described and do one or two blood tests for progesterone. Maybe you could quickly say why urine is something you believe to be preferable to those progesterone blood tests.
Dr. Amy Divaraniya
It goes back to the convenience right. Like if you ask a doctor, they would love to have daily hormone levels and that monitoring, but having a patient come in every day for that blood work is not feasible. So if I could give you as a clinician that data noninvasively where you don’t have to deal with samples, you won’t have to mail anything out, and you can have results in real time, wouldn’t you prefer that?
Dr. Robert Rountree
Yes, so really convenient. Which is again, the whole reason behind this revolution in self-testing.
Dr. Amy Divaraniya
Right. And then the other link that we connect is once the woman gets her results in her app, if she's working with the provider, they get the results in their HIPAA compliant dashboard as well. So it's all in real-time and seamless.
Dr. Robert Rountree
Wow. Well, this is all pretty darn impressive. I have to say. I'm not a fertility specialist by any means, but on the periphery of that, certainly seen a lot of patients struggle with this. And even have to point out that I just read a book called Song of the Cell by Siddhartha Mukherjee, which is an amazing book about cell biology, and he has a whole section on fertility and how it hasn't really been taken seriously as a problem. Right. And so you're saying, well, we really need to take this seriously and let's get out there and collect some data. Yeah, terrific. Well, let's take a short break, and then when we come back we've got some questions from our community that should prod your brain a little bit and give you some interesting opportunities to talk about your understanding of this whole field.
Dr. Amy Divaraniya
Sure sounds great.
Dr. Robert Rountree
Hello, this is Dr. Robert Rountree, your host of The Thorne Podcast. Do you have a health topic you want covered or a question you want answered on the show? Then reach out to us on Instagram, and we'll try and cover it in a future episode. Also, don't forget to subscribe to the show through your favorite podcast app. Subscribing to the show enables you to stay up to date on the latest in medical research, follow the next big ideas in health and technology, and get insights from experts on common health concerns. Subscribe today through the podcast app of your choice. Thanks for listening. Now let's get back to the show.
And we're back. So now it's time to answer some questions that have come in from our community. I should say thank you all for doing that. Our first question this week comes from a listener who asked, was OOVA a startup? I'm not sure exactly what they're asking. I think they're just kind of wondering, how did you do it? How did you make it happen?
Dr. Amy Divaraniya
Well, I guess overall, yes, OOVA is a startup, this isn't a company that I generated out of work I did on my PhD or previously. It was literally an idea that I had, you could say on a napkin, as is traditionally said, And then I turned it into something tangible. Not an easy road, but I think if you're really persistent and focused on what you're trying to achieve, then you’ll hit those milestones and start seeing progress very quickly.
Dr. Robert Rountree
You make this all sound easy. Why isn't this technology more broadly used and are there other things that we can use this technology for by peeing on cartridges at home and looking for changes? So what doors are we going to see opening as a result of this kind of technology?
Dr. Amy Divaraniya
Well, I think one of the perks of being a startup is that you could pivot very quickly. But one of the drawbacks of being a startup is you have to be laser focused on one thing. See, that become a huge success and figure out how you're going to scale vertically and horizontally. So yes, like right now we started with fertility, a space that was very near and dear to my heart. I wanted to solve that problem. But where we're going is really addressing all the different phases of a woman's life. What our technology has done is we figured out how to measure biomarkers from whatever body fluid. It could be, urine, it could be spit, it could be blood, whatever it may be. And then you could scan it with your phone and get your results within seconds on the app. Now, you can apply that recipe to any biomarker that you care about. So while we're addressing fertility now, our next product is actually going to perimenopause. And we have plans to to scale into like the other phases, like the first period to last all the way to beyond, and then also start addressing men’s health, infant health, and chronic disease.
Dr. Robert Rountree
I can't you know, I'm a little bit overwhelmed by that concept of perimenopause because I cannot tell you how many thousands of women I've seen over the years that say, “Am I in perimenopause or not?” Well, you've got this definition: “Have you had a period in the last year?” I mean, that's it. You stopped having periods for a year. Now you're in menopause. Before that, you're in perimenopause, but you don't know until then. So, boy, if you can open that door by specific testing, I just think that's going to be overwhelming.
Dr. Amy Divaraniya
And that's where we’re going next.
Dr. Robert Rountree
Wow. That's great. So the next listener says, How important is it to track my cycle?
Dr. Amy Divaraniya
Well, it's kind of what you just said right now. Like, have you had a period in the past year? And that will dictate if you're in menopause or not. Tracking your cycle… It's a critical thing for women to understand. It's not always associated with trying to get pregnant. It is a critical point of your health, and it gives you a good picture of how your overall health is going. If your cycle is irregular, that might be normal for you. But there is an imbalance that is happening somewhere. Depending on what that is, you may want to get that resolved, but your cycle being irregular is the first clue that something is off. Like, I want to just be clear that tracking your cycle is not essential for just trying to get pregnant. It's critical for understanding your overall health.
Dr. Robert Rountree
Wow. So it doesn't mean if your cycles are off, it doesn't mean you have a disease, but it does mean something is not in balance.
Dr. Amy Divaraniya
Right. Like you could be very stressed out. What we see in our data is that on the holiday times, women's cycles are all over the place. Holidays are stressful. But that's an indicator, right, that your cycle is not going, not what you’re used to something is off.
Dr. Robert Rountree
I got to say. Given our current lifestyle. It's amazing that irregular cycles are not the norm.
Dr. Amy Divaraniya
But that's the thing. They actually are. So 87 percent of women have an irregular cycle
Dr. Robert Rountree
Wow. Then that is kind of the norm to be irregular. Wow. Well, that kind of feeds into the next question, which is what role did diet and exercise play in fertility testing? I would say, what role do diet and exercise and even stress play in regular cycles, right? So the two are interrelated.
Dr. Amy Divaraniya
They play a huge role. So now if we're talking about fertility specifically, if your body is battling something, right, like let's say it's very stressed or you have a high BMI and it's not healthy for your body or you have an insulin resistance, it's not going to prioritize getting pregnant. It's going to prioritize getting those factors in check before it opens up the door for you to get pregnant. So being in the best health of your that you can be in prior to getting pregnant is critical for successful pregnancy.
Dr. Robert Rountree
Would you say most fertility specialists acknowledge all this, or most of them are just focused on, say, just, but they know their main focus is what drug you know, giving you metformin and progesterone or Clomid or whatever?
Dr. Amy Divaraniya
I think it depends on your doctor. Right. Like there are so many clinicians that do look at women holistically and are like, “Look like we need to get your BMI in check in order for this round of IVF to be successful,” or like, “OK, look, everything was done properly on the medical side. Here are some lifestyle changes that we can make to help optimize that same medical protocol.” I think there's a lot more acceptance of being a little bit more holistic in treatment, but I will say it's not the same across the board. So if you are going down that road of fertility treatments, definitely find a doctor that aligns with you. So this is important to you that you should definitely find a doctor that accepts this as something that's viable in your treatment plan.
Dr. Robert Rountree
Great piece of advice. I think if a woman starts to use your tests and then brings it to the doctor and the doctor says, I don't want to hear it, then you find another doctor, right? Because this is solid. This is legitimate science and solid science. So, you know, that shouldn't be an issue for any doctor.
Dr. Amy Divaraniya
Correct.
Dr. Robert Rountree
So what areas of “femtech,” I guess, technology oriented towards women, what areas need to see the most growth? What's missing now?
Dr. Amy Divaraniya
So if you do look at things like maps of companies in the femtech space, like the fertility space is like super crowded, but they're just crowded with brands, not solutions. And if you look at that map and you look at all the different players, there's a lot of communities, there's a lot of brands, but there's very few solutions. And I think what's really missing is the data. Understanding who a woman is and what is unique about her and being able to treat her – not a population or a market – treat the patient. So what we're really prioritizing at OOVA is getting accurate and solid data to be able to create these models, to provide insights to women overall and being able to segment them out by demographic and give them the insights that they need to really achieve whatever their health goal is.
Dr. Robert Rountree
So a big part of that data is making it convenient and easy to collect that data right?
Dr. Amy Divaraniya
Correct. I mean, it's funny because I come from it, but that's exactly it. I come from a genomics background where I used to seeing sparse data. You'd never have a full data set when your dealing with genomics, but with OOVA this is a dream data set to work with because you're never going to find a more diligent woman to use a product correctly than someone who is trying to get pregnant.
Dr. Robert Rountree
She's motivated.
Dr. Amy Divaraniya
The insights that we're gleaning from our data is they're just so fantastic, and I’m excited for what we can do in other spaces like perimenopause and a lot of underserved areas of women's health.
Dr. Robert Rountree
You know, you've already kind of mentioned this or alluded to it in passing, but do you have advice for new entrepreneurs that are looking to make products targeted at helping women? I assume that's products like a dietary supplement or timers, little reminders. “You need to have sex today." You know, if you want to have a baby, time for a romantic evening.” So what kind of advice would you have?
Dr. Amy Divaraniya
The biggest piece of advice that I would give, because I found this to be the most helpful on my side is to be a sponge, talk to people like don't have walls up, be very receptive and open to feedback and new ideas because you never know what shiny nugget someone's going to say that's going to take your idea to the next level. I go to the point of I'm actually answering customer support tickets to understand what their pain points are so we can make sure we're building something that women want. So I think it's really important to be a sponge and don't walk in with an ego saying like, “OK, my solution is the best one in the room.” You need to figure out how to make it work for you. No, figure out how to make your solution work for the majority of people in the room.
Dr. Robert Rountree
Great. That's wonderful advice. And you've offered us some amazing insights over this podcast. So that's all the time we have this week. So, Dr. Amy, thanks so much for coming on the podcast. If people want to follow your work, you know, I guess if they want to find out about OOVA for sure, then where do they go? What's the link?
Dr. Amy Divaraniya
They could go to our website, which is www.oova.life. That's O-O-V-A dot L-I-F-E. Or you can follow us on all social channels @oovalife.
Dr. Robert Rountree
So that's the best way to keep track of what's happening next. All right. Thank you, everyone, as always. Until next time, we will have another podcast that expands this topic. So, stay tuned.
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