Did you know that someday understanding your health might be as easy as peeing in the toilet? While we will have to wait to see how those “futuristic toilet sensors” play out, it is true that understanding fertility and women’s health is becoming much more accessible thanks to “femtech,” new pieces of technology (and AI) designed to provide a comprehensive picture of women’s health. Though early femtech options mainly consisted of basal body thermometers (including wearable ones like the TempDrop), there are also promising new machines and devices that do even more to measure and track the various biomarkers of female reproductive health. Here’s a brief rundown of the most popular ones.
Mira
Mira is distinctive in the femtech world because it is basically a hormone lab in your own home, utilizing the same technology as a professional lab to identify even the smallest changes in hormone levels. It tracks your changing hormones throughout your cycle via urine samples —perhaps consider it the “2.0 version” of the ClearBlue fertility monitor that the Marquette Method was designed around. While the ClearBlue monitor gives qualitative values, aka ‘Low’ or “High’ or ‘Peak’ to reflect levels of fertility, Mira gives quantitative values—aka actual numbers—concerning the amounts of a few key reproductive hormones across the cycle.
Mira includes a monitor (or “analyzer”) and a bundle of wands that detect E3G (a metabolite of estrogen), LH (the luteinizing hormone), and PdG (the urine metabolite of progesterone). The “Clarity” kit is for women over 35 who are trying to get pregnant or for women who are approaching menopause. “Clarity” kit wands specifically track FSH (follicle-stimulating hormone) for women who want to understand their cycle more deeply, particularly if they are having issues.
Mira pros
For those who want a truly detailed and holistic picture of their health, Mira fits the bill. Its focus is analyzing your whole cycle, rather than just ovulation–so, for example, as one of the reviews notes, users can predict more precisely when ovulation will occur days before it happens, because Mira tracks the estrogen rise that precedes ovulation. It also appears to be a good tool for cancer patients as well as those with PCOS, endometriosis, and other fertility issues, because the monitor can track the daily hormone changes and fluctuations immediately. These women wouldn’t have to go to a lab to have a blood draw or urinary hormone test and wait for the results. Mira is also FSA/HSA eligible, and may be covered by some health insurance policies.
Mira cons
Unless you have a health savings account or a flexible spending account, Mira is expensive. A basic starter kit retails at $199, which includes 10 LH and E3G wands, and then a resupply of those wands costs just under $60 per month with a subscription. If you want to go with the “Max” starter kit, which also includes PdG wands, the price goes up to $229 for the kit and $80 per month for the subscription.
Additionally, as Dr. Thomas Bouchard notes in this interview, there is something to be said for taking a more modest approach to your own fertility, especially if your goal is primarily just to track ovulation. For those with straightforward cycles, he says, something more simple is probably better; whereas those with fertility issues such as PCOS and endometriosis may benefit greatly from a system like Mira.
Inito
Next up on our review of femtech devices: Inito. Similar to Mira, Inito is an at-home hormone testing kit designed to be comprehensive and user-friendly. It also tracks four key hormones: estrogen, LH, PdG, and FSH. With its test-strip reading attachment for the iPhone, Inito’s results display in charts on your phone in the Inito app, which can be easily shared with medical providers.
Similar to ClearBlue, Inito gives qualitative results, such as “High Fertility,” “Peak Fertility,” or “Ovulation Confirmed,” but, like Mira, Inito also shows the user quantitative values of all four hormones. Uniquely, Inito requires only one test stick to test for all four hormones, rather than four separate ones. The one-strip-for-all-hormones feature may be especially useful for those with irregular or even anovulatory cycles, for whom two hormonal confirmations of ovulation (estrogen and progesterone) may be better than one.
Inito pros
Inito is valuable for those struggling with infertility or other cycle issues because of its ability to identify anovulatory cycles, which are the number one cause of infertility. Reviews mention the benefits of using Inito with PCOS and irregular cycles, and how grateful users were for the extra information they were able to garner about their cycles. It is also cheaper than Mira, coming to $149 for a starter kit and $49 for a refill of test strips (users with an average cycle length use 12-15 strips, according to the website, so that would come out to $49 a month for continued use of Inito). Inito, like Mira, is also HSA eligible.
Inito cons
It may be a small con, but because Inito comes with an attachment to your smartphone, you have to remove the case off of your phone whenever you are taking the test. More inconveniently, only iPhones after the iPhone 7 are supported with Inito. If you are an Android user or still have your old iPhone, Inito won’t work for you. Additionally, as mentioned previously, Inito is a bit of an expense. For those who want to keep things more simple or within budget, Inito may not be a practical option.
Kegg
Kegg is another popular femtech device. It differs from the last two options because it tracks fertility changes via cervical mucus secretions. Specifically, Kegg measures changes in electrolyte levels in your cervical mucus over the course of your cycle. It is a device that is inserted into the vagina for 2 minutes daily, and then held near your phone to transfer the data to the Kegg app.
Kegg pros
Besides being a fertility tracker, Kegg also can be used as a tool for Kegel exercises. The website notes that Kegels may improve the quality of cervical mucus because of improved blood flow (and there are other benefits for Kegels as well, though they may not be a beneficial practice for everybody). Kegg also seems to be immensely beneficial for achieving pregnancy; most of the reviews mention getting pregnant while using Kegg, either quickly or after months (or years) of trying other methods. It is also helpful for understanding cervical mucus, as one reviewer notes, “I am not the best at being a CM detective and Kegg really helps me with that.” Furthermore, Kegg is a one-time purchase rather than requiring the expense of additional test sticks, like Mira and Inito.
Kegg cons
Kegg is not reliable as a postpartum fertility tracker, and the website’s FAQ recommends women with endometriosis consult their healthcare provider about whether or not it’s a good option for them. The website recommends waiting until two consecutive periods have passed during the postpartum period before using Kegg—and, oftentimes, women who want clarity about their fertility during the postpartum time are looking for something that will catch that very first ovulation when fertility returns! Finally, as with Mira and Inito, Kegg is FSA/HSA eligible, but expensive for those who don’t qualify for coverage—$249 for the kit.
Ava
Ava is a first-of-its-kind wearable fertility monitor. It is a bracelet worn during sleep and then synced with the app on your phone in the morning. Ava predicts fertile days and ovulation through tracking five physiological signs: skin temperature, resting pulse rate, heart rate variability ratio, perfusion (or flow of blood and other fluid in the body), and breathing rate. It also monitors sleep quality by tracking movement during sleep, allowing users to understand their unique sleep patterns and how those relate to their overall cycle.
Ava pros
Ava is easy to use—simply wear it at night and sync in the morning. It is a one-time purchase that requires no other purchases or additional effort to gather physiological information. The company is very transparent about the scientific studies behind its fertility monitor, and very clear about how what they claim is supported by research. Ava also provides other valuable health information in addition to fertility, like sleep patterns, and, fascinatingly, is even thought to be able to predict intraamniotic infection in pregnant women with PPROM.
Ava cons
Ava is not a fertility awareness method because it only tracks peak fertile days rather than the days leading up to the fertile window. It also has 4 out of 5 stars in the reviews on the website, and it is not clear why, as the content of the reviews is not displayed. While testimonials are given about women with issues like endometriosis being able to conceive while using Ava, Ava is only compatible with women with cycles in the range of 24-35 days—a range that covers a great number of cycle irregularities, but is not comprehensive (especially since FEMM and other restorative reproductive technologies define a long cycle as over 36 days). Again, as with other technologies looked at here, Ava is an expense, although it might be eligible for FSA or HSA coverage.
Other femtech health monitoring options
While not strictly a fertility monitor, the Oura ring is a revolutionary wearable femtech device that tracks over 20 biometric signals. Research has shown that if worn during weeks 1-2 of a woman’s cycle, it can accurately predict the LH surge and ovulation. Oura can also be used in conjunction with Natural Cycles, the only FDA-cleared “natural birth control” app that tracks fertility via temperature changes. Similarly to Ava, users can wear the Oura ring to bed and check their physiological readings on the app in the morning. Oura is expensive (from $299), and also includes a $5.99 per month subscription. If used with Natural Cycles, that’s an additional expense of $119.99 per year.
One yet-to-be-released option is the Incora health earring. This monitor is worn as an attractive pearl earring that will be able to provide physical information such as core body temperature, oxygen saturation, respiration rate, and heart rate variability. The earring can also be used to track the menstrual cycle, although the website does not say how, specifically. Presumably, like the Ava bracelet and the Oura ring, the earring will use heart rate changes, temperature, and breathing changes to predict fertile days and ovulation. The Incora earring is still forthcoming, however, so no additional information, like pricing, is available—only a waitlist.
As with fertility awareness methods, the best femtech device is the one you’ll use!
It’s exciting that we live in a time where there are not one, not two, but several femtech devices available for women seeking to understand their own health and fertility better. In fact, the array of options can be overwhelming, especially as many of them are worth a pretty penny. As with choosing a fertility awareness method, you need to choose the femtech device that works best for you—and the one you know you’ll be most likely to stick with and use! Of course, for the women who desire simpler methods, this may mean not even opting for a piece of femtech in the first place! But for those eager to delve more deeply into the nuances of their personal reproductive health, there are many good options available.
Photo source: Mira website
