We are all works in progress; even the successful women you see owning it on Instagram faced stumbling blocks along the way and continue to work hard to stay at the top of their game. In this series, we're sitting down with the people that inspire us to find out: How'd they do it? And what is success really like? This is "Getting There."
The decision to start a family is a daunting one no matter your stage in life, but when you throw the possibility of decreasing fertility into the mix, it becomes even more complicated. For decades, the prevailing guidance around women's reproductive health was essentially, "You never know until you try."
But why should we have to wait until we're ready to have kids to find out whether or not we actually can? That's the idea behind Modern Fertility, a company that provides fertility hormone tests. We spoke with the company's co-founder, Afton Vechery, about building a direct-to-consumer business around the notion that women should have more information about their own bodies.
TMRW: What were you doing before you started Modern Fertility? And what prompted you to build the company?
Afton Vechery: Before starting modern fertility, I was working at direct-to-consumer genetic testing company called 23andme. It was actually while I was at 23andme that I kind of took a step back and realized that I was waiting until later in life to start my own family.
Years before that, I started my career in New York working for a health care private equity fund. And my job was basically to identify sectors of health care that were interesting, growing or had some consolidation potential. Because of my personal interest in women's health, I ended up spending a lot of time there and within women's health, I was spending a lot of time in fertility. From an investment perspective, rapidly growing fertility space was very attractive so I ended up spending a lot of time learning about the space.
I learned the business, I learned the science, but it was really the emotional aspect that stuck with me throughout the years. I had to go into infertility clinics and talk to women, these amazing women who had never been told that fertility declines with age or had never been told that IVF wouldn't work for every single person. I was 22 at the time and I just felt like I had this window into conversations I definitely wasn't having with my girlfriends, and I probably wouldn't have for quite some time.
I don't think I knew what to make of it at the time, but there was something about it that wasn't quite right.
Fast forward: I was at 23andme and I remembered the baseline testing that I had learned about back in my private equity days and I tried to get that testing done. So I went into my OB-GYN appointment and I said, "Hey, I'd like to get this panel of the test." And my OB said, "No, I'm not going to order that for you. You're not actively trying to have a baby, and it's not not working for you. So no, don't worry about it."
And I was like, "Huh, that's not right."
So I actually made an appointment at an infertility clinic to have an initial consult and get that baseline testing done. I got a script to go to a LabCorp Quest Diagnostics facility. I was lucky because at the time, I was working for a flexible employer, but I had a really irregular cycle so pinpointing when day three of my cycle would be and coordinating and going ... it took me probably three months to get that panel of tests done.
When I finally got that testing done, a few things happened, but I think that the most impactful for me is I had a conversation with myself, I had a conversation with my partner, with my doctor, and it was just so empowering to learn about my body.
I started talking to friends, friends of friends and eventually literally hundreds of women. And I think that that was really the "aha moment" — hearing that women wanted more information. This "wait and see" black box was not good enough and there are these better predictors of future fertility than just age alone. They're not crystal balls, but there's more that we can do to learn about our bodies. That is really what starting Modern Fertility was all about.
Was there anything that intimidated you about starting this company in the beginning?
Oh my gosh, everything.
I believed with my heart that this fertility information gap has to do with the last frontier and true reproductive equality and for women to have this information, it was an overwhelming feeling. But even with all of that, taking the step and telling my friends and my immediate network that I was starting this company, I remember it distinctly being this really scary process.
Talking to your friends and your former co-workers and saying, "Hey, do you or anybody else in your network want to quit your job to work on this thing with me?" — there are a lot of emotions going on, so I remember that being this big milestone for me.
And then I think that the next big one that comes to mind is fundraising.
I was talking to a lot of investors who were not potential users of the Modern Fertility product, so I think that introduced another set of challenges. For me, it was really taking a step back and not looking at any of these things as challenges or obstacles, but just other things that you have to solve. You have to problem-solve. So if they couldn't use the product, if they weren't going to experience the need themselves, how could I do surveys and provide some data to show that this was a real need that women wanted?
Can I ask why you were so certain that you wanted a co-founder for this?
I think that deciding if you want a co-founder and who that co-founder is is one of the biggest and most important decisions you'll make within a company and statistically that is very tied to the success of early-stage companies.
I had this exposure to business and product and science over the course of my career, but I knew that taking fertility and really bringing it into mainstream wellness, destigmatizing it, making fertility a part of a conversation that every woman would want to engage in and feel comfortable having ... we had to build a consumer brand that women wanted to engage with. We needed to have a voice as a company that was your OB-GYN who was also your best friend — someone who was just going to give you the TLDR and fill in the weeds. I was really looking for someone who had that skill set, who could complement the skill set that I was bringing to the table.
I've started co-founder dating, which was really odd. I was introduced to Carly (Leahy) through a mutual friend in what we refer to as the most epic introductory email of all time. It was just the match that works in this kind of crazy process.
How do you hope women use the information that they get from Modern Fertility? How do you see them using it in their life?
We see a world where every woman can own the information impacting her, own the decisions impacting her body and future. We see a world where women have access to more information about their bodies, they understand what that information is, the limitations of that information, and they can use it and make the decisions that are right for them.
I think it's really hard to overprescribe information. Our goal and our view is to be this clinically-sound, neutral resource to help women understand their own bodies so that they can use that to make the decisions that are right for them.
Do you think that there's something fundamentally off about the way that women's health care works here in the U.S. that has made it challenging to get this information before now?
Yes, I mean, having a baby in the U.S. is not a right, it's a privilege. There is no federal reimbursement for infertility. It's crazy.
There's a condition that I'm super passionate about, it's called POI or premature ovarian insufficiency. It impacts one in 100 women and one of the side effects of POI is having an undetectable number of eggs in your ovaries. So this can mean you can still spontaneously ovulate, it's still possible to get pregnant naturally, but it looks a lot different. And it's correlated with early menopause onset in many women and a variety of other health implications. But because, you know, fertility is impacted by POI, we don't have a care pathway that looks to early screening or management of it at all. Because that care pathway isn't fully defined, we don't have any screenings, we don't have the right steps from a woman's health perspective and I think that that that's wrong.
The second point that comes to mind is that 20% of millennials identify as LGBTQ. The traditional definition of infertility just doesn't apply. So what does that mean in 2020?
The third is we have so much information about clean beauty products and every ingredient that we're putting on our faces, we have mortgage calculators to help us plan for a home — we have these tools and resources, yet fertility is still just this total black box. For us, the first step in combating that is information and that was the first step that we took as a company. We see a world where every woman has access to this information where fertility hormone testing is as routine as a pap smear and as a company, we can continue to elevate that conversation and continue to bring more products and services to market to meet those needs.
What’s the one thing you still hope to achieve?
We hope to integrate proactive fertility information into mainstream consumer wellness — and we still have so far to go! We fundamentally believe that all women deserve the opportunity to own their fertility, regardless of their age, identity or fertility decisions, with the support of their community and free of judgment. Whenever I hear someone talking about fertility on the bus, in the park or with a colleague, it feels like a win, even if it has nothing to do with Modern Fertility.
We also hope to push fertility science forward. Fertility is a severely under-researched area in health care, particularly when it comes to understanding the proactive stages. We want to give women a much clearer view of where their body is at, and that requires more research into better predictors of future fertility.
Fertility and career planning are in a way inextricably linked. How do you hope Modern Fertility will be able to help women balance aspirations for both a family and a career?
From the earliest days of thinking about Modern Fertility, the intersection of careers and fertility was top of mind. One of the biggest reasons why fertility has become so complicated is that we’re having kids later in life, in large part because we’re prioritizing our careers and living lives of opportunity. This isn’t going to change and neither is our biology — but something has to.
I think at Modern Fertility, we’re able to do a few things to help with this tension. First, we’re working to normalize fertility conversations so they’re commonplace, embraced and even an act of responsible, forward-thinking. We’re also working with employers to bring education about fertility into the workplace. The going standard is to assume fertility is a secretive black box, so the importance of being conscientious and accepting can’t be understated.
Second, we can give her the tools and information she needs to better navigate fertility decisions as they relate to her career, so she can advocate for what she needs to build the life she wants. We have all the tools we need to manage our finances and hobbies, and track our fitness, nutrition, step and sleep— why not the same for our reproductive health? When it comes to fertility, we believe that information is power, and information is for everyone.