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Virtual fertility clinic aims to challenge treatment experience

The world’s first virtual fertility clinic uses AI to maximise the chances of conception

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FemTech World meets Caroline Noublanche, co-founder and CEO of Apricity, the virtual clinic on a mission to change fertility care. 

Few people know that the world’s first baby to be conceived via in vitro fertilisation (IVF) was born in Manchester in 1978. Since then, IVF success rates have grown from 10 per cent to 50 per cent, according to a report from 2018.

Although the modern use of ultrasound imaging to harvest the eggs under a mild sedation has advanced the procedure, the complexity of the treatment has not changed a lot, says Caroline Noublanche.

“When you can’t conceive, you have to actually give up on the idea that the baby will be born naturally,” the CEO tells me.

“Even though IVF has existed for 40 years, it’s still a very painful process, organised around the constraints of the clinic and the doctor and emotionally, it’s a roller coaster of emotions. On average couples need three cycles, but in some cases they might need more or they might not succeed at all. So, IVF remains uncertain.”

Along with her co-founder, Andrew Berkley, Noublanche came up with the idea of reinventing fertility treatments, and launched Apricity in 2018. “Instead of having to go to a clinic 10 times on average during treatment, we wanted to arrange everything from the comfort of your home,” the CEO explains. “That includes video consultations, but also blood tests, scans, sperm analysis and drug delivery.

“The patients would only have to go to the clinic for two procedures: the collection and the embryo transfer. We also wanted to make the whole process a lot more digital so that the patients can have access to a fertility advisor who can answer their questions, arrange appointments and make sure that when they are short of drugs, they can get a top-up in time,” the co-founder continues.

“We also have a dedicated care team who supervise patients’ treatment and help with early diagnostic. Our two objectives [using the platform] are to deliver the best experience possible for patients and to maximise the chances to conceive through a mix of protocol adherence, treatment efficiency as well as a mix of algorithms and data-driven decisions which are there to help our patients.”

In a virtual clinic, doctor-patient communication is key and with a rise in digital health technology during the pandemic, more and more people are open to remote consultations. “When you have to go to the clinic, it can be quite intense,” Noublanche points out.

“We very much believe that delivering the best experience from the comfort of your home, where your partner can be present as well, can make a huge difference. There are 30 per cent mistakes today in treatments in traditional clinics, because it’s a lot of word of mouth. During a video consultation, however, one of our nurses is able to support the patients, so that they know the exact dose they need, when they need it and subsequently, have a much better product regimen.”

Apricity found that their doctors, nurses and advisors’ relationship with their patients is very different from the one they have in a traditional clinic. Seeing the couple – not just the woman undergoing the treatment – can enable doctors to also observe the dynamic of the two.

“I think COVID has really changed the perception of people on digital health as a whole,” says Noublanche. “Virtually, you’re gaining on aspects such as convenience and doctor-patient quality of the relationship itself. The goal of all of the data [collected] is to make sure that you don’t get a treatment with a one-size-fits-all type of approach.

“We use the data to inform our decisions and to make sure that we better personalise treatment. The customisation also comes from the emotional support we offer and which is extremely important in terms of mental health.”

A fertility predictor is also able to tell patients what their chances to conceive are when following a certain type of treatment. The CEO says that: “We try to show our patients the glass half full because it’s a moment when they tend to be a bit more fragile, but [the predictor] also tells them black on white what their chances are.

“We are also transparent about the costs from the very beginning. What we don’t want is starting a treatment you would think would cost £4,000 and then find out that you have to pay another £1,000 for drugs or additional consolations. Yes, sometimes we lose and sometimes we gain, but we always want to be transparent. I think that’s very important.”

Caroline says the team have big plans for the future, focusing on the expansion of the company beyond the UK. “Our mission is to become the queen of Europe in fertility treatment,” she proudly tells me.

“We are planning to be present in Italy, Germany and in other European countries and continue to deliver the same quality of care and same attention to patients.”

She adds that: “At the moment we already outperform the national average of 61 per cent, so we have amazing success rates. We do everything with a data-driven approach and tech to provide efficiency. What we want is to continue to increase our success rates.

The CEO says that the feedback they receive is what keeps Apricity going and what motivates her, as an entrepreneur. “We often get pictures of new-born babies and that moves us a lot. Even from the people who don’t succeed, we get really amazing feedback on the support that we offer. Our one mission is to help patients live their life while creating one.”

For more information, visit apricity.life.

 

 

 

 

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‘We need to disrupt the system’- the founder redefining maternal health outcomes through ultrasound technology

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Blanca Lesmes, co-founder and CEO of TeleScan

The use of ultrasound in pregnancy is vast and has become the standard of care during pregnancy.

Ultrasound scanning machines have become central in the management of the problems of early pregnancy, particularly but not exclusively in the management of women after assisted conception and those with a high risk of miscarriage.

But despite the increasing importance of this imaging technique, the United States is struggling with a shortage of sonographers.

A study published earlier this year found that from 2011 to 2021, the increase in the number of ultrasound exams has significantly outpaced the increase in the number of sonographers.

Furthermore, the increase in demand for sonographers has grown significantly faster than the supply, leading to a shortage and consequent strain on the healthcare system.

To address the shortage, the study suggested that the number of sonography school openings should be increased and the attendant challenges addressed.

While these measures could help, they don’t address a bigger problem, namely performing ultrasounds more effectively and conveniently.

Blanca Lesmes, co-founder and CEO of the telesonography provider TeleScan, says the missing piece is innovation.

“Women’s health has traditionally taken a back seat,” Lesmes tells Femtech World. “When you look at investment dollars globally, the money is not there. It’s an unfortunate state of affairs, but it’s true.

“The way ultrasound is delivered has not changed since it started back in the 70s. However, if we want to have different outcomes for women we need to disrupt the system.”

Improving health outcomes through innovative ultrasound technology

Disruptive thinking, Lesmes says, is key to bringing high-quality prenatal ultrasound care to patients. She believes that focusing on increasing accessibility to maternal health services, like prenatal ultrasounds, would in turn solve the shortage of sonographers and ensure better patient outcomes.

“Most women do want to see their foetus, they want to have that experience. However, if they live in areas that are underserved by specialised healthcare professionals or they have limited access to healthcare facilities, they are less likely to show up.

“By putting a software like TeleScan as close to them in the community as possible, we can enable medical professionals to perform diagnostic ultrasounds remotely, identify high-risk pregnancies and intervene early.”

The winner of this year’s Femtech World Maternity Innovation award, TeleScan is an ultrasound delivery software that allows for remote ultrasounds to occur anywhere.

The tech-enabled solution connects healthcare facilities with remote perinatal sonographers, making ultrasound more accessible and helping providers identify high-risk pregnancies.

“TeleScan allows health professionals to be able to hold a probe with couple of days of training,” explains Lesmes.

“We’re not asking them to be able to do an ultrasound; we’re doing the ultrasound remotely. We essentially capture video clips at the patient bedside but do all of the diagnostics remotely.”

The software, currently set up to serve OB practitioners, family practice providers, radiologists and maternal-foetal medicine specialists, has been shown to reduce examination and report turnaround times, allowing professionals to see more patients and decreasing the time until the next available appointment.

“We’ve served over 2,000 patients and we are seeing the impact,” says Lesmes. “I think for me it wasn’t surprising that we saw the outcome shift but it was surprising that we saw it shift that fast.

“We’ve even had interest from providers from Pakistan, India, Morocco and Brazil. It’s incredible.”

With nine locations already secured in the US, Lesmes and her team are now working to reduce the costs to make the model sustainable globally.

“We are working with Philips and the March of Dimes on a project where we hope we can package more of the remote monitoring piece of it,” the co-founder explains.

“Serving the underserved is not just good for business, but good for our greater human community and if we’re going to have a global impact, we know we have to be at the heart of the community.”

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The start-up on a mission to transform metastatic breast cancer management

More than two million women globally were diagnosed with breast cancer in 2022 alone

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One in eight women in the US will be diagnosed with breast cancer in their lifetime and one in 39 will die from it. Could this start-up have the solution?

Nine years ago, Hollywood actress Angelina Jolie announced in a New York Times op-ed that she’d decided to go public about her elective double mastectomy to “encourage every woman” to think about their own risk of breast cancer.

The article went viral and increased breast cancer awareness around the globe, leading to the so-called “Jolie effect”.

But while campaigns like this have changed the way we talk about breast cancer, they haven’t translated into better patient outcomes.

The World Health Organisation revealed that in 2022 the “burden of breast cancer” caused 670,000 deaths globally.

In the UK, one woman is diagnosed with breast cancer every 10 minutes, leading to nearly 1,000 deaths each month.

Survival rates have indeed improved in many parts of the world and diagnostic methods have come a long way in identifying a tumour’s molecular profile. However, questions remain when it comes to choosing the most effective treatment combination for a particular tumour or patient.

“Oncologists consider multiple factors to determine the treatment strategy: the patient profile, the clinical tumour stage, the pathological tumour grade, the molecular tumour profile, treatment guidelines and study results, and patient-specific contra- indications,” Wolfgang Hackl, translational oncology scientist and founder and CEO of OncoGenomX, tells Femtech World.

“But there is nothing to assess whether a certain treatment works in a specific tumour. Oncologists can only be certain about that after the entire treatment journey, which can take months, sometimes years.”

Without a tool to support clinical decision-making, doctors turn to risk-adapted approaches, extending moderate therapies for low-risk cancers and intensive therapies for high-risk cancers. But this doesn’t solve the problem, says Hackl.

“Many patients are still over-treated for fear of being under-treated,” the founder explains.

“In breast cancer, about 60 per cent of women receiving treatment are over-treated. These patients end up having side effects which means they have to stop treatment. When they stop treatment, they are at risk of recurrence.

“This applies to under-treatment too. Under-treating and over-treating patients can both lead to sub-optimal treatment.”

The solution, however, could be closer that we might expect. PredictionStar, a decision support technology developed by Hackl and his team at OncoGenomX, could potentially transform breast cancer drug development, diagnosis and outcomes, facilitating individualised therapeutic decisions at any stage of the disease trajectory.

Wolfgang Hackl, founder and CEO of OncoGenomX

The tool, which uses AI and machine learning algorithms, identifies whether a certain therapy works in a particular tumour and finds the treatments proven to be the most effective for each patient and their specific tumour.

“It harnesses four patent-pending core technologies,” says Hackl.

“The first technology is an innovative tumour profiling test, the second one is an individualised prediction model, the third one is a digitalisation tool for information sharing without migrating patient data and the fourth one is a reinforcement technology, which helps the algorithm learn from treatment decisions.”

As far as tumour gene tests are concerned, PredictionStar works with standard, unsupervised, or commercial target gene panels, not only expanding their scope but also raising the applicability of test results from an average 65 per cent to more than 80 per cent.

For the first time, Hackl says, oncologists will be able to understand which treatment combination will work the best for a patient and their tumour.

“PredictionStar takes away the uncertainty around breast cancer treatment decisions and increases the likelihood of opting for the most effective treatment combination without delay and without exposing the patient to the side effects of an ineffective treatment.

“The whole technology is designed as an instrument agnostic which can work with any other existing technologies to allow for seamless interactions, irrespective of the systems that already exist in hospitals.”

The fascinating part is that the tool has a feedback loop which means the technology improves, the more information it gets, refining its therapy guidance.

“This is dramatic if you think about it,” says Hackl. “The US, UK and European countries spend hundreds of billions on cancer treatment every year.

“However, data shows that in cancer R&D, the clinical failure rate is about 30 per cent, which means that one out of three phase three clinical studies fails.

“This is a problem because this is the part of the development which generates 70 per cent of the development cost. Based on the data we have, we believe PredictionStar could reduce treatment expenses by at least 20 per cent.”

At a time when healthcare budgets are being squeezed, this reduction would be significant.

“We tend to believe that healthcare costs are a problem of the poor economies, but richer countries struggle with high healthcare costs too,” Hackl points out.

“This is something that has become very clear in recent years. The way healthcare costs are incrementally increasing over time is not sustainable and needs to be addressed.”

With such impressive capabilities, it seems to be only a matter of time before the availability of robust patient data sets extends the scope of PredictionStar to other cancer types. Hackl doesn’t rule this out.

“Currently, we are focusing on breast cancer, but we are intending to roll this out in other cancer entities,” he says.

If everything goes according to plan, PredictionStar could be ready for use in clinical and translational studies in the next 15-18 months, the founder adds.

“OncoGenomX’s data on file suggest that PredictionStar is leading the game and we have good reasons to believe that it has significant potential to improve clinical and economic outcomes beyond today’s achievements.”

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Could an adhesive device be the answer to perineal tears? This start-up thinks so

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Ditte Marie Fog Ibsen, co-founder and CEO of oasicare

A new device promises to provide midwives with a “third hand”, substantially reducing perineal tears, but could it really work?

“Simply surviving pregnancy and childbirth can never be the marker of successful maternal healthcare”, the World Health Organisation concluded after a damning report revealed that 287,000 women died in 2020 during and following pregnancy.

While maternal mortality rates are down sharply from where they were 20 years ago, research by United Nations shows that progress toward reaching the UN’s sustainable development goal of reducing maternal mortality has stalled.

According to the United Nations Population Fund (UNFPA), every two minutes a woman dies because of complications due to child birth or pregnancy.

But maternal mortality is not the only problem – for every woman who dies, there are about 20 to 30 women who experience injury, infection, or other birth or pregnancy related complication.

“Maternal mortality is only the tip of the iceberg when it comes to maternal health,” says Ditte Marie Fog Ibsen, co-founder and CEO of oasicare, a medical device start-up based in Copenhagen.

“Maternal morbidity is the hidden base, predominantly featured by perineal ruptures.”

Perineal ruptures are extremely common and expected complications of vaginal birth. In the UK, about 85 per cent of women sustain some degree of perineal trauma during childbirth.

Multiple studies have found that some women who experience severe perineal lacerations suffer long term psychological trauma and social isolation. However, the stigma around the topic means that many feel too embarrassed to seek help.

“Postnatal care is mainly focused on women with higher grades of perineal ruptures, downplaying the impact of lower grade ruptures on woman’s quality of life,” says Fog Ibsen.

“Short, medium and long-term complications are fairly common but rarely acknowledged or prioritised in the global health landscape.”

‘Women’s tears are not properly assessed’

Fog Ibsen and her friend, Julia Sand, were working as industrial designers creating solutions for midwifes when they realised the scale of the problem.

“We were trying to help midwifes manage their work-related musculoskeletal symptoms when we came across a even bigger problem: perineal ruptures.

“At the time, we didn’t know much about it, but we knew we had to do something about it.”

The duo began researching the issue and came up with a single-use medical device designed to protect the perineum and reduce uterine ruptures.

The product, which is currently being tested in several hospitals in Denmark, is adhesive and acts like a protective layer that prevents ruptures during childbirth.

“We are essentially trying to replicate the skin so we can prevent ruptures, which tend to happen when the vagina and perineum stretch during birth,” explains Fog Ibsen.

“We’ve made it very simple so that it can be easily applied and easily taken off.”

The interesting part, she says, is that women don’t actually notice it.

“That’s a quite good thing because there’s a lot of attention on the birth. The midwifes were a bit worried initially about the adhesive and whether it could last and stick to different types of skin, but so far it’s been great.”

The midwifes have played a crucial role in the product development process, helping the oasicare team identify issues early on and improve the device.

“We relied on their knowledge to get the balance right so that in the future we can give the product  to people who don’t have the same level of experience, but can still use it to prevent ruptures.

“The product is very easy to cut in, for example, so that midwives can adjust it easily.”

Currently, the team is not allowed to disclose any details about the efficacy of the product but a study, which is expected to conclude later this year, will establish how much the device could reduce ruptures.

“If all the studies go well and we get good data from the hospitals we work with we could see the product on the market in 2025,” says Fog Ibsen.

Her goal, however, is to launch the device outside Denmark where, she says, women desperately need it.

“In Denmark, I think, the midwives are doing a great job, but in other parts of the world the situation is very different. Women’s tears are not properly assessed, which means that despite having suffered serious tears they are being told that everything’s just fine.

“Our goal is to make the product available in countries like India, where a lot of women would benefit from it. It’s a simple device, but it can have such a big impact.”

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