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‘Algorithms do not always match human complexity’ – interview

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FemTech World meets Dr Ghazala Aziz-Scott, specialist in integrative women’s health and bioidentical hormone balancing for the Marion Gluck Clinic, to discuss the potential of bioidentical hormones and the future of femtech.

How can bioidentical hormones treat menopause and women’s hormones related issues?

Bioidentical Hormone Replacement Therapy (BHRT) has an identical molecular structure to the naturally occurring hormones which are produced in the body. BHRT uses bioidentical hormones to treat hormonal conditions. It is most used to treat symptoms of peri menopause, menopause, pre-menstrual syndrome (PMS), depression, endometriosis and thyroid dysfunction. 

BHRT can be compounded into a personalised dosage and in different application methods, creating a better solution, with less side effects, for many women. With BHRT, shortages are rarely faced as individual prescriptions are made in the compounding pharmacy.

BHRT is prescribed in personalised dosages, based on thorough testing, and produced to order. This means that the pharmacy (which must meet industry standards for purity of Active Pharmaceutical Ingredients and Good Manufacturing Practice) is able to prepare custom doses and application methods to address the individual needs of a patient.

What difference can BHRT make compared to HRT (Hormone replacement therapy)?

Synthetic HRTs made from estrogens are derived from horse urine or synthetic oral estrogens and are still available on the NHS and are not the optimal choices – the British Menopause Society recognises that bioidentical HRT is the gold standard form of HRT which is derived from plant sterols such as beta sitosterol and diosgenin from Mexican yams. 

Bioidentical and body identical hormones are the same thing but body identical refers to the regulated standard dose treatments available on the NHS and bioidentical refers to the personalised HRT from a compounding pharmacy.

Although body identical and bioidentical hormones are made with similar ‘ingredients’ there are differences between the two, including the manufacturing process, dosage, delivery, and which hormones are available in terms of estradiol, progesterone, DHEA, and testosterone. For example, body identical progesterone is only available as utrogestan which is an oral capsule rather than a cream. The availability of suitable testosterone preparations for women is also limited.

Body identical hormones are produced by large pharmaceutical companies in regulated, set doses and application methods, and while this one-size-fits-all approach works for some patients, the dosage and application of body identical hormones cannot be altered to cater to those with more specific needs.

What do you see in the future of therapies for menopause and other hormones related issues?

There needs to be continued research on the long-term benefits of bioidentical HRT treatments including the role of testosterone and DHEA, and there needs to be greater awareness of the risks of using synthetic HRTs as there is plenty of research evidence to show that they are not the best forms of treatment. 

Personalised care is also important to assess each woman’s individual situation, especially when it comes to hormonal imbalances. Health can be optimised and we can use advanced scientific testing to look at nutrigenomics which demonstrates how individual nutrients can impact the genes coding for hormone synthesis and metabolism, so for example it can give us clues as to why a women may not tolerate HRT that well and what other approaches might be more beneficial.

DUTCH testing takes dried urine samples to assess an individual woman’s estrogen metabolism while on HRT and if she has a tendency to produce the more toxic metabolites of estrogen which can increase the risk of estrogen dependent cancers, so we can make more informed decisions about treatment.

Drugs are also being developed to help hot flushes that are non- hormonal which act on NK3 receptors in the brain and may have therapeutic benefits for women who cannot take HRT for example with recent breast cancer.

Stem cell therapy is also being researched where intraovarian injections may reverse premature ovarian failure in younger women.

What do you think it’s missing in the femtech industry?

Femtech refers to technology specifically focused on women’s health needs and this is a growing industry from apps assisting women in managing their menstrual cycle and reproductive health such as Clue, to apps to manage symptoms of the menopause and new treatments for female health conditions such as endometriosis. There needs to be much greater education and awareness of these tools as they can help break taboos about women’s health and also meet the needs of underserved populations such as those on a low income or minority groups.

Women’s research has historically been underfunded and not prioritised and this is now being recognised widely, including at governmental level and in the education of doctors. Increased investment in femtech can be part of this revolution.

The term femtech must also be inclusive of transgender and non- binary communities who may have the same biology as a cisgender woman but do not identify as a woman or female.

We must remember, however, the importance of connection with an empathetic practitioner who understands the issues in the context of each woman as algorithms can assist but do not always match human complexity.

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#FromBerlinWithSolidarity: period tracking app Clue on reproductive rights and data privacy

Femtech World sat down with Clue chief product officer, Rhiannon White, to find out more about the company’s latest campaign

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To mark the one-year anniversary of the overturning of Roe v Wade, the German period tracking app Clue has launched a powerful campaign.

From Berlin With Solidarity, a passion project by American Clue users and advertising creatives Amy Char, Heather Patterson, and Ashley Milhollin, aimed to bring attention to the very real fear of reproductive surveillance faced by women in US states where the loss of reproductive rights means people are afraid their health data could be used to prosecute them for seeking abortion.

The campaign, which featured bold billboards in the US and humorous posters in Berlin, was, in co-CEO Audrey Tsang’s words, directed at sparking a conversation about the importance of privacy rights for equal healthcare.

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The AI start-up on a mission to democratise IVF

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Daniella Gilboa, co-founder and CEO of AIVF
One in six people experience infertility globally, according to the World Health Organization. However, many couples are still unable to afford treatment. Daniella Gilboa, co-founder and CEO of the Israeli fertility start-up AIVF, tells us how AI could democratise IVF and increase access to affordable, high-quality fertility care for those struggling to conceive.

 

What is AIVF?

AIVF is an Israeli reproductive technology company transforming the fertility journey to be intelligent, accessible, and full of hope.

Based on scientific research and driven by real-world clinical use, AIVF developed a proprietary Fertility Operating System with automated embryo evaluation and deep learning algorithms to optimize clinical processes and improve patient outcomes.

Our solution, EMA, addresses two unmet needs in fertility. First, AI capabilities assist embryologists in their embryo evaluation, instantly identifying what the human eye cannot detect alone.

Second, with the integration of platforms, our single dashboard system streamlines all data in one place. From patient records to personalised embryo analytics, our platform connects the patient, lab, and clinic all in one place.

What is the story behind your company?

While writing my Ph.D. dissertation, it was suggested that my thesis could be a start-up. This field attracted me immediately. I believe being an embryologist is the most fantastic job in the world —using expertise to support individuals and families in bringing life into the world and homes.

While passionate about being an embryologist, I realised the more significant impact I could make is combining this with my previous experience using complex data to solve problems.

Knowing this field’s “ins and outs” made me realise there had been no significant progress and a lack of innovation for decades. I decided to jump right in, knowing I could make a difference for the better.

The move from embryologist to CEO of a start-up was a huge step, and I am constantly learning. My passion for helping bring children into the world remains the same. It’s my greater obligation to the world around me to create the next generation of IVF for clinicians, embryologists, and, most importantly, patients.

What makes your technology different?

The AIVF software algorithm was developed using hundreds of thousands of images and videos of embryos tagged with successful conception and leading to a normal pregnancy.

Currently, the programme can independently identify the embryos with the highest chances of developing into normal pregnancy.

The software AIVF developed identifies biological processes the human eye can’t detect. For example, the technology can spot mitochondrial ‘energy action’ directly linked to the embryo’s collapse or chances of implantation.

Unlike most deep learning algorithms, the AIVF platform identifies the patterns driving its actions and can explain its decisions.

It will mark, for example, that it has given a low score to a specific embryo due to disruptions or disorders found during its development, a different behavioural pattern at the cell division stage, or abnormal morphological appearance such as fractures.

How would your technology change the patient experience and fertility care more broadly?

On average, the IVF journey takes four years, seven cycles, and three miscarriages, costing an average of US$12,000 per IVF round.

By improving the embryologist’s capabilities in selecting the most viable embryo, there is potential for AI to help a patient conceive in one or two cycles. Our technology aims to minimise IVF’s financial and emotional costs by reducing the cost and time spent.

Additionally, our technology aims to add transparency to each patient’s IVF journey. While patients can access more information than ever, they make decisions based on a leaflet in the doctor’s office or a quick internet search.

Individuals need friendly and professional guidance to help them understand their journey’s complexities. Our integrated platform provides a window into the IVF lab and personalised analytics that help patients understand each step of the journey.

Where are you with the business now?

We are integrated with Southeast Asia, South America, North America, and Europe fertility clinics. So far, studies from our European clinics show that the platform has demonstrated a 70 per cent probability of success for embryos with a high EMA score.

The clinical studies also showed that EMA improved embryologists’ accuracy by 38 per cent and reduced the number of cycles to achieve pregnancy by 21.5 per cent on average. By improving embryologists’ accuracy, AIVF saves both time and money in the fertility journey.

What are your goals for this year?

IVF is one of the most important medical innovations in the last 50 years. Yet, the legacy technology used today in clinics can’t serve the 25 million women in the US who have limited or no access to fertility care.

At AIVF, we aim to use technology to make IVF efficient, accurate, and accessible to all who wish to grow their families.

Where do you see AIVF in five years?

Embryo evaluation using AI will democratise IVF by increasing access across underserved groups. More specifically, it will facilitate reduced costs by optimising our labour, laboratory performance, shorter time to a healthy, live birth of a singleton, and reduced failed cycles by not transferring embryos with a low chance of implantation (deselected embryos).

The promise of AI mitigated freedom for the computational embryologist is not just a new toolkit. It is the democratisation of high-quality IVF services. We call it IVF 3.0.

As we integrate AI technology into IVF practices and our work as embryologists and clinicians, the goals should remain the same: minimise costs and patient drop-out due to stress and financial fatigue while ensuring the highest quality patient care.

 

Daniella Gilboa is the co-founder and CEO of the AI technology start-up AIVF. As an IVF researcher, she is dedicated to advancing the science of using machine learning to optimise IVF processes. Gilboa is committed to driving the next generation of IVF technology and increase pregnancy success rates.

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The founder on a mission to help women find the perfect-fitting bra

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Valentina Biglia, founder and CEO at FindYourBra

When Valentina Biglia launched FindYourBra she had one mission in mind: to change the way women shop for bras. Driven by her grandmother’s battle with breast cancer, she set about creating a unique platform that would not only redefine women’s shopping experience but assist them with finding the perfect-fitting bra. She tells us all about it below.

 

Can you tell us a bit more about your background?

I studied product design at the Politecnico of Turin, Italy. The idea of creating things from scratch has always fascinated me. Beauty and harmony are two characteristics that I seek and pursue.

I did a master’s degree in advanced interior design for commercial spaces at the IED in Barcelona. Products, fashion and the user experience in shopping are something I have always been passionate about, just as I am interested in philosophy, psychology and anthropology.

I studied gestalt, a branch of psychology, to better understand the behavioural patterns of human beings.

During my professional experience I had a parenthesis where I trained and worked as a bra fitter in a specialised lingerie shop in Barcelona. This experience changed my life and led me to founding FindYourBra.

What inspired you to create FindYourBra?

There are three main things that inspired me to create FindYourBra: firstly my personal experience with my body. I have never been satisfied with it, in particular with my breasts. I thought they were a “problem” until I found the right bra size.

On the other hand, I saw how finding the right bra size immediately changed the expression on the face of the people I was serving in the fitting rooms of the bra shop. At the same time I understood that the user experience was quite poor that any comment or look could create a trauma for them and that at that moment their self-esteem was at stake.

And, third reason, certainly not because of importance, is because of my grandmother. She has fought breast cancer twice, she has come out the winner again in November 2022.

She has been hiding her breasts every day for the last 30 years, fixing the breast asymmetry with socks stuffed with rice. She and other women like her inspire me every day to create a solution to help them get their lives back as soon as possible.

How would you describe your innovation in a few words?

The easiest, fastest and more intuitive way to buy bras online that suits you in total privacy and autonomy. A selection based on you, your measurements – taken with our patented measurement system – needs and preferences that changes as you changes.

No barriers, No measurements, No conversions, No size charts: just buy what fits to feel supported, comfortable and beautiful.

(more…)

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