Trying? Why ovulation isn't everything

Spoiler alert, I have been focused on ovulation for as long as I can remember and as a result have likely been missing my fertile window. I don’t know about you but despite fertility treatments, I always had a small glimmer of hope that in between them perhaps I could be a part of that tiny group of women who were surprised with a miraculous pregnancy. As a result, I have purchased more ovulation prediction kits than I could ever count over the years, either in hope or because of treatments.

I recently had the opportunity to try the Pearl Fertility ovulation prediction kit and it was unlike any other kit that I had ever tried. You might be thinking, but why, what makes it so special?

It’s unique because it provides laboratory-style testing at home and taught me that the time of ovulation and peak fertility aren’t necessarily one in of the same. Having access to my own personalized data through a scientific app and the ability to throw out the generalities of a typical 28-30 day cycle that I thought of as gospel, blew my mind.

My Pearl ovulation prediction kit arrived in a beautiful box with a barcode to set up my app on my phone, (15) LH sticks and (15) FSH kits, a urine catch cup, along with a cute little coaster to set it down on (love this attention to detail especially because I veer on the neat freak side of things). It also comes with two pregnancy tests, which I saw as an optimistic and sweet gesture for the “infertile” bunch of us that are going through treatments and may want to cheat during the 2WW. All I needed to provide was my mobile phone to take photos of the provided sticks through the Pearl app. The app analyzed my cycle through the images, provided a detailed description of my fertile window. What’s more is that it cheerily reminded me each morning that it was time to test.

The testing strips provided detect different hormone levels called lateral flow immunoassays (LFAIs) in urine. LFAIs bind the hormone to biomolecules which makes them easy to measure because they change color when they come in contact with urine. Most of these tests are usually interpreted in highly specialized labs but as you can imagine, these are quite expensive. This is where Pearl’s software steps in and is disrupting the space by providing more accurate results beyond the traditional ovulation kit. Pearl’s proprietary algorithm utilizes data from the test strips to detect hormone patterns to predict the cycle. (Note that after approximately two cycles, the software can predict a cycle well in advance so that you can “plan” accordingly). 

The software detects a patern of FSH (follicle-stimulationg hormone), LH (lutenizing hormone) and PdG (progesterone), which accurately predicts the fertile window when you are actually more likely to conceive. 

And guess what? I found out that the peak fertility window is actually approximately 3 - 4 days PRIOR to ovulation…

After ovulation, an egg is only “fertile” for 12 – 24 more hours. Sperm can survive in the body for 2 – 6 days post intercourse so maximizing a peak fertile window is important. This is especially important for those of us that are trying to conceive after 35. Every opportunity counts. Am I right?

I was so intrigued by this new FemTech which is redefining what we should expect from an ovulation prediction kit that I asked to connect with Dr. Leo Martinez, Founder of Pearl Fertility. I was interested in learning more about his new FemTech business and what inspired him to create it. Read on to find out more about Pearl Fertility.

What inspired you to start Pearl Fertility?

Women are busier than ever, take more (executive and) management positions, and spend far more time outside home than what used to be decades ago. This has created a more equitable society, but has become a challenge for fertility.

Natural fertility starts decreasing with age because of ovarian reserve. Thus, for women above 35 years of age it can take on average up to 10 months to conceive. That does not mean they are infertile, it just means that the chances are lessened. We found a gap when we found many sources of misinformation during our research that weren’t serving women who are desperate in finding actual solutions.

As a result, we leveraged our scientific backgrounds to build a product that can not only help women understand their fertility better (whether they are trying to conceive, or just tracking their hormones for treatments). This was (made) possible because of our core award-winning* technology, Google launchpad, and the European Commission which has allowed us to read all kinds of colorimetric diagnostic tests (specifically three individual hormones) by way of the camera on a mobile phone.

*The Pearl Fertility ovulation prediction kit was awarded as a Top Innovation by MIT Tech Review.

How is Pearl different than other ovulation prediction kits?

Pearl helps you chart your hormone levels: No more happy faces or ranges or thresholds. Instead, you get real hormone levels tracked over time. We have developed intelligent algorithms that run over the daily hormone data to give better predictions of the upcoming ovulation and based on that of a true clinically proven fertile window (the days with the highest chance to conceive). Now there is no more guesswork. Our test strips also measure hormones independently so you know exactly what hormone you are measuring. Other apps have appeared on the market that take pictures of the strips, but they lack the scientific intelligence levels to make (accurate) predictions. Additionally, our prediction algorithms which measure more than one hormone (and how they work together) are patented. The app can read FSH, LH and Progesterone. 

Is there a misconception about ovulation prediction kits that you would like to debunk?

Totally. Women are led to believe two things that are wrong about traditional ovulation prediction kits. The first misconception is that a positive test means the day of highest fertility. This is incorrect because the fertile window starts 6 days before ovulation and the top fertile time frame is 2 - 4 days before ovulation.

Although a (traditional ovulation) strip when positive can indicate fertility, it does not mean those are your most fertile days.

The second misconception is that a positive test means ovulation. This is incorrect because a positive test (in the case of LH) means that hormone levels are high or at their peak.

Many studies confirm that ovulation in fact happens approximately 24 hours after hormones peak. Another important factor to consider here is that not all peaks lead to ovulation as there are anovulatory cycles. 

To highlight the science behind this, please see the two figures built from a collection of clinical studies which represents the fertile window (FW) and the hormone peaks.

Pearl Fertility is innovating to allow women to better understand their cycles. What are you most excited about when you think about the future of fertility?

I think Pearl Fertility is showing the world what is possible in terms of home diagnostics in the era of digitalization. Pearl Fertility is one of the first apps to be a medical device by itself listed in the FDA, and soon will be CE certified.

We have big plans for other tests. With regulations and investment which are tough for medical devices, it requires some time and a lot of money to develop. Pearl is a pioneer in the future of medicine. Right now we only show hormones, (all tested and interpreted) at home. Imagine if you could interpret patterns to prevent disease, treat disease, or predict disease.

I think that the future is that the clinic will come to you.

About Pearl Fertility’s Founder, Dr. Leo Martinez: Dr. Martinez is a Biotech Engineer and Entrepreneur. He holds a PhD in biosensors by the University of Cambridge, has published dozens of academic papers in the fields of biosensors, photonics, mobile apps and fertility. He was listed as one of the Top Innovators under 35 in 2015 by the MIT Technology Review for the developing of the ‘smartphone-diagnostics’ technology behind Pearl. For more information about Pearl Fertility please visit pearl-fertility.com or follow them @pearlfertility

*Please note that I was not paid to review the Pearl Fertility ovulation prediction kit. I am an affiliate however which means that if you purchase a kit at 10% off with my discount code: FERTILUST10, a small percentage of the sale will go to me.

The morning ritual that sparks joy

Photo by Nara Gaisina. Organic cotton sleepwear by Leena & Lu. Toothpaste by RiseWell.

Lately everything is about sparking joy. After meeting with Kori Estrada, co-founder of RiseWell, I am convinced that our first morning ritual of brushing our teeth should be too.

Think about it. From product to packaging, toothpaste that our grandparents used is similar to what we are still using. Big industry toothpaste works but is laden with chemicals including possible endocrine disruptors like triclosanand fluoride. And even though organic toothpastes make us feel better about ourselves and the environment, its efficacy is questionable and possibly counterproductive. In fact, natural toothpastes may be as effective as brushing with water, and toothpastes with activated charcoal have been noted to damage enamel due to its abrasiveness. 

Kori realized this gap in the market and the need for a clean toothpaste when she was battling PCOS and going through fertility treatments. During fertility treatments there is a growing school of thought that what you put in, and on your body may affect egg quality and possibly influence outcomes. During the fertility process, Kori was eating well and mindful of endocrine disrupting chemicals that mimicked harmful hormones that have been found to get in the way of fertility.  That got her thinking about the toothpaste that she used.

“The first thing that I do in the morning is brush my teeth. Toothpaste is the first thing that we absorb through our mouth and possibly ingest a little of.” Kori went on to share that there is a warning sign about ingesting most commercial toothpaste for good reason. If a child gets its hands on a tube of toothpaste with those levels of fluoride, that child’s health may be in serious jeopardy. That statement really made me think.

Anything with a poison control warning label probably shouldn’t be on anything that we ingest. Kori had already had all of these thoughts which had led to her AHA moment of creating a clean and effective toothpaste. This prompted her to call her brother, Dr. Derek Gatta who is a dentist in Florida, land of pearly white teeth. It became a family affair and Kori who runs a hedge fund by day, along with her brother and husband decided that there was a reason to “RiseWell” with that first morning ritual. They are so passionate about their craft that they researched what could bridge the gap between clean and effective. Their answer was hydroxyapatite. 

Hydroxyapatite has been used as a remineralizing agent in toothpaste in Japan for the last three decades. It has been shown in field trials as an active anti-cavity ingredient to cause a similar reduction in new cavities to that seen with fluoridation in the U.S. Not to geek-out but I will; up to 90% of enamel and 70% of bone is a modified form of hydroxyapatite (aka bone mineral).

Armed with a clean(ing) alternative to traditional toothpastes, Risewell also sought out to differentiate by backing its claims and building their credentials which resulted in the creation of its own Scientific Council with leading experts in dentistry and functional medicine including Robin Berzen, MD, Founder and CEO of Parsley Heath.

Risewell has put the traditional and organic toothpaste products on notice with a full suite of products to include toothpaste, mouthwash, and floss for both adults and children. Most importantly, Risewell stands by the fact that its product is safe for everyone which in my opinion gives it a stamp of approval for anyone looking for a clean and effective toothpaste to use during fertility treatments, pregnancy and to support long-term healthful hygiene habits. 

I was so excited about the prospect of also “rising well” and using a clean toothpaste product that I tried RiseWell and have been using it for the last four months. The verdict? I am impressed with how clean my mouth feels, how comforted my mind is knowing that I am not ingesting endocrine (hormone) disruptors and maybe I am just hallucinating, but I think that my teeth may actually be whiter. The tube is also definitely chic enough to leave out on my bathroom counter.

During our interview Kori mentioned that she wished that she had a community of support during her fertility treatments. Kori is grateful that the fertility experience opened up her eyes to what was missing and gave her the opportunity to create a truly necessary product. To that end, Kori has graciously extended her support for the fertility journey with a special offer to try RiseWell. Follow this link add in the promo code: FERTILUST20 to receive 20% off of your purchase.

Perhaps I am speculating but think that Marie Kondo would also agree that your toothpaste and your morning ritual needed an upgrade.

About Kori Estrada: Kori is the co-CIO of Axon Capital which is an asset management firm managing ~$500mm in capital globally. She has had a focus on consumer related investments throughout her career in both public and private capacities. Prior to joining Axon Capital, Kori was an Associate at Shumway Capital Partners and an Analyst in the Investment Banking Division at UBS Investment Bank. Kori received her BA from Columbia University. Based on her fertility experience, Kori made the notion of a clean toothpaste a reality together with her husband, John and brother, Dr. Derek Gatta. Kori, John and their baby Leo live in New York City.

Disclaimer: I was provided free product in return for my honest review. All thoughts and opinions herein are my own and are not influenced by the developing company, and/or its affiliates in any way. Please note that I am NOT an affiliate marketer for RiseWell or Leena & Lu and will not be paid a commission for any product purchased through the provided links.

Review: The Stress-Free IVF Nutrition Guide by Liz Shaw

I have been around the (in)fertility block a few times. Even though I have educated myself about the role and importance of nutrition for overall long-term health, it’s amazing how I have had amnesia about how to nourish my body beyond the basics during the IVF journey. I recently did my fourth (yep you read correctly) IVF cycle at the age of 40. Although my diet is predominantly plant-based with a side of meat at this point, I was so grateful that Liz offered to let me try out her Stress- Free IVF Nutrition Guide leading up to and during my cycle. Liz said that I needed one less thing to worry about and she was right.

Under the expert tutelage of Liz who is a Registered Dietician with her own fertility story, she has created a concise, poignant, evidence-based guide aimed at elaborating on the Mediterranean diet with a Pro-Fertility diet and lifestyle. If you are anything like I was when I started all of this out, that may have just as well been written in Taiwanese. In a nutshell, Liz breaks down which nutrient-dense foods have been researched to help optimize cellular growth for egg quality. She also shares how fitness, self-care and avoiding endocrine disrupting chemicals are supportive to a possible optimized outcome. To put the new found knowledge in to action, Liz provides tips on how to easily stock your pantry with a checklist and provides sample recipes for every step of IVF, from retrieval to transfer.

I found the recipes tasty, quick and easy to make. (Just to elaborate, I am that person that when it says a recipe takes 30 minutes to make, it usually takes me an hour.) I was grateful that the length of time required for the recipes was actually accurate! My favorite recipes that I batched to last over a few days were the Berry Chia Slow Cooked Oats, and BBQ Lentil Burgers. Post-Retrieval, I enjoyed the Roasted Potato Tacos with Eggs as a healthy way to get the sodium necessary to dry out the egg follicle sacs and stave off OHSS (Ovarian Hyperstimulation Syndrome). I also appreciated that the Guide helps the reader put a nutritional plan into action at home and/or on the go. Let’s face it, while cooking at home is ideal, it isn’t always possible or convenient.

I spent a semester to get my holistic health coach certification so that I could understand the basics of nutrition to then decipher how it tied back to fertility. Liz broke down the IVF process and an IVF supportive nutritional/lifestyle plan in 47 pages. I am grateful that this Guide exists now because it is what I dreamed of finding so many cycles ago…

After reading the guide, I am also rethinking my hard and fast stance on avoiding dairy altogether during IVF. According to Liz, “the longitudinal evidence really has found it's somewhat moot, meaning it doesn't necessarily help or harm fertility. The benefits have been shown in those with anovulatory infertility, but in the long run, it's totally an individual preference. If you have difficulty digesting dairy, I always tell my patients that the best rule of thumb is to choose other calcium and vitamin D rich foods like fortified plant milks and mushrooms!” (In full transparency, I don’t consume much dairy in general as it is known to be inflammatory and I am a little lactose intolerant, however having good quality cheese from time to time in moderation is now something that I am comfortable with in my general diet.)

By the time that you complete the Guide, my sense is that you will feel empowered by being able to control the one and most important thing that you can do during the process; what you put into your body. I am also willing to bet that you’ll want to be best friends with Liz because she may be one of the most kind, gracious and supportive souls that you might ever encounter.

As Liz can attest, this way of eating may not necessarily guarantee the outcome of a baby, however, you will be and feel healthier following a Pro-Fertility diet which is largely anti-inflammatory and anti-bloating. The upside of long-term health benefits is definitively also a positive. I appreciate that the Guide offers a long-term health solution, not just a fad diet.

Interested in taking your nutrition into your own hands? You can pick up a copy of Liz’ Stress-Free IVF Nutrition guide here. Use the promo code fertilust for 10% off!

*Please note that this review is entirely voluntary and no funds, services nor goods were exchanged outside of an advanced copy to read.*