We can track everything from the number of steps we’ve walked to our heart rate, so why not a woman’s fertility?

With more and more women wanting to interpret their menstrual cycles from understanding their bodies to becoming pregnant, there’s a need for comprehensive fertility care solutions that aren’t just convenient, but also reliable.

Based in Zurich and San Francisco, Ava Women has designed a bracelet, app and self-learning algorithm that tracks women's menstrual cycles, giving them accurate and reliable data about their fertility and how their cycle fits into the bigger picture of their reproductive health.

In this episode of HealthRedesigned, we chat with Allison Sarno, Head of Design and User Experience at Ava Women. She shares how Ava Women is using technology to revamp women’s health and helping women understand their bodies better, whether they’re tracking their cycles or determining the right moment to conceive.

Bringing technology to women’s health

What is Ava solving for women?

A woman can use Ava at any time throughout her fertile life. Our goal is to be a companion throughout her reproductive life. If she's interested in learning more about her body and understanding how her body reacts at different times throughout her cycle, she can use it when she's cycle tracking. She can also use it when she's trying to conceive.

Ava helps a woman figure out when the best time is for conception. It gives her a heads up a little bit before that time comes and if she does get pregnant, she can continue using Ava to track her temperature, weight and heart rate throughout her pregnancy.

How is Ava different from other fertility tracking tools?

If you look at some of the ways that women track their cycles right now, they're either really inaccurate or inconvenient. One example is the temperature method where a woman takes her temperature at the same time every morning and looks at the fluctuations to give her an idea of when she might be ovulating. The downside to this method is that you have to do it religiously and it only tells you whether or not you’ve ovulated after it happens. That defeats the purpose if you're trying to get pregnant or even avoid pregnancy.

Some women who are trying to get pregnant use ovulation predictor kits which involves peeing on a stick and can sometimes require women to do this every day from the start of the cycle until the time they might ovulate. There's also the cost factor—these kits can be expensive and it adds up over time. With Ava, it's as simple as wearing a Fitbit. People are already familiar with wearable devices and how they work and it's just as simple as wearing the bracelet before bed. It tracks 9 different parameters while you sleep. When you wake up in the morning, you sync the bracelet and it gives you your data right then and there and updates your predictions.

Empathising with the user’s needs

How did your team start approaching the design of the bracelet and the app?

It’s really important to understand our users and have empathy for them. We really tried to understand what we needed to do to make this whole process easier for them—for instance, we wanted a bracelet that's comfortable and one that you only wear at night.

We also didn't want them to input a bunch of data. So with Ava, you just enter your correct period date if our prediction is off. An interesting thing that we learned is the right amount of information to give users. We started with having a very simple calendar on the app and told users what their parameters were as well as whether or not it was a fertile part of their cycle.

But users really wanted more and wanted to see a visualisation of their data. We brought graphs into the app and visualised all the different data points. The next thing was, "Oh this is great. Now, what does this all mean?". We’re now figuring out how to help them understand the data and visualisations, and that’s quite an interesting challenge.

How do you engage with users when you're discussing private topics like their menstrual cycle and fertility?

We have a very strong and active closed community on Facebook. Within that, we have one that’s dedicated to cycle tracking, another for women trying to conceive and another one for pregnancy. All of us on the product team are members of this community and we typically don't respond unless it's related to the product or user experience. But we’re active listeners and see what women are talking about and what their needs and struggles are. We really try to put ourselves in their shoes and understand what they're going through.

We also actively survey our customers, measure our Net Promoter Score and try to understand what we can do better. We do usability testing and user interviews. We’re a startup and a relatively small team, but we take advantage of different technologies to make this easier. We mainly do remote usability testing and recruit from our community.

Even though we're really focused on the usability aspect of the app, it's really interesting what comes up sometimes. Many of the women we talk to are very open and willing to discuss their struggles and what they've gone through when they're in the whole process.

A fertility tracker for all women

Have you had assumptions that you've completely debunked when you started validating them?

We had this assumption that most of the women who used Ava had been trying to conceive for a long time or trying for their first kid. We realised that it's actually a much more diverse group than that. There are women who are just starting this process and learning about their bodies. They aren't that familiar with the menstrual cycle and all of the science behind it. It was interesting to find out that our audience was much wider than we thought and it was actually kind of cool because we really want to be a tool that's accessible and available to all types of women.

We also thought that the women who first adopt Ava would be technically savvy and live in urban cities. But we realised that's not really the case. We appeal to all different types of women and they're not all urban hipster city dwellers, they're just regular women.

Were there any blockers you had to overcome to improve the user experience?

Trying to figure out where we sit within this spectrum of medical versus lifestyle. This is something that impacts not just the app but even the way we communicate to users through our marketing. We’re a medical device, but we're also a lifestyle product and there's a very emotional part of the product that we can't ignore. Sometimes, we struggle when creating a new feature—is this too medical or too lifestyle?

How do we come across as medical and trustworthy, but not as a product that someone uses because they have a problem? A lot of the ways that we've worked towards that is by keeping the science accessible and understandable. It's like if you were to talk to your older sister who’s a gynaecologist. We use terms that you’d understand but we don't dumb it down.

We also want to stay away from a design that’s sort of pink, flowery and girly like many of the fertility apps out there. It’s just so immature and cliché. Women are much more sophisticated than that and just because it's a women's product, doesn't mean that it needs to be pink and have kittens on it.

We also strive to help women talk about things like cervical mucus and the menstrual cycle. Sometimes it's easy to forget that these topics in some cultures are still very taboo. That’s what’s so great about our communities: it’s very open and people talk about things that they maybe didn't talk about before, like miscarriage. That was also an interesting challenge for us when we developed the pregnancy aspect of our app. How do we handle that in a really sensitive way? We really looked to our users to validate our decisions when we worked on that on that part of the product.

How can women join the Ava community?

Within the Facebook group, there are several different communities. The larger communities are for women who have already purchased Ava, so those are closed. As you can imagine, if you're trying to conceive or if you already are pregnant, maybe that’s not something you want your entire Facebook community to know about. But there’s a community that people can join that's open for those considering Ava by going on Ava Women’s Facebook page.

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