Twenty-seven-year-old software developer Amitha Sivaji has been trying to conceive for the last three years. As suggested by her gynecologist, multiple attempts at getting pregnant during her ovulation cycle were also met with disappointment. Eventually, she did conceive, but not without facing the side effects of taking multiple hormone-inducing injections.

She said had she chosen to opt for the in-vitro-fertilization process (IVF), she wouldn’t have had to go through long physical turmoil. However, she told KrASIA that she didn’t take the IVF route because the chances of conceiving at the first attempt were meager.

The basic problem with using IVF is that it’s not possible for doctors to manually choose the healthiest embryo for fertilization, and it takes about two to three attempts before a woman can conceive. This is where Chennai-based GoHealthe’s artificial intelligence-powered solution comes into play. The company claims its AI can help doctors pick the best embryo that improves the probability of pregnancy by at least 25% than the manual selection done by a seasoned embryologist.

Over the last few years, a handful of medtech startups in India have been working to address women’s health issues, which in itself is set to become a USD 41.05 billion industry globally. Companies like GoHealthe, Niramai, Veera Health, and Inito are deploying different solutions to help doctors diagnose as well as cure diseases specific to women.

AI and parenthood

The world’s second-most populous country is ironically facing a 50% fall in fertility rate, according to the World Population Prospects 2017, leaving nearly 27.5 million couples struggling with conception in India. Most of these couples resort to IVF and other assisted reproductive technologies.

In 2018, the market size of IVF in India was USD 478.2 million and is estimated to reach USD 1,453 million by 2026, with a CAGR of 14.7%.

However, couples leaning towards IVF think twice before opting in for the procedure, as the entire process is quite expensive. A typical IVF procedure costs anywhere between INR 250,000 (USD 3,356) and INR 300,000 (USD 4,027). And since its success is largely left to chance, most couples typically get successfully pregnant after a minimum of two to three IVF cycles.

Dr. Geetha Manjunath, CEO & CTO of Niramai posing with the thermal scanner. Photo courtesy of Niramai.

“My wife and I made the decision to go for an IVF after three months of trying to have timely intercourse. We had to consider the fact that each cycle of IVF cost two months of our salary,” Giri Philip, a software developer at Hewlett Packard, told KrASIA.

Dr. Gayathri Karthik, the head of the department and consultant of obstetrics & gynecology at Manipal Hospitals, said, “Women who cannot conceive naturally and opt for IVF need an average of two to three cycles for a successful pregnancy.”

GoHealthe claims it is possible to decrease the number of cycles using its product. GoHealthe uses AI and image processing to determine the healthiest embryo.

The software is trained on over 8,000 images of embryos collected from around the world. The company has partnered with 11 clinics globally, and every time its partner clinic uploads an image of a patient’s embryo, the software scans and compares the morphological features of the embryos to give a score out of ten, which corresponds to the likelihood of a successful pregnancy.

Moreover, it can rank embryos that it has never seen before and improve the accuracy of the selection process. Since the predictions are based less on the opinion of embryologists and more on unassailable data, patients tend to feel more confident.

Dr. Michelle Perugini, founder of Presagen, the parent company of GoHealthe, said, “With AI, we can identify the most viable embryos and help women conceive faster.” Implanting embryos that increase the chances of pregnancy not only reduces the number of IVF cycles needed but also helps prevent emotional burnout of women and couples.

However, turning to IVF is the last resort for couples wanting to become parents. The first step for women who face trouble getting pregnant is to try during their ovulation cycle.

With respect to ovulation, most women believe that they can get pregnant close to the 14th day of their menstruation cycle. This assumption is incorrect, as ovulation varies from woman to woman, and the cycle is controlled by an individual’s hormone levels. LH (Luteinizing Hormone), a key fertility hormone, rises 24–36 hours before ovulation and is a strong predictor of a woman’s fertility period.

Bengaluru-based company Inito, which manufactures fertility testing kits, measures estrogen and LH levels—present in urine—to accurately predict a woman’s fertile days. Its testing kit, which received regulatory clearance from the US Food and Drug Administration last year, is a small device that connects with smartphones to provide customers with information regarding their ovulation cycle and can point out peak fertility days.

Inito claims to be able to naturally increase the chances of pregnancy by 89%.

Tech to the aid

When it comes to women’s health, medical conditions such as infertility, Polycystic Ovary Syndrome (PCOS), and breast cancer have been on the rise over the past decade.

Mammography, the process of using low X-rays to diagnose breast cancer, is invasive, painful, and comes with a risk of radiation, which causes many women to shy away from getting tested. However, doctors say this hereditary disease can be largely controlled if detected early.

When 25-year-old Susan Matthew, whose sister was diagnosed with breast cancer seven years ago, decided to get the checkup done as a precautionary measure, she chose to go with Bengaluru-based medtech startup Niramai’s non-invasive and painless diagnosis technique.

“Stage zero detection has a five-year survival rate of 95%, whereas stage three detection has a five-year survival rate of 10%. This drastic difference in survival rate, quality of health, and treatment efficacy are all signs that women should be proactive about their breast health,” said Dr. Geetha Manjunath, founder of Niramai.

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While a typical mammogram identifies breast cancer only after visible lumps have been formed, Niramai’s Thermalytix tool, which uses AI and thermal scanning, can identify breast cancer well in advance.

Last year during the pandemic, the company launched a home screening service for women who are due for their annual preventive diagnosis as well as for first-time customers. Niramai has diagnosed 36,000 women so far and is present in 14 cities with over 50 hospitals using its breast screening technology.

As these companies see an uptick in terms of usage from patients as well as doctors and hospitals, they have started attracting the attention of top-tier venture funds.

In 2019, Niramai raised USD 6 million in Series A funding led by Japanese VC firm Dream Incubator, Beenext, Flipkart co-founder Binny Bansal, pi Ventures, and Axilor Ventures, among others. The ovulation testing kit manufacturer Inito is backed by Y Combinator and has raised USD 1.8 million from several angel investors.

Last month, Veera Health, a digital health platform for women, received USD 3 million from Sequoia Capital India’s Surge, Global Founders Capital, Y Combinator, CloudNine Hospitals’ co-founder Rohit M.A, Tinder India Head Taru Kapoor, and other angels.

Founded by sisters Shobhita and Shashwata Narain in August 2020, Veera Health connects PCOS patients with doctors, dieticians, and caregivers to create a personalized treatment and health plan. It claims 110 million women suffering from PCOS in India have used its platform.

“I was extremely frustrated by how long it took me to get diagnosed with PCOS, get proper medical advice to manage my condition. Even after trying multiple doctors, I felt like I was in the dark about how to treat my symptoms,” said Shobhita Narain, COO and co-founder of Veera Health.

Women in India face a lot of stigma and judgment, even from the doctors, when it comes to treating their health. “There’s definitely a lot of judgment in the Indian context as well. We hear story after story from our customers about how they were body-shamed or told to get married instead of treating PCOS,” Shobhita said.

These Indian medtech startups are changing how women take care of their health