iFertracker- First Overnight Basal Body Temperature tracker to monitor the fertility

iFertracker™ by Raaing Medical is the first overnight fertility monitor that measures the core body temperature continuously throughout the night. It also simultaneously calculates and record the Basal Body Temperature (BBT) to predict the fertile window.

Usually, to measure the BBT a woman must use a special thermometer to record the temperature early morning each day at the same time before she gets out of bed. This task itself is tiresome and unreliable, sometimes a day is missed, or some error might occur.

iFertracker eliminates all this hassle and does all the work while the woman can sleep soundly throughout the night. It comes in beautifully packaged, with two CR2025 batteries (each battery is predicted to last for 45-60 days so the other is kept as spare one), a battery replacement tool, and 150 double-sided, single-use adhesive patches.

Setting up the iFertracker before the woman can start measuring the temperature is a very easy task. The woman has to simply download the free app to an Android or iOS cell phone and input all her menstrual cycle details along with her biometrics.

The device itself is very small and lightweight and has a very sleek, oblong design. It powers on automatically as soon as it comes in contact with body heat and a small blue light starts flashing indicating that Bluetooth capabilities are enabled. After once connected the iFertracker will recognize the user’s cell phone and will connect with it every time the app is opened.

To begin using, the woman places a new, double-sided adhesive patch on the oblong wearable thermometer and adhere it to the armpit. It is advisable to shave the area before putting on the device. The device turns on by itself and collects 20,000 data points in a single night, continuously monitoring the temperature as the user sleeps through the night. These are eventually uploaded to cloud and analyzed by an advanced algorithm to calculate the BBT.

The next morning, she removes the device and goes around with her morning routine. At her convenience, she opens the app on her smartphone and the device sync to it and starts downloading the temperature readings collected overnight.

In an event that internet connectivity is lost, or the user is very busy to open the app, the device has the ability to store data up to 10 days and it syncs with the app as soon as it is opened.

The iFertracker app displays the information collected in the form of graphs that are user-friendly and easy to understand. The graph color codes each phase of the cycle, including Menstruation, Follicular & Luteal phases, Fertile Window, and Ovulation day.

In addition to the display of last night’s BBT, the home screen informs the user about her fertility possibility and days until ovulation. The app also allows the user to input relevant event such as cervical mucus, mood, sexual activity, etc. The accuracy of prediction increase linearly with the duration of use as the tracker collects data over time and harness it to predict the fertility window and day of ovulation.

Besides getting pregnant this information can be used for natural family planning, hormone tracking during pregnancy or return to full fertility after delivery.

Raiing Medical also manufacture iThermonitor ™, the only wearable, wireless, clinically validated, and non-invasive core temperature thermometer.  It is worn similar to iFertracker and can be used in children and adults.

The iFertracker is available on Amazon or directly from Raiing Medical for $109. The adhesive patches are also available separately. 

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Here is a video about how to track your BBT using iFertracker

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Stair-step ovulation induction protocols are not just limited to Clomiphene

Stair-step ovulation induction protocol with Letrozole is also as effective as stair-step method using Clomiphene Citrate, and has a slight edge over CC in obese patients reports the result of study published in March issue of Fertility and Sterility.

Stair-step ovulation induction protocols have shown to achieve ovulation induction in shorter time as compared to traditional protocols in women with PCOS. But, so far studies and clinical trials have mainly focused on Clomiphene Citrate(CC).

Letrozole has shown to have superior ovulation rates over CC in women with PCOS, but no study has so far evaluated the stair-step method for Letrozole in cases of absent follicular recruitment after the initial dose.

This Retrospective cohort study recruited 92 infertile PCOS patients, 49 patients completed a letrozole stair-step from Jan 2015-Oct 2016 while 43 patients received stair-step protocols from July 2013-2014.

Letrozole protocol used in the study

CC protocol used in the study 

The demographics of both the groups were nearly similar, except patients in the Letrozole group were obese with a mean BMI of 30.8 as compared to 26.3 in CC group.

Ovulation rates were comparable in both groups (95.9% vs 88.1%, p=0.09), as also time to attain pregnancy, clinical pregnancy rates and side effects.

Thus, letrozole can also be effectively used in stair-step doses for achieving ovulation and pregnancy in PCOS women resistant to traditional protocols.

Abstract

Stair-step clomiphene protocols shortens time to ovulation in women with PCOS

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 Stair-step clomiphene protocol shortens induction time and brings about more ovulation in women with PCOS says the results of a retrospective cohort study published in January issue of Journal Obstetrics and Gynecology.

The researchers looked at traditional and step-up protocol in terms of ovulation rates and time to ovulation in women who have not responded to initial dose of 50mg of clomiphene citrate(CC).

Over a period of 2 years, the study included 109 patients attending a university hospital infertility clinic, with 66 women receiving traditional treatment and 43 were given the stair-step dose of clomiphene.  

The women were monitored for time to ovulation, as well as ovulation rates, clinical pregnancy rates and mild to moderate side effects.

The traditional protocol was used in 2012, in which CC 50mg was given between days 5-9. If no ovulation occurred, the dose was increased by 50mg after a spontaneous menses or a progestin induced bleed.

The stair-step protocol was used in 2013, in which CC 50mg was given between days 5-9. If no developing follicle >10mm was noted between days 11-14, the dose was increased to100mg immediately for 5 days and an ultrasound was repeated 12 days later. The dose was increased in increments of 50mg until a dose of 250mg was achieved.

It was seen that time to ovulation was nearly 50% less with stair-step method as compared with that of traditional method (23±1.8 vs 47.5±12.5 days, p<0.001). With 100 mg of CC, ovulation rates were comparable with both methods but was nearly 3 times with 150 mg CC (37% vs 12%, p=0.004) and 4 times with 200mg CC (21% vs 5%, p=0.01), with stair-step method as compared to traditional one.

Once ovulation was achieved, clinical and overall pregnancy rates did not differ between both the methods (16% vs 17%, p>0.05).

Women with stair-step method did experience mild side effects like headaches, vasomotor flushing, mastalgia and GI more frequently; however, incidence of severe side effects were similar in both the groups.

The authors concluded that stair-step method is an efficient and effective method for ovulation induction with CC at significantly decreased time. Authors of a prospective cohort study even cited the stair-step protocol as an alternative to gonadotrophin therapy with similar efficacy.

The abstract was also presented as 70th Annual Meeting of the American Society for Reproductive Medicine, October 18-22, 2014, Honolulu, Hawaii and could be accessed here.

Abstract

A revolutionary personal fertility sensor that sends you a message- “You are about to ovulate”

A Medical Device Premier Innovation summit was held recently at Minneapolis, MN by MedTech Strategist in association with The Medical Alley Association. About more than 40 start-up and emerging medical companies presented their technologies and devices at the summit.

Among the display was “Priya”, a vaginal temperature sensor that is being developed to wirelessly capture your continuous core temperature to detect the subtle changes that occur PRIOR to ovulation. 

Priya is developed by Prima-Temp, a medical device and technology  company situated in Boulder, CO, USA.

Priya is currently undergoing clinical trials, the intravaginal ring directly sends the temperature data to Priya App on the patients’ smartphone. When the subtle fall in temperature before ovulation is detected, the smartphone alerts the women.

Priya is an intravaginal ring made from medical-grade silicone form-factor and have a wireless continuous temperature sensor inserted within it. It’s dimensions and flexibility are similar to Estring®. Women are using these contraceptive vaginal rings or estrogen containing rings since may years. Prima-Temp just replaced the medications with a very sensitive sensor that measures core body temperature. Currently an algorithm is being tested to detect the DIP in temperature prior to ovulation.

This device has no extra monitor, urine strips or other extra parts that needs to be attached or monitored. The patient only needs to pair the ring with the app on the smartphone and insert the ring in the vagina.

Unlike the Basal Body Temperature (BBT), Priya monitors the internal core temperature continuously, which has been shown to more precise than oral or skin temperature. Based on this continuous core monitoring, the algorithms developed for Priya have been shown to achieve a 99% sensitivity for detection of ovulation, with a 99% percent accuracy in clinical trials.

Women’s body shows a striking diurnal variation and exhibit a pattern that is has been established as highly reliable marker for circadian rhythm. This pattern shows a distinct dip in body temperature 48- hours period prior to ovulation which is detected by the continuous monitoring by the ring sensors.

Meet Ava: The First Fertility Tracking Sensor Bracelet

Ava Bracelet 

Ava is the first fertility tracking device that is worn in the nighttime like a bracelet around wrist. It is accurate to narrow the fertility window to 5.3 days in a menstrual cycle .

It works by monitoring 9 physiological parameters that are in relation with the changing reproductive hormone levels. The data is gathered through night and it is fed into an algorithm. It does not rely on patient to input the data.

It measures pulse rate, breathing rate, heart rate variability, sleep duration and sleep phases, movement, skin temperature, heat loss, perfusion, and bio impedance.

Sync the data in the morning with the Ava app displays the information through several graphs along with a timeline of the cycle, which depicts the fertile window with 89% accuracy.

It saves the patient from taking the Basal Body Temperature (BBT), checking the quality of cervical mucus or doing the urine test for ovulation.

The accuracy improves with longer period of wearing the bracelet.

It is FDA registered and CE approved, based on a yearlong study at the University Hospital of Zurich led by Prof. Dr. Brigitte Leeners, who is known as an expert of mathematical modeling of menstrual cycles.

Ava is specially indicated in patients who have irregular cycles, couples who want to have timed intercourse and patients taking treatment for anovulatory infertility.  

If you get pregnant, the Ava bracelet will track you other parameters like sleep quality, resting heart rate, and stress levels.

Ava is a medical technology company founded in Switzerland in 2014 by data scientists, experts in wearable technology, and women’s health researchers bringing innovation to women’s reproductive health.

Ava is the first easy and accurate method for women to track their fertile days and ovulation,” Ava founder & CEO Lea von Bidder said. “Only worn during the night, the Ava bracelet uses completely novel technology to detect the very beginning of a woman’s fertile window. Ava is registered with the FDA as a medical class one device and has proven to be 89% accurate to detect 5.3 fertile days in a woman’s menstrual cycle.”

Ava is currently priced at Ava's £199, €249 and $199. It can be ordered here.

Ava is also the recipient of Best of Baby Tech Award  in fertility category at the world's largest consumer electronics show 2017(CES) at Las Vegas.  

The company is currently recruiting patients for further clinical studies. 

Here is a video on how Ava will detect  your fertility window.

ASRM and SREI issues guidelines to optimize natural fertility in absence of evidence of infertility.

 

Courtesy:Pixabay

American Society for Reproductive Medicine(ASRM) in collaboration with the Society for Reproductive Endocrinology and Infertility(SREI) issued counseling guidelines for achieving pregnancy in couples who are perfectly normal or no abnormality is detected in any test results.

These guidelines were published in January,2017 issue of Fertility and Sterility. [1]

The guidelines and recommendations are:

1) Fertility declines with increasing age in women and women > 35 years of age should be advised to consult a physician if they do not achieve pregnancy after 6 months of uninterrupted intercourse. For women < 35 years the time window is 12 months.

2) Specific recommendations regarding frequency of intercourse brings in unnecessary tension among couples. But, reproductive efficiency is maximum if intercourse occurs every 1-2 days, but the couple should be counseled about it and advised to follow “their own preference” within the context.

3) The fertile window in the cycle is best defined as the 6 days’ period that ends on the day of ovulation, because viability of both sperms and ovum is maximum during that time. Chances of fertilization is highest if intercourse occur on the day prior to ovulation.

4) Most postcoital practices adopted by couples like lying supine after intercourse and avoiding using the bathroom has no scientific backup. Some commercially available vaginal lubricants inhibit sperm motility by as much as 60- 100% in vitro but no results in vivo. But if needed mineral oil, canola oil, or hydroxyethylcellulose-based lubricants should be recommended during this time.

5) Fertility decreases at the extremes of BMI but, variations in daily diet or any specific diet does not have an effect on the fertility. Healthy eating may help improve fertility and diet high in mercury because of seafood consumption is known to be associated with infertility.

6) Women who are trying to conceive should receive 400 mcg of folic acid daily.

7) Smoking has very deleterious effect on fertility with the odds decreasing by 60% in women who smoke and increasing the rates of miscarriage. Smoking also causes rapid follicular atresia accelerating the occurrence of menopause.

8) Alcohol and caffeine in heavy doses have a deleterious effect on pregnancy and should be avoided. That amounts to > 2 drinks/day, with 1 drink >10 g of ethanol for alcohol and 500 mg; >5 cups of coffee/day per day. Moderate coffee consumption of 1-2 cup per day have no effect.

9)Similarly, recreational drugs, environmental pollutants and toxicants are all recognized to decrease fertility and exposure to them should be avoided.

The full text of the article can be accessed from here.

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[1] http://www.fertstert.org/article/S0015-0282(16)62849-2/fulltext