[0:30] Maiko: In today's episode, I speak to Lina Chan and Tyler Christie, founders of Adia Health, a startup that helps couples test and improves their fertility with a simple at-home test. Adia has recently graduated from the zinc program, a company builder aiming to solve the developed world's biggest problems. Now the company has raised investment from seed camp and is testing its product with the first users. It's great to have you on Impact Hustlers.
[0:53] Lina: Thank you, happy to be here.
[0:55] Tyler: Thank you very much.
[0:57] Maiko: Thanks for joining. You're actually not just co-founders, but you're also a couple, you're married. And Adia Health was born out of a very personal experience for you guys. Can you tell us a bit more about that experience and why Adia Health came out of that?
[1:13] Lina: Yeah, absolutely. So, Tyler and I met a business school and I think like many couples when you graduate after Business School, your focus is very much a career. So, we left the US, moved to England and basically throughout my early to mid-30s, that was my focus, I wanted to build on my career. The last thing we really thought about was getting pregnant, we got married. But then once we did get married, we were like, okay, you know, you're 35, maybe we should start trying because you always have this notion that you're heading towards 40 and your fertility falls off a cliff. But then both of us came from pretty big families so I had, personally never thought it was going to be hard, I actually thought it would be pretty easy. And it wasn't easy at all, it was probably one of the hardest things we've done, and we faced as individuals and as a couple. My first pregnancy ended up as a stillbirth. My second pregnancy was a miscarriage. And I think the trauma of all of that just meant that it was quite hard for me to conceive. So, it took me over a year to conceive. So, all of that just even, kept opening more and more can of worms for me, where I was thinking, how can I have been so unprepared for this? And just also realizing that the whole service is really fragmented.
[02:36] Lina: So, after a number of months, after our first loss, I kind of reached a turning point where my first doctor had said to me, like, oh, the chances of this happening to you again, it's just so low that you should just go ahead and you know, continue with you live and continue as you are. And something just didn't sit right for me, I thought, yes, you know, maybe this is completely unexplained, but I owed it to myself to, kind of go after any answers, even if the answer was, there was no explanation for what happened to you. So, I was, kind of like, on a mission for a few months to find the right doctor and really kind of like, ask, you know, can you figure out what happened. And I was really lucky to find this one doctor and I think my life really changed on that day that I met him. And he said to me, he said, you know, unfortunately, obstetrics today is very reactive. A lot of the times when a woman walks into my office, it's almost too late, I can't really do anything. And what we need to do is help women become more and more proactive about their health and their reproductive health specifically. So, he actually told us not to try to conceive for a couple of months until he did all his investigation. And not just me, Tyler too because you know, we're 50-50. And I think women often just carried all on their own shoulder, they blame themselves for everything but really, you're 50% of the equation. So, we did a battery of tests, we actually were lucky enough to find out what was causing it, he had identified that I actually had a precondition. And then he put a plan in place, I started taking prenatal a lot earlier, Tyler did too and then, under his care, we managed to conceive our two girls.
[4:25] Maiko: Wow, amazing story. I mean, obviously, a very sad story to begin with but amazing in terms of how you managed to turn that around and not know you're bringing out this product that's supposed to help people out there to deal with this problem. How big is this problem? I mean, obviously, it's not you alone that have suffered from this, how big is this problem, how many people are facing it?
[4:49] Lina: Yeah, millions of women, 30% of couples struggle with infertility. One in four pregnancies end in loss, and one in five women will experience some form of perinatal mental health distress. So, it's very common, it's millions of women around the world. And unfortunately, it's such a taboo subject. So, often you go through it, and you think you're the only person that is going through it but actually, once you start opening up, and I've recently really encouraged women to speak up. I think Michelle Obama has done an amazing job for that, just kind of like you know, she's somebody that people think have a perfect life but now she's kind of really talked about how it's been challenging. And, when you take a step back, a ton of women around the world is having this challenge, but they feel so ashamed to talk about it. So, once you start talking about it, you actually, that's when you realize, like, I am really not alone like there's a ton of women out there going through this. And that's why I think we're in this point, where there's a massive wave around, changing the services, changing the way we talk about it, and changing how women demand help and support for it all.
[6:04] Maiko: So, the first product you have developed is the at-home test kit for fertility. Can you walk us through how this works and how this could have helped you when you went through this? Or how this helps people actually solve that problem?
[6:18] Lina: Yeah, so yeah, so we've partnered actually with another seed camp portfolio Thriva, and they help us deliver the at-home test. And it's very easy, you receive a kit at home, you take a little finger prick, and you fill up a vial, and you send it to the labs and then we get the results. We've worked together with fertility specialist from St. Mary's Hospital, who basically developed the panel of the fertility hormones that we need to diagnose. And through that, we're then able to understand a woman's, actual egg reserve, whether she's ovulating regularly and her general hormonal health. And what we're doing here is we're really trying to empower women and make them more confidence that if everything's fine, they know it's fine, and they can carry on doing things the way they've been doing it.
[07:07] Lina: But if things aren't fine, you don't have to wait six months or one year to find out that it's not fine, you'll be dealing with it at day one. And what we really want to do is eventually, now we have most of the women who come to us, they're already in the path of trying to conceive and what we want to start moving that dialogue to a lot earlier. So, as soon as, women are aware of their reproductive health, and you know, think that that's in their horizon, we encourage them to start having that dialogue, understanding their body, understanding their choices, because I think the sooner you understand how your body works, and know what your goals are, you can then get those to marry, rather than kind of what happened to me, getting into my mid to late 30s and being a frenzy and just being super stressed out, that the clock was ticking and it's just not a very pleasant place to be. So, that's kind of like our step one,
[8:02] Maiko: I previously spoke to Hamish from Thriva on one of the previous episodes, which I would say is probably one of the pioneers in at-home blood testing in the UK, and really kind of pushing the boundaries on that, that people test their blood at home and watch the health more regularly at home. And your solution is similar, in terms of the approach that are tested at home as well. Do you think there's a general trend that we'll be doing and watching our health much more closely at home and not have to rely on doctors? Are you part of the bigger trend here or is this just a step to the, to the big vision?
[8:40] Lina: Yeah, I mean, I think there is a trend where, not just women, but men, but I think people in general, want to take a bit more control of their health. And they don't necessarily want to be going to the clinic and booking and taking a few hours out of your schedule to go to the clinic or book and wait and all that. So, there's a trend of people wanting to just have the ease of it and I think technology has really kind of bridged that gap. I think also, it's important to put tests, though, where tests belong, because I think we ought to facilitate and help people test and identify issues early, but you need to provide the right support at the same time, because not everybody will be within range, there will be people who will be, some problem might be identified and that's what we want to do. So, if there's something wrong, we want to be able to identify it early.
[09:36] Lina: But it's really important that you then provide the right support for these people along their journey. So, it's not about cutting out completely the medical experts and medical support, but it's really kind of empowering people to have that dialogue a lot sooner and a lot more informed. Because I think, I know I remember getting those reports from the labs and going, what does this mean? You know, so for example, our report really contextualizes the science, breaks it down into a way where it's very, kind of consumer-friendly but the whole database has been developed by the doctors, it's just that the way it talks to somebody, it's in a way that you can really understand. And also, as part of like our product, it starts with the test but really the core of our product is really helping women improve their preconception health. So, we really help them plan around it because the test is just giving you the baseline, but then how do you then improve it over time? And that's where a kind of, most of our product sits, is providing that plan and the expert support.
[10:35] Tyler: And one thing I've actually had a very long relationship with the health care industry, my father was a cardiologist in the United States. So, since the evolution of healthcare over several decades, and, you know, it doesn't take much to look in the news and find that we basically are facing a crisis of, how are you going to deliver quality health care to an aging population or changing population? And whereas a lot of healthcare services, like what we're talking about here, are reactive, that gets to be very expensive. And so, I don't see another way, frankly, and I don't see any other better ideas or solutions besides providing, you know, lower costs, more easily accessible, proactive care, that keeps people from having to even go into the system, or at least helps to route them to where they're going to get the best, you know, care in the system. So, instead of going to a GP, and then getting referred and going into you know, that all add cost on the system, that is just not going to work and obviously is not working for a lot of people. So, when we think about it as a trend, there's a consumer side of convenience, certainly, and we see that. But I think intrinsically, you know, the health system will need to evolve to that. And we're seeing it across a lot of different areas, not just in this, but when you even think about, you know, diabetes, or like my father's area, heart disease, you know, and, of course, that's taking longer than what my father would have hoped in the 90s. But I think we will get there and there's a lot of innovation and services to do that whether, you know, Babylon Health or Thriva, or others and, that's really awesome to see.
12:12] Maiko: So, what I spoke about with Hamish and noting you guys are on the same trend is really this big need for prevention, right? Like the whole health care system is focused on dealing with results of a lot of things that could be prevented, but we only go to the doctor once, you know, yeah, it's already too late, right? So, that's the exciting thing, I think, to see, you know like you can actually test at home when you feel perfectly fine, but you can prevent certain things from happening.
[12:39] Tyler: Yeah, I mean, the unique thing about infertility, we think, you know, not totally unique to infertility, but it's particularly, sort of relevant infertility is that it's really a journey. Whereas if you have a symptom for a disease, and you go in and you get that solved, it might be a month or two issue, but when you're planning to get pregnant, you're trying to get pregnant, you conceive, or you struggle to conceive, that can be a multi-year issue, so maybe has another kid and you go through it again. And so, what we focus on actually is, you know, what we think of as care pathways in a real journey that people have. So, we think about these tests, it's great to have the tests. And then others who are providing tests, it's really important for them within the context of, where are our users out there, their age, their history, a context and a lot of current labs or clinics that just give you the, you know, anti-hormone test result figure, but don't really help you interpret that or understand how that fits into your life, don't help people with that journey. And often, what we see with some women is that it's actually a disservice sometimes, because they get very scared, and they don't know what to do with that. And so, it's really important. And I think you'll see that even more in health care of providing people, you know, assisted journeys throughout their pathways, especially for chronic conditions, or long term conditions where it takes kind of persistent care, to help people through that, you know, such as cancer, or even diabetes, other areas, and then fertility, we can certainly see, as you can see from our story, it's definitely a journey.
[14:10] Maiko: I'd like to focus on an issue and it's good to have you here Tyler as well for that, is, when I researched the topic about, it seems really, like everybody's talking about fertility as a woman's issue or something that women have to worry about and a lot of content out there is focused on women. And when I went to your website, one of the first things I saw was actually, Tyler, your blog post about how your experience affected you and so on, which I found quite great to see, like in terms of, you know, this is not just a woman's issue, this is an issue for couples for both men and women. So, how do you think about that, and in terms of what's your approach as well, to kind of get this awareness out? You know, men have to worry about this too, and actually, play a role in it, and they might be the cause of fertility issues as well?
[14:57] Tyler: Certainly, I think there's a lot going on with this right.? I mean, the one thing I'm trying to do is just in sharing my own story to take that first, you know, punch a bit. And I think, hopefully, that can spark more people to do that as one way. But, you know, it's a bit more complicated than that, you know, when I was, I think when I was a kid, even I knew I wanted to have kids, so, and I just always thought it would be easy, and it would happen, and, you know, goes fine. And so, then when we had complications, and miscarriage and loss, you know, I felt like this power position that men think they have all the time and being able to care and take care of solutions, I realized that I didn't have any of that, because there's nothing I could do. I felt like you know, with that, I think that's can be really complicated for men and their role in their image, as well as in their relationship. And so, making people understand that, you know, that's actually not too uncommon to have some of those challenges and that then also, there are things that you really can do or be, you know, really helpful for people. And so what we want to do is, you know, empower women to have those discussions with their partners and empower men with the information they need, in a day, in a format that's digestible for them. Many men are very different in this experience, I don't foresee men having fertility apps on their phones in the near future. But, you know, more men, knowing that supplements for them can dramatically boost their chances that certain other lifestyle behaviors can really make an impact and that also, you know, mental health can play a really big role for both partners and particularly partner.
[16:49] Tyler: And so, in terms of, you know, caring for your partner, maybe you don't think you can solve the problem, but you can be supportive in ways for your partner that can actually reduce anxiety and stress and whether that means, you know, doing meditations together, like, you can find on our product, or, you know, going to sessions with the doctor together and things like that, that can just really help the partner. And I think that can help, you know, change the discussion of what a man's role is in this, you know, that it's not just to, pardon the language, but you know, deposit sperm, but you are part of this journey, as well. And you have a role to play in that and you get a very powerful role as well.
[17:27] Lina: And I guess, from even science standpoint, there's always been this idea that women's fertility decline, but and men don't, because every three months, their sperm will regenerate. But actually, that has completely been debunked, men's fertility will also decline in the quality of their sperm will also decline. So, and actually, even the women blame themselves so much for fertility, Linda 17:54 [inaudible], who's our fertility specialist wrote a great blog about so fertility and she identifies, and we posted that, that over 50% of subfertility is actually driven by male factors, not female factors. And, the interventions for men is a lot easier than the interventions for women. So, actually, one of the first things when we speak to women, is we really encourage them to have the dialogue with their husbands about them also having to take a sperm test and the importance of supplements for men. Because that can hugely improve their chances. So, it's also science-backed, right? It's not and there's a physical element, as well, as an emotional element.
[18:32] Maiko: You just mentioned, you're working actually with a range of experts on fertility, and you're looking to back, you know, you're backing your product and science, right. I'd be interested, how do you translate the scientific insight that probably you went through the process from not knowing much about it to actually talking to the people and by researching it and working with top scientists in the field, to actually translating that into a product? Can you walk us through a bit about that and maybe also the difficulties that he faced with that or how do you translate this science out there into actually a product that works?
[19:07] Lina: Yeah. So, we've developed a 12-week program with our experts. And, the 12-week program tackles three main areas. One is fertility education, the second one is nutrition and the third one is emotional support, particularly around helping reduce anxiety and stress. And all the modules that we've developed, the educational modules and coaching modules have all been developed in conjunction with our advisors. And they range from fertility, obstetrician, maternal nutrition, and clinical psychologist, and it's a very easy way to engage with the product, every week you have a module across one of those domains and the women engage with it on a daily basis. We developed also a meditation, daily meditation where the mindfulness coach around a woman's reproductive cycle. So, that's kind of how we've distilled all the knowledge from them, we've created these modules written by them, actually, by all the doctors. And what they've done is trying to just filter the latest science into very tangible steps that women can take in their lifestyle to improve their fertility.
[20:21] Maiko: When you're developing this product, do you think there's a need like or when you went through it, was there needing to come up with radically different testing methods? Or is it more about applying what's already out there, repackaging it, enabling people to do it at home, and innovating on that process? Again, I bring up the example Thriva again, but the blood test they're doing, they're not radically new, they're just enabling people to do that.
[20:50] Lina: Yeah, it's access, because now a lot of women, they'll have to be trying for six months to a year before they even qualify for the tests, you need to miscarry three times before even speak to a specialist. And a lot of the information that you get out there is quite fragmented, it won't necessarily look at your emotional health, as well as your physical and fertility health. And what we're doing is we're breaking down the access barrier. So, on our platform, you order the tests at any point, at any age, even before you start trying, we have channels, that people can submit and speak directly to specialists, not a GP, but specialist, in, fertility, obstetrician, obstetrics, and nutrition and psychology. And everything is on the ease of your app, of your mobile phone. So, we're completely breaking that down, people can get it all in one place.
[21:44] Tyler: Yeah. And I think the other element here would be on access, is also trust, you know this is a very personal or important issue. And it's very hard to sift through this, we experience that ourselves. So, you know, for instance, you're on cursory research, people might think, well, if I get my AMH test done, you know, that'll be great and that's a good indicator. Well, the truth is like you actually, to really understand this, you need to test several different hormones, then you understand how they interact. And you know, sort of a combination of that may be indicative of your ovarian reserve and other elements, right. And so, it's very important, we found to really create that trusted research products, you know, we could probably sell individual hormone tests at a lower price and maybe that would be easier for people, but it'd be very misleading, we see that happening in other areas. And so, I think the other element around that is really, you know, having us getting into the science, working directly with these leading experts in the field, to ensure that we're really putting the right quality of test together.
[22:49] Maiko: Throughout this journey, from facing these issues yourself to creating a solution to it, if you reflect on this journey, what do you think for you personally, what's been the biggest misconception that you had initially, or the biggest learning that you had throughout this journey that you might want to share with people that are in a similar situation now? Is there anything that you would now advise people that you wish you knew when you started out, or when you had this problem yourself?
[23:15] Lina: I'd go back to the taboo topic. I think when something is very taboo, you delay diagnosis, you delay treatment, and you create an environment that's just very hard for somebody to thrive in. And I underestimated how much of that taboo affected me personally when I was going through it, and even now encouraging women to talk about it. I think it's a little bit of a learning curve for everybody, for all women, that it's fine to talk about it, it's fine to share. You know, and I go back, to like the Michelle Obama example, and other celebrities actually, and I think that will really kind of help move the needle and move it a lot faster because, you know, we even have users that will come to us, and they still feel very ashamed about it, they'll even feel ashamed talking about it to their partners. So, it's very much ingrained in our culture that this is a difficult topic. And I think I underestimated how much it had affected me when I was going through it and how much it's still very prevalent across the board.
[24:21] Tyler: Yeah and for me, someone links to that is, you when you take a step back from this, you think about it, it's just shocking that people don't have a plan. Like I didn't have a plan, I knew for decades that I wanted to have kids, I had no plan, I hadn't thought about it. Like, I think I'm a decently educated person, but this is like, idiotic. Like when you now take a step back of the world we went through, and all we learned and all that we learned that we could have known beforehand, and then you talk to people, and nobody has a plan for this, right. But it's arguably, one of the most important things in their lives, you know, so that's just shocking. And I think that's a behavior that's going to change and the behavior that we want to change and somewhat to make that, both more proactive, but an empowering thing for people as well. And I think that's the, to me, really the eye opener of destroying between how important this is, and how little we actually plan for it and get on top of it.
[25:17] Maiko: When you look at the next 10 years, maybe you're just at the beginning of your company, you've achieved a lot but if you look at the next 10 years, what's the sort of world you're trying to help create with your company? What's world do you want to live in, in 10 years where you might be able to contribute with Adia?
[25:36] Lina: I mean, we're starting now with fertility and conception, but our goal in 10 years is really to develop a product that handholds a woman throughout all the life stages in her reproductive health, all the way to menopause. Because talk about another taboo subject is the whole perimenopause and menopause live stage. So, it's really kind of being able to see our product develop all through all of that. And you know, and as we're growing, as we're learning, as we're understanding and having, you know, more knowledge of interventions and their impacts is honing our product to become a lot more personalized, a lot more predictive, so that anybody who comes on to the platform, we can understand their context and be able to predict already, what a future care pathway would be for them.
[26:22] Tyler: Yeah and I think for me, it's going back to this plan, you know, like, we have a plan for our college education, for our kids, you know, plan for our retirement, you know, of this, I want to see, you know, 80% of people plus having a plan for their fertility and failure to have that globally. You know, and we see this need in developed countries as much as emerging markets as we're starting to see some users come on from places like Kenya that doesn't have access to care, don't have good quality care. But this type of education can be empowering still about what they can do and how they can think about that, in their own context. And so, we can help empower people with that plan, that's also personalized to their context or situation, their goals, that can be incredibly empowering, empowering for people and really change, systemically change this area of health.
[27:09] Maiko: Thanks very much, with that we're already wrapping up. Thanks very much for taking the time and for spreading this message and making people aware of it. I think it's a really good beginning that we start talking about this more, but it's even more amazing to see that you guys actually developed a solution to this. So, I wish you all the best on that journey and thanks for joining me today.
[27:29] Lina: Thank you.
[27:30] Tyler: Thank you very much.