"I wish there was a magic test to tell [women] when exactly they should have kids," says Afton Vechery. Until there is, 29-year-old Vechery wants to democratize fertility data for women. 

Her San Francisco-based company, Modern Fertility, which she co-founded with Carly Leahy, also 29, offers at-home blood-test kits that measure a woman's levels for eight hormones that are associated with fertility. The $159 test, which includes a one-on-one phone consultation with a nurse, is pitched as a tool to help assess, say, how many eggs she has and how close she might be to menopause. 

Modern Fertility hasn't invented anything new--obstetricians and fertility specialists use the same bloodwork as part of their initial patient evaluations. Nor does the startup aim to diagnose specific conditions. The company's goal is to make access to these tests--which can run as high as $1,500 in a clinic if not covered by insurance--easier to obtain and less costly. 

The global fertility-testing industry is a nearly $400 million market that is projected to grow to almost $600 million by 2020. Currently, most doctor-prescribed blood tests are handled by heavyweights like Quest Diagnostics and Laboratory Corporation of America. While Modern Fertility, with its $7 million in venture funding, is still very much a David to those Goliaths, the startup says it can shake up the way testing is done by marketing to young women directly. The pitch? If you have the tools to start monitoring your fertility--the same way you should continuously monitor your credit scores--you can make more informed decisions, whether it's freezing your eggs or trying to conceive sooner rather than later.

Proving ground

Vechery's interest in fertility began long before she launched her company. After attending Wake Forest University, Vechery took a job in private equity that involved doing due diligence on women's health centers and in vitro fertilization clinics. She quickly learned that infertility rates are on the rise because women are choosing to have children later. The problem, she thought, was women didn't get relevant fertility data until it was too late. By the time they decided to try to conceive, their natural fertility had peaked, and often even advanced procedures to become pregnant were unsuccessful. 

For the next few years, Vechery headed to Silicon Valley and racked up startup experience at other people's health care companies, including genetics testing startup 23andMe. She joined as a product manager while the company was still battling the Food and Drug Administration to be able to sell its health test to customers.

"The biggest thing I learned at 23andMe is that information alone is better than no information," she says. "It empowers patients to take action and take their health in their own hands."

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Eager to see how women would respond to having that kind of intelligence about their own reproductive health, in 2016 Vechery quit her job at 23andMe to focus on Modern Fertility full time. She wanted to build a company that would not only offer women a snapshot of their fertility but also speak to them like an "ob-gyn who also happens to be your best friend."

For that voice, she tapped Carly Leahy--a branding whiz who previously worked at Google and helped Uber launch its delivery program UberEats--as her co-founder. Y Combinator would help them both translate the idea to investors. 

"This is a very large population--half the population--and women historically are underserved as health care patients," says Phin Barnes, an investor at First Round Capital, which participated in Modern Fertility's $1 million seed round before it launched at Demo Day. "Everyone agrees--patients, health care providers, insurance providers--data empowers patients."

Peak fertility? 

Even so, the founders say they had a hard time getting some investors to realize this point. As Vechery and Leahy met with (mostly male) investors, the No. 1 question they heard was, will women really want to pay for this? Within a month, they had their answer: Modern Fertility had rung up $70,000 in pre-orders.

While Barnes didn't doubt the appeal for Modern Fertility's service, he did initially wonder if asking women to use lancets for the at-home blood draws was simply too big an ask. For those who don't want to puncture their own fingers at home, customers can also go to their local Quest Diagnostics lab to have a traditional blood draw. 

In addition to $7 million in venture funding, the 15-person company boasts a medical advisory panel with board-certified reproductive endocrinologists and pathologists. But the competition in the still-nascent field of at-home blood testing is booming. EverlyWell, Let's Get Checked, Thorne, Adia Health, and other competitors all offer fertility hormone testing. Even so, Barnes says Modern Fertility has an advantage in the form of its thoughtful, community-driven brand, and the clinical expertise on its advisory board. 

The medical community has mixed feelings on letting patients do their own tests. For some doctors, the proliferation of at-home fertility testing is concerning because hormones offer only a small window into a woman's ability to conceive and patients might not understand that. Reproductive endocrinologists like Ingrid Rodi of Pacific Fertility Clinic in Los Angeles say the eight hormones alone don't offer enough information to interpret a woman's fertility meaningfully. 

"You really can't expect more than generalizations," Rodi says. She adds that recent research suggests that using such hormones to measure a woman's ovarian reserve may not be a good predictor of whether she may experience infertility. Rodi says more research is needed--and perhaps just as important, "we need to do things as a society to encourage and support women to have children at a younger age, when they're most fertile." 

Modern Fertility acknowledges on its website that its tests can't predict infertility and can't reveal the whole picture of a woman's fertility. Rather, the startup says the tests are meant to help a patient start a conversation with her doctor and take an active role in her own health. They're also meant to be retaken annually, so that women know how the picture is changing over time. 

"No one ever told me that fertility declines with age or that in vitro fertilization doesn't always work," Vechery says, noting that, growing up, women mostly just hear about how not to have babies. "Women should be thinking about reproductive health during their whole life."