“Fertility care designed around you”
My name is Andreia Trigo, I am the founder and CEO of Enhanced Fertility. I’ve been involved in everything from the beginning of the company. From having the idea to start the business, to managing the team, to making diagnosis of infertility possible to so many people across the world. Together with our corporate team, I also guide the vision for the future of the company.
I was diagnosed with infertility when I was very young, I was only 17 years old. I wasn’t trying to conceive at that stage; but just like every other girl at that age I was waiting for my periods to start and they weren’t starting.
There were lots of medical investigations, which took a long time. From scans to blood test to taking medications to see if it would trigger ovulation and periods. There were also invasive examinations done by several doctors.
Eventually I had to have surgery, and it was only at that point during surgery that they realised that my uterus was missing, and the top part of my vagina was also missing. I was just 17, being diagnosed with MRKH, which happens to 1 in 5000 women who are not born with their uterus or the top part of their vagina. I was so shocked at the time, and I didn’t even know that that was possible!
Of all the possibilities that were crossing my mind as I entered the doctor’s office – being told I don’t have a uterus was not in my mind. It’s not something that people talk about. I also wondered how it can take two to three years for them to realise that I don’t have a whole organ!
It was a long time to diagnosis, and it also took me a long time to process everything that was happening. I was getting started with my nursing degree at the time and it took me a long time to process internally what I was going through. I avoided everything related to pregnancy and fertility for many years; and I didn’t want to work in an area where I was seeing pregnant women, I didn’t want to work with babies – it reminded me of what I could not have, and the pain was too much.
I was an anaesthetic nurse and worked in many operating theatres. Throughout my career I came across people who were having babies through C-section. It’s the most beautiful thing in the world, when you see that baby being born! I have seen surgeries where people were having their uteruses removed and it was always in the back of my mind, whether a solution would be out there for me or not.
It was only in 2016 when I realised, I was doing so much professionally but I wasn’t feeling fulfilled. I felt that I had to do something in the area of fertility, because that would allow me to grow beyond my wound and I didn’t want to avoid it anymore; I wanted to poke it and be exposed to the pain because that’s the only way that I could see any way of giving meaning to it.
Turing the pain into a vision
I knew I wanted to help people, but I didn’t know how. It took many years of research and talking to patients, nurses and doctors to understand the problems that people were having. That’s when I noticed that the time it took to get my diagnosis was not uncommon – for most people it takes over three years to be diagnosed, so I’m not alone in that! That’s when I knew I wanted to do something in the area of diagnosis. I wanted to make it super easy for everyone to find out why they were not getting pregnant.
Creating the business
Here in the UK, we have access to doctors and the NHS, but there is a post code lottery and not everyone has access to the same treatments. In Asia and Africa people don’t always have access to doctors readily available where they live and may not be able to travel to be seen. In other places like the USA, it’s incredibly expensive and people may not be able to pay for those professionals. So, I started thinking about a way of helping people be diagnosed without having to cost them money.
I don’t want cost to be something that prevents them from being diagnosed. That’s when we came up with the idea of the questionnaire. It’s a very long questionnaire – Fertility Risk Detection Tool. It assesses both men and women. We ask you all sorts of questions about things that could potentially affect your fertility. This is available free of charge on our website. Anyone, anywhere in the world can complete it. At the moment it’s available in English but we do have plans to translate into other languages, so that we can increase accessibility to many more people.
We then realised that a lot of people who were completing this questionnaire, had not tested their hormones. We had more than 60% of people who did not know their hormone levels, even though they had been trying to conceive for so long. Hormones control our reproductive systems, so we needed to do something about it. So, we created an at home fertility test kit that people can order from the app or the website. People are then able to test their hormones and realise if this is something that is keeping them from getting pregnant. In 30% of the cases that is the cause. By establishing the cause, we can figure out how to manage it.
Developing the platform
Last year was a very full year! We created a platform – Patient Portal – to help people understand their results from the blood tests and the questionnaire. This platform uses an algorithm to process patient data. Patients are given a fertility score from 1 to 100 and receive several personalised recommendations based on their answers. Accessing all this information is free as well. The only thing that patients pay for at this stage is the test kit for checking their hormones, or if they want a one-to-one consultation.
From where we started, to creating this amazing solution was a long journey. We had to figure out how to address the problem and do a lot of research in the meantime!
Personalisation of fertility care
Personalisation is crucial. We learn from patients that they don’t know a lot about their fertility. If we look back to our own fertility education classes, we were taught how to avoid a pregnancy. It’s all about contraception and STIs and is all about how ‘easy’ it is to get pregnant! Many women start on the pill when they’re young and then only realise later on that the cycles aren’t so good and that they might have problems conceiving. On the male side, there’s also the idea that it’s not their problem, when in fact half of fertility problems are related to male factor.
So when couples realise they can’t get pregnant naturally, there are lots of things they need to know about. In the beginning general information can be useful for them but, after a year they have read so much and they are very proficient in everything related to fertility. It’s at that point that they need that personalised information. They want answers based on their specific symptoms and problems.
There can be a very wide range of possibilities as to what is keeping a couple from getting pregnant. It is important that we figure out exactly what is the specific problem and then the right solution for this couple.
Company values: Education, Access & Transform
If we look back to our grandparents’ time, doctors were the purveyors of knowledge. People would believe 100% what the doctor told them and would follow their advice. Our generation is different and has access to a lot of information. However, people are not always trusting information online. We have realised from research that patients want access to trustworthy information; and want to know where this research has come from. They want to be able to click the link and read the article themselves. That’s why Education is one of our core values.
We want to bring that trustworthy information to patients’ fingertips. This enables patients to make informed decisions and they can communicate with their clinical teams in a more open way and have that information. If they are informed, they are more likely to go ahead with treatments.
Accessibility is one of our core values and is so important. It absolutely breaks my heart when people message me on social media and they live in countries where they don’t have access to treatment; I want to do everything that I can to help them. And that’s why we created our app, the Fertility Risk Detection Tool and the Patient Portal completely free of charge.
We refer to transform, as a lot of people want to take charge of their fertility. They want to know what they can do to improve their chances. A lot of our recommendations are based on personalised data that people have provided, so to transform your fertility gains this very special meaning of changing what can really make a difference to your journey.
We are developing a platform for doctors so they are able to visualise patients assessment data. So, when the patient arrives at the clinic, they can see exactly what diagnosis has been made and what still needs to be investigated. Then linking that to machine learning, we can track if there are certain risk factors, and if you try a treatment, which one will most likely result in a pregnancy. This is going to be a game changer and is a big project of 2022!
Most of the time, our recruitment has been about the people we know. Our first hire was our Head of Marketing, and she came highly recommended to us, we knew of her work previously and she fit in really well. The second was our psychologist, she was my sister, so I knew what she was good at in terms of research, and we needed someone to manage that.
Developers again came recommended by word of mouth as we knew the skills that we needed, and we knew about work that they had done.
I think it will be a challenge in the future as we grow and we expand the network, as to how we can attract the right people. As people stop being recommended to us through word of mouth it will have to be through other means and that’s an interesting reflection to make! It’s about identifying the right skills and see if they fit in the culture of the company and the team. I will probably need to outsource that as I would probably make a decision from the heart but might not necessarily be the right person!
Last year we were accepted into the Health Inc accelerator and that was our first initial outside funding. It was a small amount of funding from the accelerator; however, it was crucial because we have done so much work in a short period of time.
They scouted us; they had identified us. So, we applied and there was a presentation and a pitch that we had to do, after that we were one of eight that were selected out of 3500 companies! It was four months of intense work! It was a fascinating journey being part of that accelerator.
We haven’t gone for the big funding yet, maybe in the future but for now I quite like bootstrapping and doing as much as we can without giving too much equity away.
It is about vulnerability. If I’m not letting myself be vulnerable and exposing my own wounds; then I will also not be able to overcome it. I would not be able to find meaning in it, or feel fulfilled in what I’m doing; I wouldn’t be able to give back to society. For me, vulnerability is my way of unlocking everything else, being able to talk about infertility openly will make others feel less alone in getting this conversation started. We can do anything we set ourselves to.
If you are at the beginning of your journey as an entrepreneur, the question you need to ask yourself is why? Why is it important to you? This journey is so difficult; I used to say that I had a 9-5 job but now I have a 24/7 job because the business is always in my head. There is no way of separating myself from the business.
Your reason ‘why’
If you are going to work 24/7 in something, you need to have a reason why; something that will keep you going when you receive 100 no’s. There are barriers along the way and the pay is not very good because you’re trying to make something from scratch. Certainty and security are minimal, so what is your reason why, why is it important for you to keep going? If you can answer that, you will be OK, because even in the most difficult times of the year you will still find the strength to carry on.
How to contact us
You can contact us here at Menlo Park, by calling 0113 468 9230 to speak to our friendly team. We can help if you are looking for a new role, or if you are wanting to recruit to your new start up. We will listen to your needs and find you the perfect job or candidate!