Thankfully, we spoke to the ones that do. Here, they explain why they are accurate where others are not, and their best tips for getting pregnant or avoiding an unwanted newcomer
In a recent study published in Obstetrics & Gynecology analyzing 53 online tools that aim to help women predict when they’re most likely to get pregnant, of which 20 were websites and 33 were apps, the results were somewhat shocking: Only one site and 3 apps correctly identified when users were most likely to be fertile.
This means that while there are dozens of period counting apps, many of which are quite popular, most aren’t doing what they advertise: predicting a woman’s menstrual cycle. The market for such tools is enormous considering it takes at least 4 months of trying for more than half of couples to get pregnant, more than 9 months for 30% of couples to conceive, and over a year for 15% of couples attempting to have a baby — not to mention the number of young women trying to avoid getting pregnant.
But why are so many of these apps getting it wrong? Is the problem technological? Are there medical factors that go into identifying a woman’s fertile window that we just don’t understand? Or are there just a lot of dishonest people out there who don’t care about being accurate and care only about making money?
To answer these questions, we asked Dr. Amos Grunebaum, Babymed.com’s founder and an OB/GYN at Weill Cornell Medicine and NewYork-Presbyterian.
According to the pregnancy experts, what are the best ways to increase one’s chance of conceiving?
“The easiest way to get pregnant is doing it for the first time in the backseat of your parents’ car. Going beyond this, it’s difficult,” Dr. Grunebaum chides.
All joking aside, Dr. Grunebaum told Geektime that there is a key piece of information for figuring out when a woman is mostly likely to get pregnant: the length of her menstrual cycle. If she has a regular 28-day cycle, for example, she will ovulate on day 14 of it. Her fertile window, then, is the 4-5 days before day 14 and day 14 itself. Starting at some point on day 15, depending on the time of day she started her menstrual cycle, she will no longer be able to conceive during that month. So a couple has the greatest chances of getting pregnant if they have sex (but not more than once per day) during this 5- to 6-day period of time.
In other words, an ovulating woman should ovulate 14 days before her menstrual cycle comes to a close. If her cycle is shorter, it will come earlier and if it is longer, it will come later.
When asked if there is any other information he needs in determining a woman’s fertile window, he replied, “This is the major variable.”
He cautioned that other factors help with conception, including certain sexual positions, an understanding of orgasms, being in generally good health and at an optimal age to conceive, as well as exercising moderately. However, the main way Babymed calculates a woman’s fertile window — and with it, a woman’s greatest chances of getting pregnant — is simply by knowing the proper length of her menstrual cycle.
So, since a site or app determining a woman’s next period would only need to know the duration of her previous menstrual cycles, the problem with these apps is therefore bad information, not technology.
Dr. Grunebaum believes most of the websites and apps in the Obstetrics & Gynecology study failed to predict a woman’s fertile window because they were using an inaccurate method, probably relying on bad information from the internet or worse, not caring about accuracy. When I seemed surprise by the potentially widespread nature of this negligence, he responded, “Why are you surprised? People don’t care if they’re correct or not. They clearly don’t care enough about it.”
He noted, “I have been doing this for 40 years. I did not one day just think, ‘This is the internet, I can do it.'”
Babymed.com is a labor of love for Dr. Grunebaum. The site receives no external funding and only generates a small amount of revenue from ads. 90% of the work in creating and maintaining the site comes from Grunebaum himself. Beyond tracking ovulation, it also helps women identify infertility issues, know how far along they are in their pregnancy, understand ultrasounds, and learn expected due dates, among other things. Their tools section is particularly handy in offering explainers about these matters.
When we told him that Geektime is a website about startups, he posited, “We’re an old startup.”
When asked what he meant by this, he reflected, “Every time you’re trying to get pregnant, you’re trying to have a baby, which is like a startup.”
How the Clue app became a leading period counter
Ida Tin founded Clue in response to a frustration many women in their 20s share: She was in a long-term relationship and sick of using condoms, but also not reacting well to using the pill for birth control. To track her fertile window to avoid getting pregnant, she started plugging in all the data about her cycle into an Excel spreadsheet and thought, “This is stupid.”
It was 2009 and she wondered, “If I can put all this data on my phone, that would be really cool.” While she didn’t have a smartphone, her friends thought this would be useful.
Tin, alongside Hans Raffauf, Moritz von Buttlar, and Mike LaVigne, eventually founded Berlin-based Clue and launched the app in 2013. So far, the startup has raised $10.3 million and reports at least 5 million active users per month (many between the ages of 13 and 18) tracking their cycles on Clue, which is available on both Android and iOS. This is significantly more funding than both iPeriod and My Days have reported. A lot of this capital seems to have gone into Clue’s user experience, which is better designed than its competitors’, and its machine learning algorithm that increases in accuracy the longer a user engages with the app.
Speaking with Geektime at TechCrunch Disrupt in San Francisco, Tin remarked that a lot of period trackers were first generation products that simply tried (and often failed) to track users’ periods. She noted, “I think the next generation is how can you make that data meaningful.”
Like other period counters, Clue tracks users’ cycle length and ovulation days: The best way to track ovulation is by measuring one’s basal body temperature (BBT) at the beginning of the day, which should rise by 0.4 to 1.0 degree Fahrenheit on the day that a woman ovulates and stay at this temperature for the remainder of the cycle, as well as identifying when her cervical fluid reaches an egg white consistency, which indicates that a woman is ovulating. Tin advised that users who want to use Clue as a form of contraception pair the app with a basal body temperature monitor. (It is worth mentioning that the only app proven to replace contraception fully is Natural Cycles, which is available on both iOS and Android.)
But Clue also prods users to track other physical and mental conditions they notice each day, such as their alertness level, mood, sex drive, and other health features. This information, which is aggregated anonymously, is the key to Clue providing not only personalized insights, but also millions of data points for scholarship on women’s health. Clue has begun collaborating with Oxford, Stanford, Columbia, and the University of Washington to aid them in research on women’s menstrual cycles with respect to age and the effects of the pill. While part of Clue’s terms of agreement is that users consent to their anonymous data being shared for research purposes, up until this point, Tin noted that they have individually asked permission from every user whose information they have wanted to use in these academic projects.
In approaching these users to ask for their permission to use their data for research, she told us, “What I find is that most women want their data to move science forward. One of the reasons I started Clue was there was such a need for knowledge … Textbooks on female health are based on research or a clinical trial of say 2,000 people. Now we have millions of data points. It’s a completely new world. This is so exciting.”
She lamented that such data is still so important in advancing solutions to women’s health problems since there are still so many phenomena we don’t understand. For example, she stated, “We don’t know why women have periods. Why is the cycle more irregular when you’re young? Why does it get shorter when you go into menopause? Why are there hot flashes?”
Advancing women’s health v. protecting one’s information
One obvious downside to fertility trackers in general, particularly apps, is their vulnerability to hacks, particularly since most in one way or another share aggregated information with third parties. For those that keep their information in the cloud and have sharing features, these dangers increase, such as a hack that happened to competitor Glow, whose effectiveness was ranked low in the Obstetrics & Gynecology study.
Tin conceded that, “Of course, there is a risk,” with tracking data on Clue. However, she emphasized that, “We do everything we can to keep data safe, and private,” such as not storing data in the cloud. (Users have to individually back up their data.) They are soon releasing a sharing option, but have these security issues in mind as they prepare to roll out this new feature.
Can period counters that don’t accurately predict a woman’s fertile window be punished?
Geektime reached out to a number of lawyers and privacy rights experts about what can be done to penalize the majority of period trackers and pregnancy apps that don’t properly estimate the length of a woman’s menstrual cycle, including the United States Federal Trade Commission. Principally, we wanted to know if they violate one of the key laws that US health apps must comply with, the Federal Trade Commission Act, which “prohibits deceptive or unfair acts or practices in or affecting commerce,” such as “false or misleading claims about apps’ safety or performance.” Here, we focused on their performance, and found it wanting.
While the FCC has not responded to Geektime‘s inquiry and the lawyers we spoke to did not wish to be quoted, the general consensus was that since these health apps were not charging for their services, it would be difficult to file a successful FTC complaint against them. But if you’re reading this article and think differently, feel free to contact us.
In the meantime, the main steps consumers can do to engage with fertility tracking apps responsibly is write reviews about these apps, know which period counting and pregnancy apps are the most effective (we hope we aided in this process), and for those concerned about privacy violations, think twice about using a fertility tracking application.