The worlds second most populous country has an unlikely problem. India, which the United Nations projects will surpass Chinas population as early as 2022, has interestingly witnessed a decline in fertility rate. As per the World Population Prospects 2017, the fertility rate of Indians reduced by over 50% from 4.97 during 1975-80 to 2.3 for 2015-20. A further reduction of the fertility rate to 2.1 is expected during 2015-30 and 1.78 by the end of the century. The major reason behind this is not a defect in our bodies, but simply the changing lifestyle of the current generation.

Increasing urbanisation has led to people living a lethargic lifestyle and indulging in unhealthy food habits, which causes ailments such as obesity and diabetes. According to a report, more than 40% of women attending infertility clinics are found to be obese and in men, obesity brings down the semen quality. Moreover, theres a sense of social stigma attached to infertility. Theres a need of regular health monitoring without the burden of spending hefty amounts on clinics, scans and lab results repeatedly. Bengaluru-based Inito was formed precisely to cater to these needs.

Inito, the brainchild of IIT alumni Varun AV (35) and Aayush Rai (30), has built a device which makes it easier for people to monitor their health at home such as tracking a woman's ovulation cycle and diagnosing fertility conditions through a smartphone. The device has been recognized to increase their chances of getting pregnant naturally by 89% by giving the fertile days specific to their body, Rai told ET.

The AI that understood womenUpon realising the change in disease patterns in India due to changes in food and lifestyle habits, the co-founding duo, former employees of Siemens Research, came up with the idea of a home health monitoring device which would analyze the trends of body parameters, diagnose conditions and predict best treatments.

Initos flagship product- Inito Fertility Monitor is a smartphone-connected device which performs real-time lab-grade fertility diagnostics test at home. It comprises of a monitor, a smartphone app- Inito and test stripe.

To gather input, the test strip has to be first dipped in urine, and is then attached to the monitor, which in turn is attached to the smartphone.

Thereafter, the monitor uses its flat-lens technology, which measures two hormones (Luteinizing Hormone and Estrogen) in urine. This helps the AI-based app track womens ovulation cycle, understand cycle variations and identify the high and peak fertility days. The app then suggests up to six fertile days for women to conceive.

The app also works when the cycles are not regular and in fact, records, changing hormone patterns and is, therefore, able to predict almost accurate cycle variations, diagnose fertility issues and provide personalised medical guidance to women. All the data recorded is stored on the app and the cloud.

The device has been medically tested and the results were found to be comparable to those acquired with clinic-grade instrumentation which cost 100 times more and are 10 times bigger, Rai said.

(Pic: Aayush Rai)When asked about what makes Inito unique from other home ovulation tests available in the market, Rai said, Other home ovulation tests measure only 1 hormone, and are confusing to read and interpret. They are also not specific to Indian women and their hormones. The standard protocol is women going to the lab to do a sequence of ultrasound scans called follicular scans to track ovulation. However, with women leading busy lifestyles, it becomes all the more difficult to take out time to go to the lab.

He added that some women also feel a lack of privacy visiting hospitals and clinics for the tests. These insecurities are removed by Inito, whose fertility monitor reminds women when to take the test based on their hormone level variations and can easily be done with comfort at their homes.

Citing an Ernst and Young report, Rai said that South Asian women have a poor ovarian reserve compared to Caucasian women. This means that South Asian women are likely to suffer from earliest onset of infertility and poorer outcomes of infertility treatment. Therefore, even western medicine has failed to provide accurate results for Indian women and Inito has been specifically designed for Indian women and their hormonal patterns.

However, despite having over 95% of accurate results, Rai finds gaining customers trust as Initos biggest challenge. To build customer trust, we take a lot of effort in conducting third party studies, work with doctors etc. to prove the effectiveness of our technology. The biggest challenge for us is that we deal with people's bodies and health. The cost of missing out on even one variable is very high in our industry. In this case, we can't rely on guesswork, everything needs to be clinically validated, he said.

Brisk businessFrom launching the product commercially in 2017-end to have it shipped to more than 350 cities, the four-year-old startup has witnessed a soaring business. According to Rai, the firm grew 10x in the last financial year with 50% of its sales coming from non-Tier 1 towns and cities.

After doing over 1.5 lakh tests on our device, we've managed to collect the largest cloud-based dataset of fertility hormones in the world, he quipped.

Sumon Sadhu, an angel investor who was also an early investor in Inito, believes the startups innovation is a much-needed product for India. Inito has built a device which makes it easy for women to track their fertile days easily sitting at home. Similar ideas have been proposed and researched many times in India, but could never be implemented. With a mix of hardware and software, Initos innovation is supporting women by giving them an easy way to monitor their health and is addressing the declining fertility rate in the country. The firm has the caliber to reach international markets, especially, other parts of Asia as it is more demographically suited for the product.

Inito recently got backed by the American seed accelerator Y Combinator in its Winter 18 cohort. It has so far raised $2 million in funding. The firm is now planning to add 8 more hormone tests to the device, enabling them to not just track ovulation but diagnose conditions like anovulatory cycles, PCOS etc. right on the phone.

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Indias fertility rate is crumbling. Y-Combinator-backed Inito might have a solution - Economic Times

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