If I had a dollar for every time I couldn’t get pregnant… But wait! There’s an app for that.
{Hello, lovely readers. I am slowly but surely coming back to this space. More deets in a post to follow.}
If you had to guess what kind of app the co-founder of PayPal and a former Google Executive was just released, you’d think personal finance, right? Well… sort of.
But Glow does something a little differently. While the app itself is free, users can opt in to a $50/month pool of money as part of the Glow First community fund. If you don’t get pregnant within ten months, you can withdraw money from that pool to pay for fertility treatments. If you do get pregnant, you forfeit the money you’ve contributed, almost like a truncated vesting schedule for a retirement fund.
At first read, this sounds pretty amazing. And at a cursory level, I have to applaud the app’s creators for some innovative thinking. But you know me. I never just leave things at first glance and there are some genuine issues raised by launching a data-based app that feeds a community fund.
Here are the questions and issues I have about this innovative but as-yet-unproven app.
Does Glow promote the gamification of fertility?
Let’s say you sign up for Glow First. $50 is zapped out of your account each month. Meanwhile, you and your partner are going at it like rabbits. It’s almost like a backwards race: if you win, you don’t get any money. But if you don’t, there are funds awaiting you at the finish line that you don’t cross. As if infertility isn’t stressful enough, it’s as though Glow dangles this vaguely defined carrot if you don’t succeed after ten months.
PayPal co-founder and one of the app’s founders, Max Levchin, stated:
“We’re not sure how yet, but we’re going to reward people for staying engaged in the app.” (Source)
It sounds as though Glow might try to pull what GPS app Waze has done with its users, in terms of scoring and rewarding users with virtual pieces of candy along their routes. What virtual badges will Glow dole out in the months to come for egg white cervical mucus? Gamification is ubiquitous thanks to the age of mobile app development, but do we really need virtual incentives on our family building journeys?
Even the name, Glow First, implies a sense of urgency, a sense of competition. When many infertile couples feel like they’re already competing with their more fertile friends or even their very own bodies in any given cycle, is the possibility of implied or explicit competition within a fertility tracking app really the best idea?
Are you ready to hand over your personal fertility data to random fertility clinics?
We live in a society saturated with data and data-mining has become a profitable business. Even that which you may have thought was private data isn’t always (see: Edward Snowden). Any tracking app is going to harvest that sweet, sweet data. Glow is no different.
While not explicitly stated on the Glow website, a press release from yesterday reveals that Glow has been developed in partnership with both Shady Grove Fertility Center in D.C. and Pacific Fertility Center in San Francisco. While the press release remains vague about the partnership, this article goes into a tad more detail (emphasis mine):
The company has secured what it says will be the first of many partnerships with the Shady Grove Fertility Center, for the exchange of new information surrounding women’s health and fertility.
This exchange won’t be sold, so you don’t have to worry about Glow profiting from the exchange of your data… for now. From Glow’s own Privacy Policy – that is subject to change at any time (again, emphasis mine):
We may also use information to perform and improve our services, contact you, conduct research, and provide anonymous reporting for medical research.
Stop and consider this for a moment: how comfortable are you giving away the intimate details of your cycle, even anonymously, to clinics or researchers with whom you may never interact? And how do you feel about profits being made from that data? Glow might not profit by selling your data to others, but you’d be naive to think they won’t be profiting from the data itself.
Personally, I get that we live in a society where very few things are private any more, especially when it comes to personal data. But you might not be as comfortable with that as I am. Or may you have never realized that data from a simple fertility app could be used in that way. Either way, you should consider how comfortable you are with the possibility that your personal fertility information will shared with others, even anonymously, before downloading and signing up.
Is a mobile app the best way to make a statement about the inequity of healthcare coverage in America?
The company’s ultimate aim is to bring equality of treatment and a reduction of costs to the healthcare system, and it has chosen to target fertility first because according to its data, the fertility treatment industry in the U.S. generates $5 billion a year, partly because such treatments are elective — not covered in standard health insurance policies — and partly because of a seeming lack of control or access to relevant information that would make conception simpler. (Source.)
I’m not exactly sure how a free iPhone app is going to make major changes to the U.S. healthcare system. Will it raise awareness? Sure. But where are the boots to the ground?
Unless Glow First, the app’s non-profit, is also doubling as a healthcare reform lobby, I don’t see how this app is really going to make changes, let alone start an innovative conversation on a widely understood fact both within and outside of the infertility community. Infertility treatments are expensive – we get it. Another fertility tracking app, even with its fancy community fund, doesn’t add anything new to that conversation.
What about the feasibility of community funded fertility treatments?
Glow is banking on two very uncertain factors: an extremely large number of people willing to voluntarily chip in up to $500 they may never see again and a very large number of people who get pregnant within 10 months, in order to build a community fund that can sustain itself over time.
Levchin himself has put one million dollars into the Glow First community fund. Let’s say that no one signs up for the $50 a month community fund opt-in, and we’re talking about a pool of just one million dollars. My donor egg IVF cycle came out to about $27,000 with insurance – I probably would have been looking at around $35,000 without it.
So let’s say the community fund stands at only 1 million, and we use that $35,000 total for fertility treatments for one user. Only the first 28 users who don’t conceive in the first 10 months of using the app would be able to access the funds to fully cover their treatments before it ran out. Now, if I get how this fund works, that money is split between ALL the users who don’t get pregnant. So you’re not going to fund a full cycle with this money. And even if you end up getting 100,000 users and if you generously assume that only half will get pregnant, that leaves 50,000 people to divvy up one million dollars.
That $20 check should cover what, a prescription for generic estrogen pills? Maybe two sticks of Crinone (co-pay, not at-cost)?
Also concerning is that a lot about this fund is still very vague. Even on the Glow First landing page, they offer two somewhat contradictory statements (emphasis mine):
At the end of the 10 months, any woman who is not pregnant will receive a grant from the fund to go directly towards fertility treatments. If you do not get pregnant in 10 months, Glow First will help pay for your infertility screening.
So… which is it? If you don’t get pregnant, you can get a check for X dollars, the same one that everyone else who didn’t get pregnant in 10 months is getting? Or can you submit documentation for your infertility screening and receive a check to cover that specific cost? Or are they trying to say that because they hope so many people will sign up and contribute that don’t get pregnant, those grants/checks are really only going to be big enough to cover a fertility consultation with an RE? Or, as my example above provided, will those checks be MUCH smaller?
The grant distribution language is a little too messy for me to be fully comfortable with when it comes to my money. $500 isn’t chump change when it comes to fertility treatments.
So what’s my verdict?
Undecided, to be honest right now. I have some other concerns with some statements that Levchin has made (“We want to gather fresh data surrounding topics like: Is having sex on your back better for conception?” Ummm… WTF?!) and the fact that this community fund totally excludes LGBT family building for gay male couples. Because yes, even gay men experience infertility too and could use financial relief to build their families.
The Glow app just debuted yesterday in the iTunes App Store. I’ll be interested to see how this rolls out and if this start-up is fully prepared to manage the complexities of this community fund. Even Levchin has said that “We’re basically crowdfunding babies.” And as I’ve written before, crowdfunding infertility treatments is a complicated subject.
What do you think? Have you downloaded Glow yet and given it a test run?
Share your thoughts and experiences in the comments!
I’d also worry about selection bias. How many people who first start trying without any clue something might be wrong would sign up for this app? Probably close to none. The percentage of people with known fertility issues signing up would be very high.
I agree with some of your concerns, but I have to quibble with the details of your math.
If 100,000 users sign up for the crowdfunding plan, and half get pregnant, then those half will have contributed an additional $25,000,000 (that’s assuming that they got pregnant in five months, on average, which seems reasonable) to the pot. So, each of the half that didn’t get pregnant should get their own $500 back, plus $250 from the other contributors, plus the $20 from the 1 million from Levchin. So, they’ll get $770.00. Of course $500 was theirs in the first place, but still, for me, $270 is something..
And if we use the standard statistic of 1 in 8 couples are infertile, then the number would be more like $1770 (in addition to their original $500). I agree with your (implicit) assumption that the number wouldn’t be 1 in 8, because couples that have reason to suspect infertility for reasons such as age, family history of infertility, several cycles already under their belts, etc. would be much more likely to contribute $50 than those who have no specific reason to worry. Really, to work, they will have to screen out people who already know that they’re infertile, and I really don’t know how they can possibly do that. So, I agree that there’s a math problem here, just not the one that you identified.
As for the privacy issue, well, yeah. I read an article in which they identified their goal as gathering more data on the relationship between behavior and fertility, a topic that is just about impossible to study by traditional means. That’s a worthy goal, but I sincerely doubt that couples who have fertility problems because they only have poorly-timed sex once/month (assuming that these people exist) will be willing to provide that information to an iphone app!
My interpretation was that the $500 was committed up front, paid in monthly installments, so total pool of 100,000 users would be $50,000,000. If half don’t get pregnant, they essentially double their money at the end. But they’re betting that the “majority” will get pregnant. Even at 90% pregnancy rate, the payout is $5,000. AND this is assuming that the program draws a majority of cases that DON’T require IVF or other advanced treatment (blocked tubes, severe male factor, etc.). More than likely, the majority of people willing to commit $500 to the program will have already done fertility testing and know whether they need IVF. No matter how good this app is, it won’t unblock tubes. So if you have 80% IVF candidates in the pool, the payout ratio takes a major dive. It’s a nice concept, but clearly developed without much knowledge of the characteristics of the infertility community.
I actually heard about this from my grandfather (Talk about awkward). He even offered to pay the first month $50 if my husband and I were to try it. We have already been to two different fertility specialists (three if you count a urologist) and none of them were able to help us. I can’t imagine this app would be able to do so and if we opted to use the funds for a fertility clinic, what could they do that hadn’t been done already? We had already decided to move on to adoption (notice the company does not mention that option…) but still thought the app was interesting and I’m glad that the finance industry people have started to take notice. I can’t wait to see the interest in it and the results from this.