Prenatal Testing Reimagined by New Company Bird & Be

Samantha Diamond and Breanna Hughes each lost a pregnancy in 2017, and their respective reproductive endocrinologists recommended that they seek additional prenatal care from naturopathic doctors. Each of these providers sent the two women to a drugstore with a laundry list of supplements to purchase, but both women struggled to manage. While they scanned the countless pill bottles, they needed to differentiate between each ingredient (for example, folate from folic acid), confirm the correct dosage of each ingredient, and verify each supplement came from a trustworthy company. After discussing their prenatal vitamin confusion with friends and family, and seeking advice online, the two women found that they weren’t alone in their experience. Soon after, the concept of Bird & Be was conceived.

Bird & Be is a fertility marketplace that launched in July with the goal of streamlining prenatal vitamins with semi-personalized one-a-day sachets. In the coming months, (the company will also launch products for other aspects of the prenatal journey, such as fertility-hormone testing at home.) It’s the latest in a long line of companies that make fertility tracking easy (Mira, Natalist), freeze eggs (Ova, Extend Fertility) and provide full fertility care (Kindbody).

Diamond and Hughes worked with naturopathic doctors Tracy Malone, ND, Bird & Be’s director of naturopathic medicine, and Jennifer Fitzgerald, ND, Bird & Be’s director of integrative medicine, to develop Bird & Be’s five proprietary offerings.

The first thing we did was create a spreadsheet to identify what was in each of the prenatal vitamins we found on the market. “Then we figured out what was good or not great about each one for different people, and what was missing.” From there, she and Dr. Malone created a quiz designed to mimic their own patient intake forms in order to help parse out what a certain person may need in a prenatal supplement based on a variety of variables (more on this below). You will be offered a Bird & Be supplement that is best suited to meet your needs based on your quiz results.

Streamlining and simplifying the prenatal supplement market

In spite of most medical professionals recommending a well-balanced diet as the primary means of obtaining necessary nutrients, pregnancy has unique nutritional requirements that make it impossible for pregnant women to meet 100% of their vitamin and mineral requirements through diet alone. As such, prenatal vitamins are often recommended as a booster to help support a healthy pregnancy. “And for those struggling with fertility, in particular, certain supplements can help normalize hormonal signaling to spur on ovulation,” says reproductive endocrinologist Dan Nayot, MD, Bird & Be’s medical director (and Diamond’s husband).

But despite the clear and studied health benefits that prenatal supplements can deliver for fertility, there’s limited cohesive guidance surrounding exactly which prenatal vitamins to take at different stages of conception and pregnancy, and at what doses, depending on your age, biological sex, and medical history. (The CDC recommends that people who become pregnant take 400 micrograms of folic acid each day, as an exception to this rule.) And since the Food & Drug Administration does not regulate over-the-counter supplements like prescription drugs (meaning it does not verify their ingredients, quantities, or associated claims), it is sometimes hard to know what to trust.

People are lost in the prenatal vitamin aisle with contradictory directions encouraging them to buy this and that.” –Samantha Diamond, CEO of Bird & Be “People are lost in the prenatal vitamin aisle with different, contradictory directives.”

Several contradictory messages ask customers to buy this and that while shopping for prenatal vitamins, Diamond says. “And then you have a vanity full of 17 different supplements, and you’re mixing a mixture each day, not really knowing what dosage to take.”

People who struggle with fertility, especially, usually need to consult with a specialist before going to a vitamin aisle. This can be an expensive process. Although your OB/GYN can help you choose ingredients and doses in a prenatal supplement, most doctors specialize in prescription- and surgical-based fertility solutions, which is why they often recommend a fertility-focused natural health care provider. However, insurance does not typically cover this. A typical first visit can cost from $150 to $750 with follow-up visits typically costing a few hundred dollars, making that kind of care inaccessible for many. Diamond explains, “This is how we asked Dr. Jennifer and Dr. Tracy to use our platform to offer such personal care.”

After taking our intake questionnaire — which asks for information such as your age, gender, and whether you are thinking about pregnancy now or in the future — you will receive a recommendation for either Bird & Be’s basic, gentle, or power prenatal for either eggs or sperm, which start at $35 for a 30-day supply of sachets. Moreover, that price tag eliminates the need for a visit to a naturopathic doctor, as well as reducing the cost of purchasing a collection of individual prenatal supplements. The Bird & Be packets contain up to 20 fertility-supporting nutrients (like choline, vitamin B12, and folate) packed into just a few capsules.

Diamond and Hughes opted not to cooperate with a distributor (which would simply package existing prenatals into Bird & Be packets) in order to address the quality-control issue noted above (due to the lack of FDA oversight for supplements). Rather than purchase prenatal supplements, they create their own using raw ingredients that are tested by a third-party laboratory. Dr. Fitzgerald says this ensures the vitamins are given in their active, bioavailable form at therapeutic levels. So the pills aren’t sitting around on a store shelf for months (or years), where they can oxidize and lose their efficacy.

A prenatal equation without gender binary

Considering both sperm and an egg are essential for pregnancy, the idea of optimizing one’s health for fertility is logical for people with sperm as well. However, this is a relatively new belief in medicine, as prenatals have been developed specifically for people with eggs.

As a result of aging, sperm have less concentration, quality, number, and motility, which is as a result of sperm having a biological clock, Dr. Nayot says. Due to this, Bird & Be now offers both prenatals for people with eggs and sperm, joining Perelel and Natalist in developing sperm-health-focused prenatal programs.

Diamond and Hughes went beyond just providing prenatals for people of all biological sexes, however, because they wanted to remove unnecessary gendering from the packaging and design of their products.

“We noticed that most women’s supplements were pink, whereas men’s supplements were blue, and there were pictures of belly shots or even babies on prenatal packaging, which are all extremely triggering to men who are actively trying and having trouble conceiving,” says Diamond. It is confusing as to why this image would be included on a prenatal, because the woman in it already has a baby. For example, picking up a pink box with a picture of a woman on it can make a trans man uncomfortable when trying to determine if he is ovulating.”

A woman’s choices regarding how to raise her family are unaffected by her gender. -Diamond

Contrary to this, the packaging of Bird & Be is clearly degendered. Names for products are based on biology, such as “people with eggs” or “people with sperm” (instead of “for him” or “for her”). Diamond maintains that inclusivity is a priority for her company as it launches new products and offers educational content on its website, because “gender does not determine how you choose to build your family,” he says.

It will soon offer ovulation, pregnancy, and ovarian reserve (follicle-stimulating hormone) tests for people with eggs, as well as a sperm test for people with sperm. Diamond says this is a diagnostic tool that can alert a person to potential fertility issues, so that a patient can self-advocate. In the Bird & Be project, we hope to provide people with access to information about fertility early on, so they can get the care they need if they need it, and avoid the stress of the unknown.”

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