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Every sperm counts: This S’pore startup created a device that improves transport to the egg

twoplus fertility

Dr. Benjamin Tee had always wanted to build a family and have kids of his own. Benjamin and his wife started actively trying late in his career, and conception was unfortunately much slower than he had hoped.

The 39-year-old went through all types of fertility checks, and doctors were not able to pinpoint a specific problem. This led him to embark on a journey to find solutions that could help with conception difficulties.

He eventually co-founded a fertility tech company called twoplus fertility, a subsidiary of Hannah Life Technologies, with his ex-schoolmate Prusothman Raja (better known as Pru).

They first met at Stanford University in 2014, when they were both selected for the Stanford Biodesign Fellowship, which provides the most in-depth training experience in health technology innovation.

Today, Benjamin is an award-winning innovator in biomaterial sciences and medical engineering technologies. He received his PhD from Stanford University in 2014, and was selected as an MIT TR35 innovator in 2016.

Meanwhile, Pru, 34, earned a degree in biomedical engineering from the National University of Singapore, and was featured in Forbes’ 30 Under 30 Asia list in 2017 under the Healthcare and Science pillar.

Prior to twoplus fertility, they co-founded another company called Privi Medical, which develops home-use devices for gastrointestinal diseases. Their products have since passed the United States Food and Drug Administration (FDA)’s clearance and clinical trials.

Fertility challenge is a common problem

Benjamin and Pru realised that conception difficulties did not only affect them, but also many of their family and friends as well.

Fertility challenges is actually more common than one thinks, with one in six couples facing this problem globally, and close to seven million in the US and even greater numbers in Asia.

They decided to put their medtech entrepreneurship background to good use and come up with a tech solution that could help couples get pregnant faster and relieve their frustrations.

twoplus fertility was their second venture together, which they established in 2019. Thanks to their previous startup experience, they were able to quickly build a team of local engineering talent.

Benjamin and Pru made an initial investment to start the company, and later raised pre-seed and seed funding from top investors, including Y-Combinator and Golden Gate Ventures.

They managed to raise over US$2 million to help drive the product development, which they found particularly challenging given the medical need and anatomy.

Through discussions with many couples, as well as consultations with top fertility doctors and specialists from Stanford University and the University of California Berkeley, they found that having an easy-to-use, at-home device that enhances the chances of sperm cells reaching the egg at the right time was a technological gap that was not addressed well.

Most of the existing products in the market are focused on fertility tracking and insurance plans or incremental product improvements instead.

sperm count during intercourse
Sperm count during intercourse / Image Credit: twoplus fertility

Currently, there isn’t much that couples can do to improve the transport of sperm towards the egg. Unfortunately, a large number of sperms are lost during copulation and less than one per cent of sperms make it to the cervical mucus.

Considering that sperm count among men has halved in the last 40 years, it’s important that we reduce the loss of sperm during copulation as much as possible.

– Dr. Benjamin Tee, co-founder of twoplus fertility

After over 1,000 design iterations and prototypes, they developed their first product called twoplus sperm guide.

It took them a good two years to bring the idea to life, which has since been registered with the Singapore Health Sciences Authority as a medical device.

As the team has over 20 years of combined experience in developing medical devices, they had a clear regulatory strategy since day one and experienced no hiccups in getting their registration approved.

How does it work?

A common misconception about conception is that only a single sperm is needed for fertilisation to occur.

In the average ejaculate, there are an average of about 100 million sperm. More than two million need to enter the cervix so that hundreds can reach the egg for fertilisation to occur.

However, many sperm will not survive the acidic environment in the vagina. Combine that with the decreasing average sperm count in men, having a sufficient number of sperm reach the egg becomes more challenging than ever.

This is where the twoplus sperm guide comes in handy. It is a small and soft device that is used during sex to help sperm get to the right place within the vaginal tract.

twoplus fertility sperm guide
The guide acts like a canal for the sperm to pass through / Image Credit: twoplus fertility

It protects sperm from harmful acidic vaginal fluid and forms a seal to block any loss of sperm. The guide directs sperm towards the deeper end of the vaginal tract, and increases the potential for any natural conception.

The unique technology is the first of its kind to assist couples with natural conception in the comfort of their home. Importantly, the device also brings back intimacy to conception.

– Prusothman Raja, co-founder of twoplus fertility

When asked if the insertion of the device is in any way painful or uncomfortable, Pru shared that most couples said that they do not even feel the device during sex. In fact, some couples have even said it increased the pleasure during intercourse.

He also advised to keep the device inside for an hour after sex to maximise the contact between the sperm and the cervical mucus.

“Women can move about and do non-strenuous activities post-sex with the sperm guide in place, without any fear of the device shifting from its position. It’s designed this way so that women no longer have to keep their legs raised in the air or lay in uncomfortable positions in bed post-sex,” he added.

twoplus fertility sperm guide
twoplus sperm guide / Image Credit: twoplus fertility

After sex, couples should sanitise the device by simply washing it with mild soap in hot water, and place it back into the device case.

The sperm guide is reusable and can be used up to five times, sufficient for use for one ovulation cycle.

Although twoplus sperm guide was launched into the market quite recently, they have already garnered hundreds of customers.

“Based on feedback from our volunteers, over 80 per cent of our couples reported better sperm retention when using the device,” shared Pru.

They achieved their first pregnancy last year with the use of the device, and some of their early-access users have also achieved pregnancy.

The twoplus sperm guide is currently available in Singapore, the United States and United Kingdom. A one-device kit costs S$81, while a three-device kit costs S$202.

Their goal is to help couples to conceive

twoplus fertility founders
Prusothman Raja (left) and Dr. Benjamin Tee (right), co-founders of twoplus fertility / Image Credit: twoplus fertility

Developing a first-of-its-kind product is a double-edged sword.

What this means from a market entry point of view is that they needed to spend more time educating couples about the product and the role it plays in the conception journey.

Another challenge they faced was having to raise funds for their seed round in the middle of a raging pandemic last year.

“Luckily, we were selected for Y-Combinator, which helped us get access to many investors,” said Benjamin.

Covid-19 is not all that bad though, because it opened up a business opportunity for them.

“The pandemic has forced people to stay at their homes and shop for relevant fertility support products through online means. Being a startup and having our primary method of sales online (direct-to-consumer), the pandemic allowed room for more online sales and engagement through social media and formed partnerships.”

According to Benjamin, the end goal for them is to become a one-stop platform that supports couple in their fertility journey.

“We want to help a million couples conceive over the next 10 years. We have built an exciting pipeline of products that will help couples in different stages of their conception journey.”

Moving forward, the startup also has plans to expand to Australia next due to the active fertility community there.

Featured Image Credit: twoplus fertility


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