Transforming Male Fertility | An Interview with Tom Smith of Dadi
For the podcast version, click here.
Tom Smith 03:28
The genesis for the Dadi idea and the company actually came when a friend of mine was very suddenly diagnosed with cancer, and I learned about the male fertility journey through that lens. And then when I turned 30, I went and got a physical and really through that experience. The doctor never asked me about my reproductive health. And it was through that lens along with my good friend that started thinking about the concept of Dadi and ultimately planning to build the service. So although I don’t come from a medical background, I think the kind of technological and operational background for myself and members of the team helped to spawn this new generation of service.
Georgie Kovacs 04:04
Let’s talk about what Dadi Kit is and the purpose that it serves in the market. And then we can dive into kind of helping people understand where the challenges are and how Dadi Kit can help.
Tom Smith 04:14
Absolutely. So Dadi’s a male fertility company. We focus on sperm testing and storage. We have our Dadi Kit, which is an at home sperm collection Kit so it gets delivered to a member or customers home. They collect in the comfort and security, and now safety, of their home, and hand their Kit to FedEx. Within 24 hours they receive a complete fertility report, we give all of our customers a year of free storage. And then if they decide they want to continue to store it’s an annual storage fee of $199.
Our total Kit, which is the Kit and the fertility report and the year of storage is $199. And this is basically an order of magnitude more affordable than the existing industry. So if you were to go into a physical sperm bank and collect, get tested and then store for a year that’ll cost you in the territory of around $1,500. What Dadi’s trying to do is not only modernize male fertility testing and storage by focusing on the at home or the sheltered-in-place, collection experience, but we’re also trying to make it much more accessible. That comes through price and awareness.
Georgie Kovacs 05:27
And what I really like about how the industry is shifting when it comes to fertility, male or female, is that there’s so many people who’ve had experiences similar to yours. Like, for example, Fempower Health originated because of my very long fertility journey to have a child and I was later in my journey, I think I was 36, when I started.
There’s a lot of gaps in knowledge and awareness and process and cost. I mean, you name it, there are the gaps. It’s the consumers who are going through the experiences who are creating the transformation.
Why should a man need to store his sperm and use something like a Dadi, because there’s a lot of consumer at-home testing?
Tom Smith 06:56
In the simplest terms, there’s kind of two primary reasons, I think, on a macro level, what we’re seeing is that male fertility levels over the last 40 years have consistently been declining. When you look at the literature and the research on the subject, they aren’t able to point to any single factor. But ultimately, it’s lifestyle, it’s environmental, it’s a number of things that are leading to this occurrence and the kind of data point that they publicly tote is over the last 40 years, if you look at the on a generational level, my father was 50%, more fertile than I am today. And what that means is they had he had 50% more sperm than a typical individual of my generation, for example.
So inherently, male fertility counts continue to go down. And what this is leading to is kind of a compound in nature. So along with fertility continuing to decrease, couples are waiting longer and longer to have children. That’s classically referred to as economic infertility, which is the primary reason that couples wait. They want to make sure that they’re in a financially stable position before having children. And that bar is continually being raised.
What we’re seeing today is that one in seven couples can’t get pregnant through natural means. And what that means is after a year of trying to get pregnant, they’re unable, when those proactive couples go into a fertility center, for example, and get tested.
What you quickly discover is that 33% of the root cause of that infertility between the couple was female factor, 33% of that root cause the infertility was male factor, and 33% unknown. So of known cases of infertility, between a couple 50% can be attributed to the man. And what’s so interesting about this, and it’s something that that we even didn’t fully understand when we first started building up the service is when you look at society in general, and you ask people about the subject of infertility, especially, “Is it a female related issue?” Almost exclusively, people believe it’s a female related issue, when in reality, it’s not.
A big part of what we’re trying to do at Dadi is, through education and awareness, we’re trying to normalize this and help couples understand and society in general understand that fertility takes two and infertility is plagued by both. And we hope to kind of readjust kind of all the misplaced pressure that’s been put on women and reallocate it to go to the male side as well.
Georgie Kovacs 08:36
It’s great to see that you’re doing this because what’s also been happening, I’ve noticed because now it’s been about 10 years since my own journey began is the amount of awareness that is being created. I was in a unique situation where I happened to go to my OB GYN, had my annual exam, and she asked me some questions. I’d never worried about fertility struggles, so I didn’t have any complaints or concerns because my family’s extremely fertile. And she just took some tests. I didn’t know you could even do these sorts of tests. She calls me up the next day, it says go to a fertility doctor, yet I hadn’t even started trying. So right away, my husband was tested because we were at a fertility clinic.
So that’s another question I’d like to discuss in this process so that people are aware. The definition of infertility is, if you’re over 35, and you’ve been trying for six months or more, that’s a definition and then if you are under 35, and have been trying for a year or more, that’s when you typically go to see a doctor. At some point, they may recommend a reproductive endocrinologist in that process.
I have found, and I haven’t done a deep analysis, is that it’s usually once you go to the reproductive endocrinologist where the men get tested. Up front, you have couples who may not know that’s the information. A lot of them are scared to see a doctor, some of them only go to an OB GYN. Men are not going to their doctor, it’s the women. And if the OB GYN doesn’t say, go to a reproductive endocrinologist or your spouse should get tested, there’s a huge gap. So tell us a little bit more about what you’ve seen since you deal with this specifically.
Tom Smith 10:18
Yeah, I think that’s exactly right. Women in family planning matters, typically take the front seat. And I think if you look, in general, men have a tendency to exist in this kind of “ignorance is bliss” type of environment, especially when it comes to medicine. And what this leads to is, when there is an issue between a couple, really, the female factor almost gets discovered and its entirety, before the male factor is even examined at all.
And when you think about the process by which Dadi has created, masturbating at home, and pointing into a cup, and putting it in the mail, and then getting a report back 25 years later, it’s significantly easier. Now in today’s context, safer, more affordable, and frankly, less stressful, than anything on the female side. And a big part of what we’re trying to promote, because we are seeing this trend exactly, is this idea of evaluating male factor first, just because it’s so much easier and so much more cost effective. And given it’s important in this infertility calculation, it really should be discovered first. And that is a big trend that we’re trying to ultimately promote.
Georgie Kovacs 11:25
There’s so many consumer-facing companies when it comes to male fertility testing, they each test for the different things, even in the female fertility space, there’s at home testing for hormones. In talking to medical experts, one of the things that has become a question is how does the consumer decide what what they do at home, which thing to choose to do at home, and then when to go to a doctor,
Tom Smith 11:54
The actual Dadi Kit itself is a pretty unique piece of technology. So we patented it heavily. And what it ultimately does is, inside of the box, it creates a thermal environment that’s conducive to keeping the sperm alive for the journey back to the lab. When it arrives at our lab, we conduct complete fertility testing. So that’s all of the kind of, you know, typical and normal KPIs in male fertility, which is sperm count, and motility, and volume, and pre-freeze motile sperm.
We also do advanced testing, which is morphology. Now, morphology is interesting because it is actually classified as a diagnostic. And when you have a diagnostic test, the at-home requirements for completing that service are different, depending on your state. So certain states allow for direct access testing, meaning a customer or a member can order it directly and we can fulfill. In other cases, we actually need a physician to approve that order. And again, in our pursuit of trying to make this service normalized and more accessible and easier to understand. We built a complete digital process for that. So in the event that you were located in a State not allowing for out-of-State testing, we actually have a physician that’s powered by WINFertility, who’s one of our trusted partners, who actually reviews, that request approves it, when the report comes in, that physician will then again review the entire report. And then we actually link each individual customer up with a registered nurse who can then perform a detailed diagnostic review, and then talk about next steps if that’s something that’s of interest.
So we’ve really tried to port the in-lab experience, and lose no level of medical standard or level of service, but port it all with the ability to do it at home. And that’s a key differentiator. There are services that allow you to test your sperm at home typically involves a pretty cumbersome and awkward process of handling your semen and running it through a number of different contraptions. Ultimately, we felt from the very start of this, that we want to operate at the highest medical standard. We want to train lab techs using the latest technology to actually complete the fertility report
Georgie Kovacs 14:12
For all of my startup friends who are listening, you’ve done your MVP very well.
Tom Smith 14:18
That’s the exact approach. For us, what’s so interesting is, we come from a technical background, and in our arena, the pace of innovation is really the key differentiator between different companies and groups. When we looked at the subject and the industry of fertility, it’s pretty much been stagnant for 40 years. There’s been almost no development when it comes to the way that customers are ultimately serviced. And there’s been no change in the underlying business model. And we just saw an opportunity to bring the tenants that exist in a lot of leading product and service companies and bring it to this space.
Virtually, almost a year from when we launched our first Kit, we had our second generation Kit in the market. And that contained a whole number of product improvements and security improvements that were just focused on trying to create the best best customer experience.
And we’re not stopping. For us, we’re looking ahead and we see many opportunities in the fertility stack is what we call it, where we can bring the same thoughtfulness, the same technical capabilities to improve the overall level of service.
Georgie Kovacs 15:22
What happens once they send in their sample and a test has been done? And the results come back? What is the next action? So I know one is to freeze and wait till later, but what if they’re in the middle of undergoing fertility treatments? I’m assuming there’s some sort of results they get back and recommendations that you give? So how does that happen? And are there gaps that consumers should be aware of on things they need to do, regardless of the results that come in from Dadi?
Tom Smith 15:51
One thing that’s always worth disclosing and outlining is, a single collection doesn’t always directly indicate or give a signal to the overall level of fertility, because there’s a number of factors that go into that collection. We have a number of different members and customers who actually perform a test, and then they’d do it again, and maybe do it in another six months. The timeline here is quite important, but fundamentally, for us, and this is an area that we want to continue to develop.
When someone gets the report back, we outline in a kind of customer focused, easy, digestible way what their overall results were. And then we compare those results against the World Health Organization, Fifth Edition, which is kind of the standard bearer of male fertility percentiles. One of the things that a Dadi we’re trying to actively think about and work on is whether there is a better way of displaying that information. So one thing that’s worth calling out is, if you look at the World Health Organization’s Fifth Edition, the percentiles and the ranges that they’ve ultimately outlined are pretty misaligned with the data that actually exists in the industry. And if you talk to a number of doctors, there’s mixed opinions on the WHO. So we feel that there is a huge opportunity, again, on the kind of data and product side to bring a little bit more information to the space and ultimately provide more context to customers around the fertility report. That’s what we hope to do.
Today, we do present the information, we try to give a relative range, we have capabilities internally to then help support. We have medical professionals on our side to help guide people through a number of questions. And then we also offer the WINFertility nurse service that allows people to actually get a detailed diagnostic, and then be clearly pointed in a direction on how to take next steps in the case that they want to do that. But to your earlier point, we think that there’s a long way to go and ways that we can make this service more normalized, and make the information more understandable for customers and members.
Georgie Kovacs 17:55
How are the doctors perceiving results from the Dadi Kit? And what challenges might the consumer face?
I’ll give you an example of why I have to ask this question. When I started, only 10 years ago, I had to paper chart my basal body temperature. And now 10 years later, there’s over 100 apps where you can track it. And I remember going into a doctor’s office, and I was so proud, I had my charts, I have my data, I’m like what’s going on with my fertility, and I bring it in my paper, and he said, “I don’t need to see that.” I can tell you what you need to do. I left and went to another doctor, but some may not feel so comfortable doing that.
So what should the consumer be aware of that they may be facing with potential resistance for having such what I think is helpful information? Because this is a whole lot better than a lot of nothing.
Tom Smith 18:50
In the medical space, in general, there are, I would say, different classifications for physicians and their comfort for change. One of the things that we’ve been trying to be very thoughtful about is, what the physician experience is when reviewing the report. When we generate the fertility report for members, if you scroll down to the very bottom, there’s the ability to see a physician’s report.
What we’ve actually done is we’ve taken the same information that’s outlined in the customer report, and we put it in the exact format that most doctors are actually comfortable looking at the data, and then we provide as much context and information there as possible. And the reaction so far has been quite positive.
There are individuals that do, you know, still question the importance of male factor infertility There are those who still believe that male factor infertility really isn’t an area that warrants this much attention. Look, we have different opinions obviously.
Georgie Kovacs 19:52
Good to know that.
Tom Smith 19:56
But we also have a number of individuals in the medical field that have been unbelievably supportive. A really great example that we referenced is actually during COVID. With everything shutting down, what ultimately ended up happening is a number of, if not most, fertility centers ended up shutting down. And we actually had a number of medical institutions, John Hopkins being one of them, that reached out and asked us to support their Oncology Group during this period, because their cryopreservation lab shut down. And ultimately, cancer doesn’t stop with COVID. Individuals, before they begin chemo, are recommended to preserve their sperm and their ability to procreate.
It’s been interesting, we certainly get some pushback from certain medical professionals. But I think overall, there’s actually been a fairly warm welcome strictly because we haven’t done anything different. On the medical side, we try to follow absolute best practices that already exist in labs today. All that we’ve really tried to focus on is the customer experience, the collection experience, and then ways of communicating that data that’s a little bit more approachable.
Georgie Kovacs 21:06
So then back to the consumer journey. Women are in somewhat of a more fortunate position in the sense that, if we are good about getting our annual exam, we have an OB GYN that we go to. When I was at the ASRM conference last year, one of the clinicians who by the way, was a man, he said that based on what we know, men tend to go to a doctor when their mother, sister, daughter wife tells them to go, so men don’t have like a place outside of primary care doctors.
So if I’m proactive about my health, and I ordered this Dadi Kit, and I get these results, and I want to do something outside of just freezing my sperm for one day, maybe when I want to have a child, I’m doing it because I just want to be proactive and test, I get these results. Do I hand them to my spouse and say, can you take this to your OB GYN? Do I say we should probably go see a reproductive endocrinologist? Do they take it to their PCP or urologist? What’s the next step based on what you’ve seen?
Tom Smith 22:14
It’s a fantastic point. So all of the examples that you gave happened. This was not part of the overall plan when we launched, but our youngest customers today are in their teens, and our oldest customers are under 17. The spectrum is massive. And what that leads to are countless differentiated versions of life stage when we talk about what to do next. It really depends on each individual use case.
We’ve tried to make it as easy as possible to download this information and print out this information to take it to different sources. And then as we’ve been adding capabilities to our own service, we have more and more opportunities to call up and speak to a nurse and understand what’s next. We are trying to bridge that gap between men not knowing what to do next, and really never being proactive, and trying to make it as simple as possible for them to get those answers.
Georgie Kovacs 23:15
If you had your dream of how men view being proactive about their fertility, what would be your message to them. In the women’s health space, I hate to say it, but I think there’s been some aggressive marketing that I think has made egg freezing very fearful. We’ve been trained about this biological clock that is ticking. And now these companies are suggesting women hurry up and freeze eggs.
It’s very different for men. Until recently, the data has been saying that men can have kids until they’re 70. Now, data is starting to show that their fertility starts to decline. Based on some of the gaps you’re seeing, what would be that message today that you would want men to take away from this>
Tom Smith 24:25
We’re a very long-term focused company. To your point, we think that we’re at the very start of this growing space. If I were to put my future forward hat on and try to imagine a scenario that would kind of honor the importance of something like male factor infertility. People today get braces to ensure that they can get straight teeth. That is what we’d love to get to for those men who are trying to be proactive about their health. They go and they get a physical where the subject of infertility is discussed.
We try to resist fear based approaches. It’s hard to separate that sometimes, but one in 10, men are naturally infertile, for example, and what that means is, their ejaculate could look completely normal. We get deposits that arrive at our lab every single day that look normal. But when you go under a microscope, there’s actually no sperm.
And it’s a spectrum, right? So you know, these 10%, there could be cases where certain IVF procedures would allow them to procreate in the future. But I think the important point is understanding your optionality. Really, the best thing to do there is to do it as early as possible.
If I were to make a wish and rub the magic lamp, I would say that, when men get to the stage in life, let’s say early 20s, where they’re trying to understand their own biology, and they’re getting their first physical, for example, that doctors and physicians are educated and aware enough about the importance of determining their level of fertility at that stage.
To your point, family planning really remains a kind of female driven and lead topic and category. So for us, we’ve really tried to take our FAQ and take certain aspects of our website and cater them to a female audience and try to help them understand the male perspective through the female lens. And we work really hard on trying to improve that communication cycle all the time. But we certainly have a lot of women that engage with our service on behalf of their partner.
One of the things just to kind of mention on the product side that I think is an important piece for the kind of male psychology, and maybe your audience would find it interesting. The same lens of saying that men operate in this kind of blissful ignorance state, we actually believe that when a man orders Dadi Kit, they need to be rewarded for that courage. Because ultimately, when you do complete the Kit, and you hand it off to FedEx, you’ve exposed yourself, you’ve exposed yourself to the possibility of getting bad results, when if you had never completed the process, you would never even run the risk of getting bad news. So we’ve really focused our energy on trying to honor that courage. The best way that we found to be able to do that is a 24 hour turnaround.
I remember when I’ve done my own form of testing, sometimes you’re waiting a week to get your results back that entire week, depending on what you’re getting tested, you could be stewing and waiting for those results. With the Dadi Kit, in our service, we’ve made sure that, within 24 hours, the next day, virtually you are getting back your test results. And that’s really a commitment to honor the courage for that individual stepping forward.
Georgie Kovacs 28:12
It’s an important insight because, you know, I can only imagine with the stigma that men face, just generally in society, and then trying to get them to do this test and waiting for the results. So it’s great that you really looked at the entire journey. Well, Tom, this has been such an incredibly helpful discussion, and I know it’ll be valuable to the consumer.
Tom Smith 28:34
That’s so kind and and I just like to say, for anyone who is watching or listening, we’ve invested a lot of energy and trying to build up our capabilities around education. I’d invite anyone to go to www.dadikit.com and then shoot us a note, send us an email, call us, and send us a chat. We’ve really tried, this quarter especially, to beef up our ability to help those on the educational side. So we’re here to help support even in a situation where you’re not trying to necessarily order a Kit or even if you don’t necessarily have a male partner. If you want to learn more, we’re always available. And again, we’re really trying to normalize this conversation show, so please reach out.
Georgie Kovacs 29:16
Awesome. Thank you so much, Tom.
Tom Smith 29:22
Thanks so much.
About Fempower Health
Georgie is the founder and host of the Fempower Health podcast, a top 10 women’s health podcast with 5 stars on Apple. She is an advocate leveraging her 20+ years in healthcare and personal fertility journey to transform women’s healthcare, answering your health questions. She brings on top experts in women’s health with the aim of educating women about their bodies to have more empowered (and speedy) health journeys.
Follow Fempower Health on Instagram for the latest in women’s health.
Originally published at https://www.fempower-health.com on November 10, 2020.