Founded in 2019, Adyn is a precision medicine company targeting optimal health from birth control to fertility. This Seattle based company recently raised a seed round of $2.5 million co-led by Lux Capital and M13. Anne Wojcicki of 23andme is an angel investor. Personalizing birth control is a problem that needs a solution, and so let's find out more about the problem and how they're trying to solve it.
First Market: Adyn's beachhead is personalized birth control. Beachhead is a term used in the venture capital world to describe a company's first market in which they hope to find product-market fit. Essentially an investor is betting that they will succeed in securing their beachhead which will rocket the company to vertical or horizontal growth into related markets. VCs borrowed the term from the military where it literally describes taking a defensive position on an enemy's beach after landing. From that tactical position, they can then launch attacks to move further out but only after the beachhead is secured. With this little detour let's dig into the problem.
The Problem: It turns out 52% of women try 4 or more different methods of contraception before finding one that works. Seeing as women in the US take birth control for 30 years on average, finding what works best with minimum side effects is important. Common side effects are weight gain and acne and less common side effects are blood clots, or potentially depression and suicidal thoughts.
The easy to use birth control pill made its debut in the US in 1960 at which point almost 9 million woman were on it right away. By the 1970s, almost a third of women were on the birth control pill and the sexual revolution of the 70s also happened to coincide historically. Fast forward 40 years, now the pill is the method of choice for only 20% of women. On the other hand, once the intrauterine device (IUD) got over some of its initial bad press about not being safe, it saw an exponential increase in adoption going from 2% in 2002 to 14% by 2017. The way it is marketed today is akin to oven timers where the 'set it and forget it' convenience is appealing. Depending on the brand, IUDs can last 3, 5, or 7 years. Compare this to having to remember to take an oral birth control pill, and one can see the appeal. For those who wonder if it requires a commitment, it doesn't. It can be removed in the doctor's office with tiny forceps.
The Solution: Adyn's first product is the Birth Control Optimization Test which is a home test kit that collects samples to test two things:
1. hormone baseline levels and
2. Genetic risk for blood clots and depression.
This data is compiled along with medical history to produce a recommendation for birth control.
The founder herself, Dr. Elizabeth Ruzzo, a geneticist, suffered from suicidal ideation after changing her birth control prescription. Dr. Ruzzo received her PhD from Duke University in human genetics and genomics. She completed her Postdoctoral Fellowship at UCLA where she used machine learning to uncover 16 new autism genes.
The Simple Science: The image above (credit to Wikipedia, contribution by user Isometrik, 2009) shows the stages of ovulation with the corresponding hormone levels and uterine cycle. To simply, of the more than 200 different brands of birth control methods (including the pill), all contain a derivative of the progesterone hormone. At a high level, a woman's body thinks it's pregnant and doesn't release additional eggs or what is known as ovulation. Notice that in this luteal phase, estrogen lags behind progesterone but also rises. The lining of the uterus also thickens assuming a new ball of cells would attach and start growing. If there is no attachment or what medicine calls implementation, then both progesterone and estrogen start to drop back down. During this descent, the lining of the uterus slowly begins to get ready to shed which is the event we know as menses. Once estrogen and progesterone drop to a certain level, FSH or literally follicle stimulating hormone rises to start the process all over again.
Commentary: ovarian/uterine cycles and hormone levels vary at the individual level which is why when I thought of personalized birth control, I thought of precision adjustment of the dosage, so advanced--it was probably an implanted device with a sensor and some mechanism for administration of the perfect progesterone and estrogen derivative doses. That may be science fiction for now. Until then, what Adyn is doing is a step forward in limiting side effects and switching costs as women discover which product works for them. It's also helpful for those who don't have the luxury to see multiple doctors or try multiple products.
If Adyn collects enough genetic, blood hormone level, and medical history data, then there could be a potential future of managing dosing for disorders ranging from osteoporosis to endometriosis, but that's much more complicated than managing the dosing of insulin for diabetics. For Adyn though, the next simpler expansion is either horizontally into fertility or vertically into a telehealth and pharmacy model. We will find out more next year after they get initial outcome data from their first product.