Once I figured that out, I deleted the app and rearranged my sex life. Two months later, I had a thumping little heart on my first ultrasound. I was elated. I was furious. Data shows that most fertility apps can’t do what they were designed to do, and only four out of 53 platforms can accurately identify fertile windows. For people hoping for a child, faulty technology may be hindering a most desired pregnancy. For those wanting to avoid pregnancy, it may have resulted in an unwanted one. “The truth is all these apps make unfortunate predictions based on unfortunate assumptions,” says Brian Levine, OB-GYN, director of CCRM fertility clinic in New York City, and a specialist in reproductive endocrinology and infertility. Levine is just one of many doctors in the field who are frustrated with fertility apps. And failure to predict the best time to get pregnant is just the tip of the iceberg. “The app will use a formula to compare your data with data points of other women with [for example] 32-day cycles to better predict when you should ovulate and adjust the day of ovulation,” she explains. Well, big whoop indeed. A 2018 study analyzing period apps says a deviation of a few days may lead a couple to try for a baby on days where fertility is low or non-existent. When it comes to the likelihood of getting pregnant, this approach maybe even worse than random intercourse. Multiple studies, including those mentioned above, point to a major problem with the data apps use to determine your next fertile window: previous cycles. Trisha Shah, a reproductive endocrinologist at Conceptions Florida, says some apps use cycle information from thousands of users on their own database to make predictions. But determining the official first day of your cycle can be confusing and you can’t count on your app telling you or helping you by providing the right options to log it. Some apps have different options to track spotting, and the beginning of your cycle, while others assume your cycle started when you logged spotting. Both approaches are problematic. “Garbage in is always going to yield garbage out,” Levine says. “The first day [of your cycle] is the first day of full-flow bleeding—what your normal menstrual cycle flow would be,” says Lauren Bishop, OB-GYN and assistant professor at Columbia University Fertility Center. If your app is throwing you off, you can use a pictorial blood assessment chart, which Levine recommends to his patients. This score-based system uses a simple spreadsheet to help people track the timing and intensity of bleeding for each day of their cycles. He asks his patients to fill it out and bring it back to him to reveal any issues. You can fill out the chart manually by printing the PDF file in the link or adding details directly using your computer or smartphone. By recording which type of sanitary product you used, and how many times a day you changed it, you will have a much more detailed picture of your period. In turn, this will provide much more accurate data to determine when your cycle actually started. If you have problems reading the chart, you can bring this information to your OB-GYN on your next visit. They will be able to help you assess the data and teach you how to interpret it. Aside from the ethical and security concerns, having big tech companies knowing too much about your cycle can also lead to unnecessary and increased worry and emotional distress. The medical definition of infertility, Levine explains, is when someone under 35 unsuccessfully tries to conceive for a calendar year, or when someone between the ages 35 and 40 has the same results after six months. “The problem is that these apps have not gotten smart enough yet,” Levine says. He explains some people try to improve accuracy by manually inputting their ovulation test results, but apps are just not designed to integrate multiple data points. Fertility apps don’t handle aggregated data well, so imperfect things—faulty data, wrong assumptions—combine to produce misleading conclusions. For example, if an app says you’ll be ovulating on day 15, but you have a positive ovulation test on day 11, it doesn’t average the two, or isn’t smart enough to pick the best choice. But your app might be telling all of to platforms like Facebook or Google, and other marketing and analytics-based companies. A Federal Trade Commission complaint filed against menstrual tracking app Flo in January 2021 revealed just that, and accused the platform of misleading users and sharing personal health information between 2016 and 2019. “But typically these apps, after three cycles, start fear-mongering,” he says. “They start pushing content to you, pushing forums to you. And that’s unfortunate.” You might also start seeing ad recommendations on social media that may be related to the data on your fertility app. If that’s the case, take the time to read the platform’s terms and conditions to ensure your data is secure and you know exactly who has access to it. If you see something you don’t like, dive into your app’s privacy settings and see if you can limit how third parties use your information or consider switching apps altogether. “[If] scientists are unable to predict with sophistication true pregnancy rates, a phone app certainly does not have that ability at this time,” she says. If your fertility app is bombarding you with articles, take a minute to identify where they come from and always look for a list of sources either at the beginning or the end. You should also pay attention to how the app might be curating them based on your personal health information. And if you need help interpreting the data, all of the experts we consulted had the same recommendation whether you are trying to prevent pregnancy, conceive, or simply figure out when your period might come: ask your OB-GYN. They are trained to screen for issues your app can’t, and have more context on your body, your history, and your goals. “[The apps] are also frequent reminders that you are not pregnant,” Levine says. “They can actually become quite devastating to the patient.” Either way, history shows we will continue to procreate somehow—with or without an app.
