How She Made It: An Interview With Ava CEO Lea von Bidder

In 2014, Lea von Bidder co-founded Ava with the goal of making it simpler for women to track their fertility window while trying to become pregnant. Ava did just that in 2016, releasing their wrist-worn fertility tracker – a device that, in combination with an app, calculates and tracks levels of hormones like estradiol to tell women exactly when their fertility window is open, even for some women who have irregular cycles. The Ava tracker only needs to be worn to bed at night, making it a non-invasive, non-intrusive solution to fertility tracking.

Photographed by Kelly Vorves in San Francisco, California, July 2017

Now, less than two years after the launch of the tracker, Lea is on the Forbes 30 Under 30 list in healthcare. I sat down with Lea to talk about that honor, Ava babies, and the differences between the startup cultures in San Francisco and her native Switzerland. Here’s our chat, which has been edited for length and clarity.

First of all, congratulations on making the Forbes 30 under 30 list for healthcare. What did that mean to you?

I was really excited about it, because making that list on healthcare is really important to us. It was always our vision to contribute to the healthcare space. That was the first thing that we heard from the healthcare space recognizing us, so that’s been really great. And I think on a personal level, I am from Switzerland originally — Forbes 30 Under 30 was always something far away. I think especially if you’re not from the Bay Area and you haven’t been in this environment for a really long time, it’s a very special recognition, so I was super happy about it. I wish that my co-founders would also be on the list.

What is it about healthcare specifically that made you feel good about that recognition, rather than making it on the consumer tech list?

I’m personally extremely excited about healthcare. I think we have a healthcare product and I think we have a medical device, but we’re selling directly to consumers. Digital health companies are at this very interesting edge right now between healthcare and consumer tech, and if I could choose in which side I would want to fall, I would want to fall on the healthcare side. We have so many ideas about healthcare in particular and what we want to contribute, so it was just a great recognition to have.

The Ava bracelet and app

Since the beginning, Ava has conducted peer-reviewed research, and has been involved in a study published in Scientific Reports. Going into the Ava project, was that kind of research something you were focused on from the beginning?

Yeah, that was always at the core of what we wanted to do. That’s how Ava even existed, it’s not that we just randomly stumbled over this technology. We started with the first clinical trial, where we looked at our assumptions. Ava wouldn’t exist without the clinical research that we did. Since then, we’ve made clinical research and data science the core of our company, and we want to keep innovating in that space.

In San Francisco and Silicon Valley, there’s always this pressure to move very fast. Has there been any tension between the need to do clinical research, which can be very slow, and the need to move fast as a startup?

That’s a really good question. I think there hasn’t been tension within the company. We’ve always known that if we want to do this right, it’s going to take some time. I think there’s sometimes a little bit of tension with external parties. Obviously when you’re in San Francisco people expect you to be really fast, and sometimes you need to talk to the right audiences about products like ours, which might take a little bit more time. It took us about one and a half years from when we started the company to the moment we came on the market. If you talk to a typical software investor, they would say ‘Oh, that’s forever,’ and if you talk to a really hardcore medical investor, they might say ‘Wow, only one and a half years?”

You have to choose your audience, and the interesting thing with digital health is that it’s so new that no one really has a framework. There’s no clear idea of how long it should take. Some investors think the fact that we already have revenues is amazing, and some think ‘Oh, but you don’t have that much.’

Next page: Finding success with the Ava bracelet

Last August, Lizzie became your first customer to give birth after having used your fertility tracker during conception. How did you first hear about that, and what did you feel in that moment?

It was amazing. We have a community with our customers, and initially, I was in the community every single day. We still knew all of our customers at that point, like nine months before the first baby was born. And Lizzie had been very active in our community, so we actually knew she was pregnant before she told her husband! One of my colleagues who manages most of that community was actually writing back and forth with her when that happened. Lizzie was like, ‘should I take a pregnancy test?’ and she was like, ‘Yes!’ And it was this whole conversation, so we had this real-time view into this whole day. And then we were kind of with her during the pregnancy through when she had her baby in August.

That’s the moment you realize why you’re doing all of this. I think sometimes in business you’re just so stuck in hiring and finance, etc, and all of those things are important, but when that happened, it was a wakeup call for all of us. And now we get baby pictures every day, and it’s super nice.

So there have been a lot more Ava babies born since Lizzie’s?

By now I would say we have one or two babies per day. And that’s just what I see, I think there must be much more than that. It’s really nice to see that people are so happy and they send these messages, and our communication with our customers is just amazing.

Now that you have so many women who are getting pregnant or who have had children using Ava, as a company have you found more ways for the tracker and the app to be used by women while they’re pregnant or after they’ve given birth?

Yeah. Most of the women who are using the app are trying to get pregnant. Then, there’s this rather big group of women who are using it while they’re not trying to get pregnant, mostly just to understand their cycle better or to understand hormonal changes better, or migraines, headaches, anxiety, and things like that. I would say that’s 15 percent of our users.

Then, there’s an app that you can change to if you want during pregnancy. What we are missing at this point is a scientific use case for pregnancy. The app is there and it’s interesting for our users because they see data that they otherwise wouldn’t see, but there is no diagnostic behind it or anything like that. That’s what we’re working on right now.

The Ava fertility tracker only needs to be worn to bed at night

Have there been any uses that your customers have found for the tracker that surprised you?

As a medical device, we limit our users from using our product in a way we wouldn’t intend, so I don’t think we have a lot of that. I think what was surprising for me was the whole mental health world, which I don’t understand enough, I have to say. All the anxiety questions around menstrual cycles is something that no one really understands. I think the other one that isn’t surprising to me but is very interesting is menopause. We’re seeing more and more women inquiring about whether or not they could use the tracker in menopause. Right now Ava isn’t suitable for them, but it’s something that we really want to work on.

Ava’s pregnancy app

I know the tracker is not intended to be used as a contraceptive device, but has that been a concern as the tracker has gotten more successful? Have you heard anything about that from your customers, and if so, how do you react to that?

We are very clear on Ava not being a contraceptive, but we are also very clear on the fact that we would love to do it. We definitely want to get there and we are doing research on it now, and we hope that we’ll get there. But, with all the pros and cons — we will never have a perfect contraceptive. There will always be days when you’re fertile and you need to have a secondary contraceptive. So, I think we also need to manage expectations, because Ava will never be as effective as hormonal birth control, but it will hopefully be convenient for women who don’t want to take hormonal birth control. Long story short, we are working on it. Has it been a concern with our current customers? Not really, but we get a ton of inquiries about it and we just politely decline all of them and say we don’t want to do it at this point.

Next page: Switzerland, mentorship, and the future

Going back to Switzerland, are there any cultural differences between there and San Francisco that informed how you built Ava?

I think there’s a few of those, yes. I don’t think we’re talking about cultural differences between Switzerland and the U.S., because San Francisco is such a bubble in itself, right?

I think what we’re taking from San Francisco is the drive, the growth, the fast pace. That try, and fail, and try again, all of that we’re taking from San Francisco. I think especially the marketing people that we find in San Francisco, they’re amazing. And I also think what we’ve taken from San Francisco to a certain extent is that we dare to think really big with the project, which is something that in Switzerland you would not usually do. Here, it’s very clear that if you start a company and have a good product, then you’re going to dominate the market. In Switzerland it’s like, if you’re lucky, you’re going to get somewhere.

At the same time, I really like the more traditional conservative data approach that we have in Switzerland, with the long history of pharmaceutical companies. Another example is employee attrition and retention. In Switzerland, there’s still a lot of people that go to a company and work there for 10, 15, 20, 30 years, and that doesn’t exist in San Francisco.

Zurich, Switzerland

Last year, you wrote an article called “Why your daughter probably won’t be a startup founder in Switzerland.”

I love that you read that even though it was about Switzerland! I get a lot of reactions when I’m in Switzerland, but never here.

I think it’s interesting, it’s a great headline! So, you talked about the founder gap between men and women in Switzerland in particular. When you were growing up or when you were in university, was there anything or anyone in particular, maybe a mentor, that helped you overcome those odds, or was it just a mix of things?

I would say at that point it wasn’t a mentor, it was probably my parents. I think I was raised to be very ambitious by my parents, and that probably helped a great deal. My mother has her own company, and my father now also has his own company, so I think that definitely helped.

In that article, you also talked about the importance of mentorship and of women having other women they can look up to. Do you see yourself in that role now?

I wish I wouldn’t. I don’t think I should already be a role model. I look at Ava, and I understand that from the outside people would probably look at this and be like, ‘Oh wow, that is so successful and big,’ but for me, who is in the middle of it, I’m still very cautious about it. So, I wish that wasn’t the case. But at the same time, I do know that Switzerland is a very small country and there’s not a lot of entrepreneurship going on, especially not among women. I think I’ve gained quite a lot of attention for things that I do, also because I write and say things like that article, and so I think I’m somehow slowly pushed in that direction without really aiming for it.

The Ava fertility tracker

Are you satisfied with where you are right now with Ava, or are there any other startup ideas you have rattling around in your head that you want to chase down at some point?

It’s very funny. I think I’m at the point where I should have a lot of other ideas that I would want to follow through with. And I do have a lot of other ideas, but Ava combines all my biggest passions. I think empowering women has always been a really, really important part of my life. I’ve always cared about that and I think that with women’s health, we don’t address empowering women completely, but we do touch on the same social issues. I really like to somehow be in that conversation. So, no, the plans that we have for the next couple of years are exactly what I want to do. I can’t speak for more than five years ahead because I think that would be unreasonable. But it’s a good question because I know a lot of other founders at this point have other ideas that they really want to do, but I just love the space that we’re in, I really do.

Lea, thank you for the time!

Thank you so much.