Ep 18: Male Factor Infertility with Greg Sommer, Trak Fertility
Fertility Forward Episode 18:
Despite being responsible for nearly half of all cases of couples' fertility struggles, men are largely left out of the equation. There are a plethora of resources for women, from educational material to psychological support, yet very few of the same support systems exist for men. Along with this, going to a male fertility clinic can be a vulnerable experience, leaving men feeling exposed. Our guest today, Greg Sommer, is the co-founder of Sandstone Diagnostics, a Bay Area diagnostics company that develops sophisticated wellness products that allow consumers to measure, monitor, and improve key health markers at home.
Rena: Hi everyone! We are Rena and Dara and welcome to Fertility Forward. We are part of the wellness team at RMA of New York, a fertility clinic affiliated with Mount Sinai Hospital in New York City. Our Fertility Forward podcast brings together advice for medical professionals, mental health specialists, wellness experts, and patients because knowledge is power and you are your own best advocate.
Dara: Greg Summer is a PhD level engineer, entrepreneur, an executive in consumer healthcare and clinical diagnostics. In 2012 Dr Summer cofounded Sandstone Diagnostics, a Bay Area Diagnostic and Digital Health Company. Developing sophisticated connected wellness products that allow consumers to measure, monitor and improve key health markers at home. Sandstones Track male fertility testing system allows men to measure, track and improve sperm count at home to boost a couple's chances of conception. Dr. Summer was recognized as a 2015 Bay Area 40 under 40 by Diablo magazine and has won numerous entrepreneurial competitions. He is a co-inventor of 18 patents. He has secured six million plus dollars in research grants and co-authored 11 peer reviewed publications. In this episode, we talked all about at home sperm test kits, tips on how to improve sperm quality, and when to seek out seeing a physician for male fertility testing.
Rena: We're so excited to have on fertility forward today, Greg Summer from Track Fertility. Welcome, Greg. Thank you so much from joining us all the way from Minneapolis via skype.
Greg: Thank you, pleasure to be here. Thanks for having me today.
Dara: Wonderful. We would love to know what track fertility is and also how you got in this realm of the fertility world.
Greg:Sure. So track is an at home kit. It's intended for men. We kind of position it as you know, the best first step for men who are trying to become dads. It's a easy and convenient way for men to test and measure and track their sperm count and semen volume entirely at home. It's a device, actually a medical device, a Class two, FDA cleared system that you get at your home, you can run it right there in your bathroom or wherever you want to test, get immediate results. You don't have to send in your sample and do it privately. So, you know, this was something that started really out of the recognition that one, men are pretty overlooked and underserved when it comes to the fertility process, especially early on for couples. A lot of things in the space focus on women despite men being responsible for nearly half of all cases of infertility. There's not a whole lot of options for guys out there early in this process. And getting tested isn't the most enjoyable experience for men having to go into a lab or fertility center to get that semen analysis done can be a little bit of a gut check for guys. So this is an easier way, simpler, more convenient way to get that initial test and take some positive steps. Second, hopefully improve guy's sperm production and help that couple conceive.
Dara: When did this company start? When did you start it?
Greg: Well, our company is actually called Sandstone Diagnostics. This is a company that I started with some colleagues in 2012 based on a technology platform that we initially were actually developing at a government national lab. So in my previous life, I was a research scientist leading a research group developing pointed care tools, handheld instruments, primarily around biodefense applications, so things where you potentially have a mass population of people exposed to maybe a nasty substance. There's a challenge there. And how can you really, rapidly and comprehensively test all the people who were potentially exposed and get treatment to those who need it. Out of that spun a technology that we developed that worked really well for doing things like blood tests and white cell counts and things that we wanted to commercialize. So we left those jobs. We started sandstone, actually in the garage of a rental house in Livermore, California, in 2012 and identified male fertility as our first product that we wanted to bring the market one because of the I guess what I mentioned before around the market need, especially at that time very few tools for men. And two from a technology standpoint, we knew we had the capability to build a very precise and accurate sperm count test and set off to be our first foray into the market and change the way couples conceive.
Rena: Well, that's incredible. So where can you purchase one of the kits?
Greg: So we saw it mostly online today and still through our website www.trakfertility.com. We’re also on Amazon and a few other websites, so the product is approved for purchasing with your health savings account and flex spending account. There's a few websites such as the FSAstore.com that specializes only in products that are under that banner where or track can be found as well it makes a little easier f you have a FSH or HSA debit card, you can use it right there.
Rena: Sure. And I was looking at your website, and the price point is not crazy. I mean, this is not something that's gonna cost people thousands of dollars. It's pretty manageable. It seems.
Greg: Yeah, our entry kit is a $75 device, and that comes with the device and two tests, and we sell a refill tests on top of that, really emphasizing the importance of repeat testing and tracking. But you're right. I think it's really important here that this not be a cost barrier. You know there's enough barriers to get in your semen tested cost shouldn't be one of them for these guys,
Dara: And since we’re women, I'm not quite sure, is there a specific time that you prefer people taking it? Do you send it all back to a lab? How does that work?
Greg: No. So you do it on your own time. You don't have to send it back in. Comes with a device and consumables and little pipettes everything that you need to run the test entirely at home.
Dara: That's great.
Greg: Yeah, there's not really a right time of day or time the week to test. What we do recommend, especially for couples who are trying to conceive, is that you test while your partner is on her period so that you're not interfering with the baby making process, of course. It's a good time to test and we actually recommend that men test monthly Sperm counts can change a lot. And you know, that's one of the really interesting and empowering things about this whole space of men's reproductive health is that a guy's sperm quality is not set in stone. It can fluctuate a lot for a lot of reasons, you know, environmental and personal and things that you're doing with their health and wellness, what you're eating, how you're exercising. Those things could all play a role. So really, what we do with the track system is we encourage men to adopt what we're calling sperm friendly habits and we're not talking about a lifetime of changing your whole lifestyle. We talking about a few months could make a big difference. Let's try to yield it better if you're overweight let’s try to lose some weight. Maybe, start walking and exercising a little bit more cooling, you know, big thing that we are proponents of is testicular cooling. The testicles need to be a few degrees cooler than the rest of the body for a reason that can really help sperm production. So if you're really motivated and want to do what you can to improve your chances of conception, guys are into it. They're taking these daily supplements, they’re doing cooling and all these other things that can make a difference.
Rena: What is cooling exactly?
Greg: There's kind of the passive approach, I guess which is, well, let's stay out of a hot tub and sauna and, you know, stay off the mountain bike for long hours a day, and then there's more active stuff. There's actually products out there that cool down your testicles. You know, there's underwears with ice pack in them and other devices to sit on.
Greg: Not quite that extreme. You don't wanna go too nuts, but pardon the pun. The ice out there. The guys can sit on while they're commuting to work and back. And there's actually quite a bit of clinical research around the active benefits of this not just for sperm production, but a little bit of a boost in testosterone as well.
Rena: Oh wow! Because I know people are always asking, you know, what can I do to improve sperm quality so I think that’s really helpful to share anything.
Greg: Yeah, cooling. And then these one a day supplements the most doctors will tell you aren’t gonna hurt, a general blend that could be healthy for the sperm production environment. Those are kind of the two biggest things that we recommend alongside the monthly testing.
Dara: Do you have any brands that you recommend cause a lot of people come to me and ask me my opinion. And I've heard of a couple brands but is there any one specific one that you typically like?
Greg: Yeah well, we don't really promote one or the other. There is a new company actually in the space called Neutra Verve. They actually had a Canada small team that were really fans, and we've done some good work with them, kind of bundling track with their daily supplement. They called their product the male prenatal. It's got a good plan and has been performing really well again, really good reviews, So we like them. But in general, I think a lot of them are pretty similar. And, you know, if you're taking a decent, even just a good multi vitamin with some antioxidants, I think it's been shown to have a positive effect.
Rena: Okay, so cooling supplements. What else could be done to help improve?
Greg: Well, it's a great time to kind of drop those vices, especially when you think about our customer group here. I guess our demographic. You're dealing with young men who and they tend to be younger men who are kind of at an important shift inflection in their life, I guess. A lot of these guys are maybe newly married or settling down and coming out of a college party days to live a little bit more of a balanced lifestyle.This is a great time to maybe drop the fast food habits. If you're smoking, let's lay off the cigarettes or excessive drinking. All these things have been tied to risks of low sperm quality, and it's a very motivating time. You know, you're not dealing with getting healthier or maybe losing weight. You're talking about becoming a father. I think our society has changed a lot where these guys are very motivated, very excited about the prospect of becoming a dad having kids. And when they recognize that they might have a fertility issue, it's devastating. It can be really heartbreaking. We see this as a really keen opportunity to instill some healthier lifestyle habits in these guys, to not only help them with their fertility, you know, to improve their reproductive health, but to see those benefits extend into their overall health as well. I would venture to bet that these guys who are taking steps to improve their fertility when they're young are gonna have better health outcomes down the road. And it's a very positive thing.
Dara: I’m happy you mentioned that Greg. I meet with a lot of women, a couple of men, but the idea of priming your body and priming your habits early on, so down the road with the child you're already establishing healthier habits. And I know also with women, women have to refrain from alcohol and limit their caffeine during your pregnancy. And it's nice when a man can also be supportive. And, of course, it could be somewhat temporary. You know, cutting back caffeine, cutting back on alcohol, trying to cut out cigarettes. It's great to be supportive and do it together.
Greg: Yeah, I'm glad you mentioned that. I think it's overlooked a lot the benefits and power of couples doing this together. But for so long it's been women receiving this advice and doing things on their own on the council of their OBGYN or fertility specialists who whoever it is, and the men are just kind of left out of that discussion. But what we see is that the guys don't want to be left out. They don't like being on the sideline or being talked around. They want to be involved. And there's still a lack of awareness or education around the importance of the male half of the equation. So you know when you are able to coach them that hey, guys are just as important in this process as women are. The guys really respond well to it, and they get into and say, OK, well, she's doing this. I'm gonna do it to. You know, I think you're going to see that those couples doing it together are gonna be far more successful than someone doing it on their own. It's empowering to do something together as a couple, and I think it's relationship building, too. You know, you're kind of taking steps for your health and your relationship and your future family. I think it's all gonna have benefits in the long run.
Rena: Sure. Absolutely. I love that this gives men a real tangible, too, because I think a lot of times when I see couples, one partner or the other doesn't know how to support the other person. You know, it's always nice to give somebody a tangible and give them the tools to support somebody.
Greg: Yeah, it is. Just being willing to test yourself. I think is kind of a gift to your partner like, Hey, I'm really into it, it’s showing you know, I'm committed in this I'm interested in and I see what I can do says a lot, regardless of whatever the results are. You know taking that first step.
Rena: Sure that vulnerability. I mean that’s scary.
Greg: You know something like sperm count, it's not the most fun topic to talk about. You know, there's a stigma. There's a taboo around it. It’s tough to bring up that subject. You know, it's kind of like sexual health in that regard, where there’s a vulnerability to testing yourself for STDs, there's a vulnerability to testing your sperm count and seeing where it is, and it's also kind of nerve wracking. A lot of our customers the first time you test, you have no idea what your results are. It's not like there's other symptoms around low sperm count that you're walking around. Yeah you have no idea what your sperm count is until you get a test. Yeah, it could be difficult,
Dara: But the idea to do it at home I think also lowers people’s stress levels that much more. I know with my husband, when we were trying to get pregnant here at RMA, you know, he tried to make a joke of it. You have old magazines... The idea of being able to do it at home, your own comfort when you feel ready. I'm sure it's a huge relief for a lot of men.
Greg: Yeah, on your home turf, like well, like a makes a big difference.
Rena: So say you do test and you get results that say that your sperm quality or sperm count all those variables you're testing for can be improved. When should you test again? What's kind of the time frame for that?
Greg: Well, we kind of recommend that you test twice initially and that's based on the World Health Organization has standards around semen analysis that we base a lot of our recommendations off of. The WHO recommends testing twice within a few weeks to establish a baseline. We recommend that as well, and then monthly. After that, it can take a few months to see significant changes. You’re likely to see some day to day fluctuations, but to see a meaningful change often takes 2 to 3 months. It really comes down to the lifecycle of a sperm. Spermatogenesis cycle, as they say, is about 72 days from a sperm being born to coming out of a body. And that's about the time cycle when you're able to see meaningful changes due to whatever sort of interventions that you're pursuing. But for men who test low, especially when you’re testing consistently, we recommend they go see a physician.
Rena: Cause that’s gonna say what should you do? When should you call a doctor?
Greg: You know, tracks is not a replacement for a medical evaluation or a laboratory semen analysis. It's a screening and tracking tool of from important parameters. But it's not all inclusive medical diagnosis. So we recommend that the guys who are testing low go see a physician and, ideally a main reproductive health specialist, a urologist who specializes in this. And I know you know, RMA, you have one of the top doctors in the country, and Dr. Bar-Chama specializes in this, sees men all the time for these issues. But there's other doctors like that all over the country. We recommend they find one, and the sooner you can get in the door to see where you're at see if you have an issue and start taking steps. Obviously, the better your prognosis in the long run.
Dara: Greg, do you also provide some guidance or research on your website for those men who want to improve their sperm?
Greg: Yeah, we have a lot of stuff. So the product itself comes with a booklet, about 30 pages long. We kind of divide up the you know what to do about your sperm count into six different sections and give some men general tips and guidance. We also have a little bit more of a personalized tool available on our website and through our app. So we have a free mobile app out there called tracks firm Health and Fertility app. It's got a tool in it that takes about 10 minutes to complete, so it's a little bit of an involved questionnaire. But what it does is it flags potential health and lifestyle issues that could be causing fertility issues. I guess it kind of comes down to, you know, again what we're talking about before a lot of guys just don't know this area and aren't really all that well informed about reproductive health in general. So it goes through the questions to flag these things that might be causing an issue and give the guys some tips and guidance on what they can do about it. And that includes, you know, go see a specialist because this medication might be causing an issue as well as things like you're a little overweight. This might be a good time to try to lose 10 pounds if that's going to be possible. And all the other things in between that can make a difference.
Rena: Oh, I love that. It seems like you really are giving people a lot of very specific tools and advice right from the get go.
Greg: I would also mention that we built all this with the urologists who specialize in this space. We've worked with several of the doctors now who do a lot of research in this area, the guidance documents coming out of the medical societies to help us make these tools and really make a useful product and ecosystem. The thing we hear from physicians all the time, including Dr. Bar-Chama, is most men aren't getting treated, aren't really getting looked at, especially early in the process of anything that could help these guys get better educated, more aware, get tested, is seen as a positive in this space, and it's gonna improve fertility outcomes for these couples who need it.
Dara: So I noticed on your site that you guys are doing research and there's a recent study. Would you like to talk a little bit about that in terms of the 300 college-age men and women?
Greg: Oh, yeah, Yeah, we've had some interesting opportunities. Just having the product out there on the market now for a few years is to, I guess, dive a little bit deeper into health and lifestyle and perceptions, especially amongst men but amongst men and women as well. Yeah recently, over the summer, we did a study kind of coming at it from the hypothesis that it seems like a lot of people aren't really all that well familiar or educated around reproductive health until you really kind of get into the space. And I'm sure you can attest to this that you know couples who get that first diagnosis a lot of times just kind of act like they're hit with a ton of bricks.
Rena: Sure. The majority of things I hear is, well, I spent my whole life trying not to get pregnant, you know, cause that's what they teach how to not get pregnant. If someone told me how hard it would be, you know, I wish I had known all this information. I think you know a predominant message right now, is really teaching kids is that you don't get pregnant until you’re ever in the fertility space you don't realize. OK, well, other things, maybe perhaps I should have known.
Greg: Yeah, but for good reason. I mean, we don't do that for no reason. Obviously, teen pregnancies and things are an issue, and you want kids to be smart and to be healthy. But yeah, the flip side of that is there's this unrealistic expectation around fertility that just doesn't come to be true when couples kind of month after months are going by and this isn't happening. What's going on? I thought that this would happen immediately once I stopped using the pill. We went out and did a survey with about 300 college age most men and women just to understand a little bit more around. What did they think about fertility and know about it? And we actually just kind of broke it down by the differences between men and women, which we found to be kind of fascinating. So we found that women were more likely to say that they wonder about what their fertility status might be. But when you look at, we ask questions like, how important is it for you to have a child in the future and the breakdown was about the same, about the same percentage of men and women said that yeah this is really important for me. Yeah so we went through a lot of these things. Men tended to foresee themselves having kids a little bit later in life than women. Maybe not surprising there. Women were a little bit more likely to suspect that they might have a fertility issue. Although the percentages there, both men and women were still pretty low. I think a lot of people, especially young people, just tend to think that they're healthy and going to be fine. The women are a little bit more aware that they might have an issue. Interestingly, so we asked about what does fertility mean for, you know, if you're not in a relationship and trying to find a partner, we asked, you know, is fertility an important factor when you're looking for a future partner and men actually answered that a little bit higher than women though which I found interesting that men were more likely to see that as an important issue in a future partner than women. Women said they're more likely to get tested than men. Probably not surprising then, and this was maybe one that we all know but to put some data to it was interesting that women are actually twice as likely than men to have a personal doctor. Then you think about young guys. Guys don't see a young doctor.
Rena: I saw that. Yeah, it's weird. I think women are more prone to go to doctors than men. I don't know why.
Greg: Well, I think women are used to seeing their doctor or their OB annually at least. Guys only go to the go to the Doctor if you have to.
Dara: A flu shot.
Greg: Yeah, I think a lot of that stuff. The big takeaways were both encouraging and discouraging at the same time. I think both men and women see fertility and having kids in their future very strongly, but probably not as aware of the prevalence of infertility as maybe they should be. I think there's positives and negatives to come from this, but overall I think if kids of this age who are approaching that reproductive time in their life can have a little bit more awareness that infertility isn't as simple as flipping on the lightswitch I think that can be very positive. I think that can lead them or people getting tested, being aware that they might have an issue and could resolve a lot of the increasing infertility rates that we're seeing today.
Rena: Sure. Well, it sounds like, you know, we talk a lot about how we want the dialogue to be changed surrounding infertility. And I would love for the voice around the male factor to change, too and men to be you know, you think it's hard to get women to come in my office. It's very hard to get men to come in and open up and talk about this. And I always wish there was more resources and supports that I could send men to. It's hard to find because as much as women aren’t talking about it, men really aren't talking about it.
Greg: Yeah, I think it's different for women and men. I think for men it's got to be one anonymous and two very private. We see with ourselves that this might not be a topic that men are openly discussing with their friends and family but they are looking for answers, then spend a lot of time googling for information, trying to figure stuff out of. Men are naturally problem solvers and they treat this like a problem and, well, how can I fix it? How can I solve it? And they come to us in the middle of the night in incognito mode on their mobile phones, looking for information. I didn't mention our second website. We have a separate, totally educational website dedicated to men’s reproductive health at don't cook your balls dot com.
Dara: Brilliant name.
Rena: I like the humor in that.
Greg: It's been very exciting to see it grow, and it's been very useful for us not only to reach people but to learn about people and what their thoughts are and what they're looking for. We built it simply because there just wasn't anything like it at the time that most of the information on the Web around male fertility is found on hospital and physician websites, which is great, except it's just not presented in a very approachable way. It's got bullet points with rather stodgy information and stats on it usually. So we said, well, we're gonna approach this a little bit, more as we would want to get it, a little bit more conversational. And, yeah, there’s some humor and edginess in there. But that's all intentional, and it's to get over this awkwardness barrier around the topic. Okay, well, you know, if you're gonna understand your reproductive health, you get comfortable talking about semen and sperm and testicles and these things that maybe you're not really used to talking to. If you could put a joke in there, maybe that helps get that you want to keep reading. So it's been great. I think it’s done a service. It helps. You know, we bring in a lot of experts, including some from your facility. They have contributed information and articles and videos and things that helped get the words out. Infertility is pretty common, but there's a lot that you can do about it. And the sooner you can do that, the better you're gonna be.
Dara: Greg, that’s great that your company is being able to fill that void, bring more of a voice, more awareness to men, giving them resources whether it's both of those websites, your instagram account, all that research that you're doing. Where do you see track fertility going in the next five years or beyond.
Greg: We've only had the product available in the U. S. We’re actually on the cusp of getting our international approval. So track will be going overseas soon, which we’re really excited about. We're always improving the product. So we've released a few new features and some more are coming. We've got some good research we’re really built around this technology platform for remote and point of care testing across a lot of facets of healthcare and men's health, especially, is just so dramatically underserved. So we want to expand the capabilities that men can do on their own or with a physician, or whatever the case may be to help more men get access to health care. You know, men die six years sooner than women. Men are just not taking care of themselves. And we think fertility and reproductive health and things that are motivating you early in your life are going to see long term benefits. So track is kind of emerging into a brand around helping engage with these guys at this very important very intimate, private special time in their life and leveraging that to instill some healthier habits that we're really excited about.
Rena: I love that I'm so happy that we have you as a resource to refer people to and a company really working to improve men's health and, you know, hopefully change the dialogue and stigma around this space. I think it's so important.
Greg: Thank you. Well, kudos to you, too. This is a great podcast and a great resource. I think the more things like this that are out there that are talking to people, educating the people is really what's needed, and you're doing it in a very fun way. So I appreciate it
Dara: Anything else that you would like to add?
Greg: No, I think that's great. You know, we are small, We are
Rena: Small but mighty.
Greg: Simple, and there's a real benefit to being small like that, that we’re very approachable. I think of anyone has questions, don't hesitate to shoot us email or give us a phone call, email addresses. It's simple. It's info at www.tracfertility.com, and we'll respond. We get back to our customers quickly, and there's definitely a human very committed to helping people in this space. So we love to hear from people and help them out when we can. And if getting that first test is what you're looking for I think we have a great option for those guys.
Rena: Oh, good. Thank you. Thank you. And we'll, of course, post everything about how to reach you more info on all of our social media and everything so people will actually know how to get in touch with you. But that’s so great.
Greg: Thank you.
Dara: So how we always end our podcasts are we discuss gratitude, what we're grateful for today. So, Greg, what are you grateful for at this very moment? It could be anything. To put you on the spot.
Greg: Oh boy, well, I'm sitting in Minnesota. We have a 60 degree day still, so the snow hasn't hit yet, so I'm grateful for that. But maybe more so today is actually my youngest daughter's first birthday.
Rena: Happy Birthday! What’s her name?
Greg: Her name’s Elena.
Rena: Happy Birthday, Elena!
Greg: Yeah. Thanks. So that's exciting. So we got birthday cake and cake smash coming up on. And I will mention that I got three young daughters now that obviously you know the best part of my life, I think one of the most happiest things about what we do as a company is seeing those success stories. You know, my wife and I were lucky we didn't have fertility issues. But hearing the stories from couples who are out there who struggle with this, it's heartbreaking I mean, I can't imagine having these three little girls. When we get these success stories about men using the product, being successful, becoming a dad, it really is positive feedback. The best rewards we can have for, you know, I think a lot of times in a startup company, it's day to day. It's a grind. It's a lot of hard work, but very rewarding in the end to see these success stories. And we're proud of what we've built here as a company. So I'm grateful for that and the team that we have here as well. You asked for one thing, maybe I gave you to many but
Rena: No I love that. You can never have too many gratitudes. We should all be so lucky.
Rena: I'm grateful for people like Greg and for Trak for providing this and being out there being another voice out there trying to change the dialogue and someone, you know Greg, it's so clear that you really, truly are so dedicated to this and really care. And I know that you guys really do answer emails and you really do care about your clients and that it's those stories that really do make you feel like your job is making a difference. And so to meet other people in this space who care so much is always something I'm grateful for because one of the brightest spot of my job, too, is seeing my patients and the difference you can make in somebody's life. So I love having resources and something else to give people to help them when they're also starting their journey. Dara?
Dara: Kind of a similar vein. I'm grateful for living in this era where we have these resources. We have this research where we are looking at both sides of the fertility world. That's not just women, it's also men. And knowing that there are resources and a great product out there for men that they can use in the comfort of their own home is incredible. You know, I wish I saw more male patients in the clinic because I do feel like it is a team effort and knowing that there is extra help out there and the resources and the guidance for men as well is something that's pretty remarkable. Thank you, Greg.
Rena: Yes. Thank you.
Greg: Thank you so much.
Dara: You were wonderful.
Greg: Well you two as well. Thank you.
Dara: Thank you so much for listening today. And always remember, practice gratitude. Give a little love to someone else and yourself. And remember, you are not alone. Find us on Instagram @Fertility_Forward. And if you're looking for more support, visit us at www. rmany.com and tune in next week for more Fertility Forward.