Apple needs to take fertility tracking more seriously

Fertility apps have always been sketchy. As I have experienced it, this is a Faustian bargain of sorts: Venture your chances on one of many options in your application store, and choose the one with the best reviews, or perhaps the simplest interface. You will sign up if you feel uncertain about what to make of the opaque data policy, and then you will endure the ensuing deluge of targeted ads – all in exchange for an accurate prediction of when you are most likely to get pregnant. Judging by those ads for maternity clothes and organic cotton onesies, does anyone know somewhere I’m trying to get pregnant or have already given birth, even though they can not decide which one. I do not like it, but I tolerated it.

I have been thinking about the topic of menstrual and fertility disorders since I decided I was ready to become a parent, although for the sake of privacy I did not think to write about it until after I gave birth to said imaginary baby. But in the two months since Politics a draft opinion published in Dobbs teen Jacksonthe case that guarantees the constitutional right to an abortion by Roe v. Wade, many people have talked about period trackers. Some activists and privacy advocates have asked if the data captured by these applications could be used to help prosecute someone seeking an abortion in a state that does not allow it. Some have simply encouraged readers to delete these applications altogether.

I understand why. And I also understand why people use these applications in the first place: Because the version of that application built into your smartphone operating system is not very good.

In my case I have an iPhone. I’ve been using period tracking for a few years now, although Apple started introducing these features much earlier, in 2015. From the beginning, Apple has been criticized for moving slowly: Some observers have wondered why Apple did not have women’s health features ready when it launched the Apple Health app the year before.

In its current form, the application is decent in the sense that it can accurately predict when you are about to menstruate, and it’s easy to log in when you do, either through your iOS device or Apple Watch . It is helpful not only to avoid potential surprises, but to know when your last period started in case your gynecologist asks for it. (And they always ask.) What’s more, irregular periods can sometimes underscore larger health issues.

The fact that Apple did not pay more attention to this when it downloaded hundreds of millions of third-party alternatives is honestly surprising: Apple can own this space if it wants to.

To be able to do this, however, Cycle Tracking must be just as good at helping people get pregnant or avoid pregnancy. Because ultimately, those users all need the same set of data, the same predictions, regardless of their intent. If you know you are ovulating and want to have a baby, you should definitely have sex. If you want nothing less than to get pregnant, that ovulation window is also a useful thing to be aware of.

Here’s what Apple will need to add to its application to match its competitors and build a true all-in-one period and fertility tracker. (Apple declined to comment for this story.)

Ovulation prediction

First, it must be said that Apple does not try to predict when you ovulate. What you will see is a six-day fertility window, shaded in blue. But not all fertile days are the same. One has about a 30 percent chance of getting pregnant on ovulation day or the day before; five days before, your chances are closer to 10 percent. Unless you plan to have sex for six days or avoid it all the time, a six-day fertility window without additional context is not very helpful.

Other fertility programs learn from previous cycles to predict how long your typical cycle is and when you are likely to ovulate. I’ve seen more than one application display conception chances on a clock graph, with some even displaying your estimated percentage of success for a given day. Apple can decide for itself how complex of an interface it wants, but it certainly has the machine learning knowledge to predict ovulation based on previous cycles.

A proper calendar view

Apple’s is the only period tracking app I’ve seen that does not provide a calendar view with schedules. Which is amazing when you consider that everything related to fertility (and later pregnancy) is measured in weeks. Instead, Apple Health shows the days in a single, horizontally movable line. On my iPhone 12’s 6.1-inch screen, there’s enough space to see it in full view for seven days. Also, if you input any data, whether it be sexual activity or physical symptoms, that day will be marked with a purple dot. It is not useful at a glance if that dot can mean anything. Another tip for Apple: color coding might help.

If I just record my menstrual periods, I would appreciate it if the possible red-colored menstrual days do not creep up on me. (Okay, okay, you can also set notifications.) But for those trying to conceive, a calendar view will help for other reasons, such as adjusting factors such as sexual activity and body temperature against your predicted fertile days. Which brings me to my next point …

An easier way to record and understand basal body temperature

One way many people measure their fertility is by taking their temperature at about the same time each day. The idea is that your temperature will skyrocket right before ovulation and then drop again unless you become pregnant. It does not matter so much what each day’s reading is; what matters is the pattern to which all that input points. And the only way to see a pattern is to see your temperature readings on a graph.

This is how temperature tracking used to be done in the old days, in front of smartphones: with graph paper. It’s terribly hard to spot the boom when you, one day at a time, flip through Apple Health’s left-to-right calendar. It is very easy to see the boom when it is presented as an infographic. And I know Apple can do a great job with this. This is already how Apple presents changes in my daily exercise minutes or fluctuations in my heart rate throughout the day.

Oh, and while I’m raving about this topic, Apple does not just let you type in the number you see on your thermometer. You have to select it from a scroll button, similar to how you would set an alarm clock in the Clock application. (When you enter your temperature, you start at the last temperature you entered.) Basal thermometers show your reading up to the hundredth of a degree, so even slight temperature fluctuations from one day to the next can be an annoying amount leads from scrolling.

The ability to recognize ovulation slips

Not everyone uses temperature readings to predict ovulation. Many people use the newer invention of ovulation tests: pee strips at home that measure Luteinizing Hormone (LH), which rises before ovulation. The result always includes two lines, and how close you are to ovulation depends on how dark each of the lines is. Because that color exists on a spectrum, from light purple to very dark, it can be difficult to portray the nuances with the naked eye, especially to the deeper side of the color gradient. Fortunately, many applications allow you to take or upload a photo of the results, and the application will use camera recognition to classify your test results into one of three categories: low, high, or peak. Again, I have no doubt that Apple has the technology to do this.

Resources for pregnant people

One of the reasons why people download fertility programs and keep using them after getting pregnant is that they can learn week by week whether their baby is the size of a raspberry, prune or avocado. These applications can also be a resource for beginners who feel overwhelmed and unsure about what symptoms and body changes they can expect at any stage. The information in these programs differs in depth and probably accuracy. There is no governing body as far as I can tell that regulates what information applications include as resources. Not even the App Store. I do not suggest that Apple write its own content. But it can use the same system of curation it has for the App Store, Apple News, etc. used to provide users with information from trusted sources, whether it be medical sites like WebMD or trusted medical centers like the Mayo Clinic.