There are now hundreds of apps that will tell a woman when she's ovulating. What almost none of them will tell her is why that matters, what her fertile window actually means for her body, or how her fertility potential changes over time. We've built extraordinary tools for tracking — and left a much bigger gap in understanding.
This isn't a minor oversight. It's the difference between data and knowledge.
Tracking is not the same as awareness
Fertility awareness isn't just knowing your cycle day. It's understanding reproductive ageing, recognising the factors that influence fertility, and having realistic expectations about family planning — timely enough to act on that knowledge, not after the window has already narrowed.
In our recent systematic review, presented at ESHRE's 42nd Annual Meeting in London, we looked at fertility awareness across South Asian countries — nearly 40 studies, over 26,000 participants, spanning almost two decades of research. The pattern was strikingly consistent: awareness of reproductive ageing and the fertile window remained poor across nearly every population group we studied, regardless of education level or access to information. Fertility myths persisted even where healthcare access had genuinely improved.
Where the gap actually sits
A few things stood out:
- Knowledge alone doesn't change behaviour. Even where awareness improved, delayed help-seeking and low uptake of fertility services remained common. Stigma, shame, and social pressure shaped decisions as much as information did.
- The burden falls unevenly. Women disproportionately carried the weight of infertility-related stigma, often shaped by a gendered lens on reproduction that placed responsibility on them alone.
- The demand for better education is there. Across the studies we reviewed, participants consistently expressed a desire for more and better fertility education — this isn't a case of people not wanting to know.
What this means for FemTech
Most fertility technology today is optimised for tracking behaviour that's already happening — a cycle already in progress, a pregnancy already being planned. Far fewer products are built to reach people before those decisions are close at hand, when education could actually reshape the timeline of a family-building decision.
If we want FemTech to genuinely close the reproductive health gap — rather than just digitising it — the next wave of tools needs to move upstream: delivering fertility education before major decisions are made, standardising evidence-based information across healthcare settings, and designing programmes that address stigma and misconception directly, not just data collection.
That's the space I spend most of my time in now — the intersection of clinical evidence and the products trying to translate it into something people can actually act on. It's why I do the research, and it's why I advise the companies I do.
Dr. Ashlesha Patwardhan is a Medical Doctor and Reproductive Health Consultant advising FemTech companies and healthcare organisations on women's health innovation.