Aayush Rai, co-founder of Inito, outlines how at-home fertility testing is joining an array of routine tests that will be done increasingly at home and what this means for the future of clinical labs.

By Chris Wolski

With at-home testing becoming more common for everything from pregnancy to COVID-19, trips to a doctor’s office or a lab for a routine test seems be on the cusp of becoming a thing of the past. What will this mean for testing in general and the future of labs in particular?

In an interview with CLP, Aayush Rai, co-founder of Inito, a company that provides at-home fertility, diabetes, and thyroid testing, outlined how at-home fertility testing is simplifying patients’ lives, why at-home testing for routine tests will become commonplace, and where labs will fit into this new, evolving landscape. 

Answers to CLP’s questions were edited for length and clarity.

CLP: Inito has developed and released an at-home fertility/ovulation test — can you explain briefly how it works, and how it replicates, in-lab testing? 

Aayush Rai: Previously, couples trying to conceive could only track when they are fertile at home using ovulation tests. Ovulation tests can be done at home, measuring the presence of L.H., which shows up in the urine after ovulation occurs. Modern ovulation tests, like Inito, have advanced such testing by measuring the actual value of three essential fertility hormones, two of which predict, in advance, the time of ovulation and one that confirms that it did actually occur. The user can simply send the chart of their hormones to the doctor rather than going through the anxiety and stress of lab tests. Once users and doctors experience the ease of use of these, they will not want to back to traditional methods.

CLP: There’s a growing prevalence of at-home testing that’s becoming more sophisticated. What’s driving this? 

Rai: The ability to conduct home testing dovetails perfectly with online consultation and medicine delivery. With modern connected devices, patients can directly share test reports with their doctors, consult with them online, have their prescriptions renewed, and await the arrival of medicines at their doorstep. A complete ecosystem.

CLP: How is at-home testing changing the way the public thinks about health care? 

Rai: People want to live healthy lives autonomously without excessive medical intervention. Even after the pandemic, consumers will continue to adopt home diagnostics. As technology sufficiently matures, every house will have a single connected device capable of conducting these tests — becoming as much a part of the household as a thermometer is today. This is especially critical in the U.S., given the high incidence of chronic diseases.

CLP: On the Inito website, it is stated that the results are “lab quality” — what do you mean by that? 

Rai: Lab Quality means that the hormone values measured by Inito closely correlate with the results obtained by lab methods like ELISA.

CLP: Is the Inito solution an adjunct to or do you see it replacing a more traditional lab visit for patients?

Rai: Inito is useful in tests which need to be taken repeatedly, e.g., hormones or glucose, as they change every day and need to be measured multiple times. The other places are where privacy is key, e.g., STD testing. Lab visits will be needed for tests which need very high accuracy or tests that are complex.

CLP: I know that you provide support to patients — what does that involve? If there’s a questionable result, what do you recommend?

Rai: In most of our support queries, users want to understand their fertility rating based on the trend of their hormones. This involves understanding how hormones behave and our interpretation algorithm. Hence, we built our support team exclusively with biology or biomedical majors. They are trained to educate and support users for anything other than giving medical advice. 

CLP: On the face of it, it seems that you and other providers are trying to take labs out of the testing equation — is that the case? What is the role of the medical testing laboratory as we progress through the 2020s and beyond? 

Rai: We believe that common medical tests that need to be done frequently — like for diabetes, thyroid, fertility hormones, etc. — will move to the home from the labs. Advanced tests that need extremely high sensitivity or are done rarely will still be done in the lab. 

CLP: Looking ahead, what’s next for at-home fertility testing and at-home testing in general? 

Rai: We feel that as the portfolio of home tests expands, services will be provided remotely. For example, if you need to renew your thyroid medication, you will be able to test for TSH on your phone, consult a doctor remotely, and get your medicine delivered.

CLP: What does at-home testing — in your view — mean for laboratory testing? How do you see medical testing labs evolving along with at-home testing? 

Rai: We think that lab testing will have to focus more on high complexity, high value tests as most of the high volume frequently done tests will be done at home.

Chris Wolski is chief editor of CLP.

Featured Image: The Inito home fertility test provides women lab-quality results in the comfort of their own home. Photo: Inito