When friends Samantha Diamond and Breanna Hughes each experienced pregnancy loss in 2017, their respective reproductive endocrinologists referred them to naturopathic doctors for additional prenatal-care guidance. These providers, in turn, sent each to the drugstore with laundry lists of supplements to buy—where both women found themselves utterly overwhelmed. There were so many variables to consider as they scanned countless pill bottles: differentiating ingredients (folate from folic acid, beta carotene from vitamin A, for example), confirming each ingredient came at the right dosage, and ensuring that the supplements were each formulated by a reliable brand. As the two women shared their struggles with loved ones and scouted advice online, they quickly found that they were far from alone in their confusion about the prenatal-vitamin space. And soon after, the idea for Bird & Be was, well, born.

Bird & Be is a fertility marketplace that launched in July with the goal of streamlining prenatal vitamins with semi-personalized one-a-day sachets. (The company also plans to launch products to serve other elements of the prenatal journey this coming fall, like at-home fertility-hormone testing.) It’s the latest in a slate of fertility-focused startups seeking to simplify everything from tracking ovulation (Mira, Natalist) to egg freezing (Ova, Extend Fertility) to full-service fertility-based care (Kindbody).

To develop Bird & Be’s five proprietary offerings, Diamond and Hughes turned to naturopathic doctors Tracy Malone, ND, now Bird & Be’s director of naturopathic medicine, and Jennifer Fitzgerald, ND, now the company’s director of integrative medicine.

“First, we created a massive spreadsheet to sort through all the prenatal vitamins we could find on the market and detail what was in each,” says Dr. Fitzgerald. “Then we figured out what was good or not great about each one for different people, and what was missing.” From there, she and Dr. Malone created a quiz designed to mimic their own patient intake forms in order to help parse out what a certain person may need in a prenatal supplement based on a variety of variables (more on this below). The quiz result includes the particular Bird & Be supplement believed to best meet these needs.

Simplifying and streamlining the prenatal supplement space

While almost all medical professionals recommend a well-rounded diet as the primary means for accessing necessary nutrients, the unique requirements of pregnancy—supporting your own body and the formation of another one—can make it difficult for a pregnant person to meet 100 percent of their vitamin and mineral needs through diet alone. As such, prenatal vitamins are often recommended as a booster to help support a healthy pregnancy. “And for those struggling with fertility, in particular, certain supplements can help normalize hormonal signaling to spur on ovulation,” says reproductive endocrinologist Dan Nayot, MD, Bird & Be’s medical director (and Diamond’s husband).

But despite the clear and studied health benefits that prenatal supplements can deliver for fertility, there’s limited cohesive guidance surrounding exactly which prenatal vitamins to take at different stages of conception and pregnancy, and at what doses, depending on your age, biological sex, and medical history. (The exception to this rule is folic acid, which the Centers for Disease Control and Prevention recommends to all people who become pregnant at a dose of 400 micrograms per day.) And since the Food & Drug Administration does not regulate over-the-counter supplements or vitamins like it does prescription meds (meaning it doesn’t confirm their ingredients, listed amounts, or related claims), knowing what to trust can be tricky.

“People are lost in the prenatal vitamin aisle with different, contradictory directives, asking them to buy one of this and two of that.” –Samantha Diamond, CEO of Bird & Be

“People are lost in the prenatal vitamin aisle with different, contradictory directives, asking them to buy one of this and two of that—especially if they’re seeking out info online,” says Diamond. “And then you end up with a vanity loaded with 17 different pill bottles, and you’re cocktailing a mixture each day, not really knowing if you’re taking the right doses of each supplement.”

Before even getting to that vitamin aisle, though, many folks—especially those struggling with fertility—first need to seek the care of a specialist, which can be costly. That’s because while your OB/GYN can surely guide you toward the ingredients and doses to seek out in a prenatal, their expertise lies primarily in prescription- and surgical-based solutions to fertility issues, says Dr. Nayot, which is why they may suggest the support of a fertility-focused naturopath in this realm—and insurance very often does not cover this. The cost of that initial visit can range anywhere from $150 to $750 with follow-ups typically in the lower hundreds, making that kind of care inaccessible to many. “So, we essentially asked Dr. Jennifer and Dr. Tracy to digitize themselves in order to provide that kind of personalized care through our platform,” says Diamond.

After taking the intake quiz—which will cover info like your age, biological sex, whether you’re considering pregnancy now or in the future, and whether you have any known fertility-impacting conditions—you’ll receive a recommendation for Bird & Be’s basic, gentle, or power prenatal for either eggs or sperm, which start at $35 for a 30-day supply of sachets. That price tag both cuts out the cost of a visit to a naturopathic doctor and reduces the total amount you may spend buying a collection of individual prenatals in order to reap all their benefits. Each daily Bird & Be packet packs upwards of 20 fertility-supportive nutrients (like choline, vitamin B12, and folate) formulated into just a handful of capsules.

As for the quality-control issue noted above (due to lack of FDA scrutiny for supplements), Diamond and Hughes sought to address that by opting not to collaborate with a distributor (which would simply compile existing prenatals into Bird & Be packets). Instead, they worked with a lab to compound their own prenatal supplements, which are fresh-pressed for each order from third-party-tested raw ingredients. “This allows us to make sure we’re actually giving people the active, bioavailable form of the vitamins and at therapeutic doses,” says Dr. Fitzgerald. And this way, the pills aren’t sitting on a shelf in a store for months (or even years), where they can oxidate and lose their efficacy with time.

Removing the gender binary from the prenatal equation

Because both an egg and sperm are required for pregnancy, it follows that people with sperm can optimize their own health for fertility, too—though this is a relatively new line of thinking in medicine, where prenatals have been developed exclusively for people with eggs for years.

“We used to think people with sperm had no biological clock, but now, we know that aging definitely does affect sperm in terms of numbers, concentration, quality, and motility,” says Dr. Nayot. For that reason, Bird & Be not only offers prenatals for people with eggs but also specialized ones for people with sperm, joining the ranks of other new sperm-health-focused prenatals from Perelel and Natalist.

Beyond simply providing prenatals for people of all biological sexes, however, Diamond and Hughes also sought to strip their products’ design and packaging of the unnecessary gendering they saw in drugstore aisles.

“We noticed that all the supplements were mostly pink for women and blue for men, and you’d see images of women holding their bellies or even holding babies on prenatal packaging, which can be very triggering for someone actively trying and struggling to conceive,” says Diamond. “First off, the person in the image already has the baby, so it’s confusing as to why they’d include this image on a prenatal. And second, that presents a potentially uncomfortable situation for a trans man, for example, who’s trying to see if he’s ovulating and is then picking up a pink box with a picture of a woman on it.”

“Gender simply doesn’t have anything to do with how you choose to build your family.” —Diamond

By contrast, Bird & Be’s packaging is distinctly de-gendered. Product names are in line with biology, for “people with eggs” or “people with sperm” (instead of “for him” and “for her”). And as the company continues to launch new items and add educational content to its site, inclusivity remains at the forefront of its priorities, “because gender simply doesn’t have anything to do with how you choose to build your family,” says Diamond.

Up next for the brand are ovulation, pregnancy, and ovarian reserve (follicle-stimulating hormone) tests designed for people with eggs, and a sperm test for people with sperm. “These are diagnostic tools that can help signal if there’s a potential fertility issue you should be aware of, in order to help you take the step of self-advocating with a doctor,” says Diamond. “What we’re aiming to do with Bird & Be is give people access to knowledge about fertility early on, so, they’re empowered to get care if they need it and avoid the stress of the unknown.”

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