Women's health has long relied on subjective measures: pain scales from zero to ten, vague indicators like smiley faces on ovulation tests, blanket diagnoses based on age rather than biology. For Dr. Amy Divaraniya, founder and CEO of OOVA, this approach felt fundamentally insufficient. Her own fertility journey revealed a gap between the data women need and the tools available to collect it.
In this episode of The Growth Layer, Amy shares how OOVA evolved from a personal frustration into a company delivering lab-grade hormone testing with AI-powered insights. We discuss the company's expansion from fertility into perimenopause, the unexpected demand that followed, and what it takes to build clinical trust as a first-time founder without a traditional entrepreneurial network.
The Origin: When Data Doesn't Match the Need
At the end of her PhD, Amy and her husband began trying to conceive. They followed all the guidance: tracking cycles, using ovulation predictor kits, taking temperatures every morning. But the tools available were designed for women with perfect 28-day cycles. For anyone with irregular cycles, the options narrowed to chance or invasive treatment.
Amy had been misdiagnosed with polycystic ovarian syndrome multiple times. She didn't want to pursue the invasive route, partly because she didn't want a doctor dictating how or when she could get pregnant. She and her husband agreed that if natural conception didn't happen, they would accept that outcome.
What followed was a dark and isolating journey. Month after month brought negative pregnancy tests and mounting devastation. Amy turned to the one thing that gave her a sense of control: data. She combed through notebooks of information, looking for patterns, for insights, for anything that might help.
What she found was noise. Digital circles that didn't blink. No smiley faces. No actionable insights. The more she investigated, the clearer it became: what she actually needed was her hormone levels. But accessing that data was difficult, and even when she could get it, understanding what it meant was another challenge entirely.
Amy realized the problem extended beyond fertility. Women's health across the board relies on subjective measures. Pain scales. Self-reported symptoms. Diagnoses based on assumptions rather than biology. She wanted to bring objectivity into women's health so that when a patient walked into a doctor's office, a real two-way conversation could happen.
That became the foundation for OOVA: a hormone testing platform that monitors multiple hormones through urine with clinical accuracy, tracks data over time, and learns each woman's unique hormone profile. While the company started with fertility, the vision was always broader—helping women navigate every phase of life driven by hormones.
The Founder Journey: Redirecting Struggle into Purpose
Amy is a scientist, not someone who came from an entrepreneurial network. She didn't have a rolodex of investors or founders to consult. Starting a company wasn't a natural next step; it was a response to being in a dark place and needing to find light somewhere.
She redirected her fertility struggles into building a solution, which became a second full-time job alongside trying to conceive. That focus actually helped her become pregnant. But then a new set of challenges emerged.
Amy wasn't a serial founder. She didn't have an exit or an established track record. When she went to raise funding while pregnant, she discovered that her pregnancy was viewed as a liability. This was 2017 and 2018, and while she acknowledges that times have changed, the experience was isolating.
Other founders advised her not to disclose her pregnancy in meetings. She was told to wear loose clothing, to hide the fact that she was expecting. Amy couldn't reconcile that advice with her values. She decided to raise a small friends and family round from people who believed in her, build a proof of concept, have her baby, and see what happened.
That decision set the tone for how she would build the company: transparently, with integrity, and on her own terms.
What Keeps a Founder Going
Amy is candid about the romanticized narrative of founder conviction. Yes, she believes deeply in solving the problem. Yes, she had enough conviction to uproot her life plan and pursue this company instead of a traditional career path after her PhD. But conviction alone doesn't sustain you through the relentless lows of building a startup.
Three things have kept her going.
First, customer stories. Early on, conviction came from her own belief that the problem was worth solving. Now, it comes from users telling her that OOVA worked, that they got the data they needed, that they're pregnant with their third child. Those stories reinforce the mission in a way that internal belief can't. Second, surrounding herself with people smarter and more experienced than she is. Amy acknowledges that if she relied solely on the data in front of her, she would have closed shop dozens of times. Advisors, investors, and colleagues help her see potential beyond the immediate challenges. When a deal falls through or a setback hits, they're the ones who point out the opportunities that emerged from pushing that far in the first place.
Third, her team. Amy leads collaboratively and transparently. She doesn't view OOVA as her company; she views it as their company. She brings the vision and the north star, but the team figures out how to get there as effectively and efficiently as possible. That shared ownership creates resilience.
Clinical Accuracy and Personalization: The Scientific Foundation
Amy's background as a data scientist is embedded in OOVA's DNA. The platform doesn't give users vague indicators like "high," "low," or blinking symbols. It provides hormone levels accurate to two decimal places, personalized to each woman's biology, and contextualized so the numbers actually mean something.
This approach is a significant differentiator. OOVA doesn't compare women to a population norm. Instead, it learns what normal looks like for each individual user. The company recently launched a feature called "women like me," which shows users how their hormone profiles compare to others on similar journeys—whether that's fertility, perimenopause, or hormone imbalance.
This feature addresses the profound loneliness many women feel when navigating reproductive health. They often feel dismissed by doctors, unsure who to turn to for support, and isolated from friends or family who may not understand their experience. By showing women that thousands of others share similar profiles and symptoms, OOVA normalizes what feels abnormal.
Amy's scientific rigor also shapes the company's marketing. OOVA won't promise pregnancy in three cycles. There's no guarantee of answers because sometimes there aren't clear answers. That honesty, while potentially limiting from a traditional sales perspective, builds trust with users who are tired of being sold false hope.
The Perimenopause Explosion
OOVA started with fertility, but Amy's vision was always to support women across their entire hormonal lifecycle. What she didn't anticipate was how quickly perimenopause would take over the business.
Even when OOVA focused exclusively on fertility, 46% of users were over 35. Many of these women reported being in perimenopause, but when Amy looked at their hormone data and cycle history, the picture was more complex. Their cycles were irregular, but they had always been irregular. They were receiving blanket diagnoses based on age and irregularity rather than actual biology.
Amy realized OOVA could distinguish between true perimenopause and other causes of irregularity. The company added estrogen to its hormone panel and launched a perimenopause experience. Amy expected a gradual ramp similar to what they'd seen with fertility.
Instead, they sold out of six weeks of inventory in less than six days.
Amy was in India for a family trip when the Slack messages started rolling in. The team was hesitant to tell her they were out of stock. They scrambled to increase manufacturing, but demand kept outpacing supply. They sold out three more times within the calendar year, even with raised production targets.
The hunger for answers was undeniable. Women going through perimenopause had almost no reliable tools to understand what was happening to their bodies. OOVA filled that gap with limited marketing spend, relying primarily on organic demand and word of mouth.
Today, OOVA's user base is predominantly perimenopause. The company has shifted most of its paid marketing spend away from fertility and toward perimenopause because the paid channels for fertility were expensive, competitive, and filled with misinformation. Meanwhile, fertility users continued finding OOVA organically. The long-tail organic growth strategy became the default for fertility, while perimenopause received focused investment.
Why Paid Channels Failed for Fertility
OOVA's experience with fertility marketing offers a valuable lesson in understanding where your product naturally resonates. The company pulled all paid spend from Meta and Google for fertility and redirected it toward perimenopause. When they did, fertility numbers didn't drop.
This revealed that paid channels simply weren't working for fertility acquisition. Organic discovery—through word of mouth, reviews, and content—was driving meaningful growth. Women who needed OOVA for fertility were finding it without paid ads. They were smart, motivated, and doing their own research.
For perimenopause, OOVA is truly differentiated. No other solution provides the same level of insight and value. The models the company has built for perimenopause are based entirely on proprietary data—over 30,000 cycles and growing—because publicly available datasets don't exist for this population.
That differentiation makes paid marketing effective. OOVA isn't fighting for attention in a crowded, noisy space. It's offering something that doesn't exist anywhere else.
B2B and Direct-to-Consumer: A Dual Model
OOVA operates both a direct-to-consumer model and a B2B channel serving clinicians. The balance between the two has shifted over time, shaped by unexpected demand and the realities of how care is delivered.
Amy initially assumed OOVA would need to prove clinical validity before doctors would adopt it. She spent three years talking to clinicians, asking what they needed to trust the data and how they wanted to see it presented. OOVA conducted clinical trials and built HIPAA-compliant infrastructure from day one, informed by Amy's PhD work with electronic health records.
Then COVID-19 hit. OOVA's clinical trial was scheduled to start in March 2020, just as New York City shut down. Fertility care was deemed elective, and patients faced indefinite treatment delays. One of the clinicians Amy had been working with reached out asking for samples. Within two weeks, OOVA spun up a HIPAA-compliant clinician dashboard.
That doctor went on Instagram Live to talk about how OOVA allowed her to continue monitoring patients remotely. She tagged the company. Within 24 hours, Amy's inbox flooded with requests from other clinicians. OOVA launched B2B first, then direct-to-consumer nine months later—the opposite of the original plan.
With perimenopause, the B2B and direct-to-consumer split is closer to 50/50. Many clinicians don't know how to treat perimenopause and are actively looking for tools that provide answers. OOVA's data serves both patients seeking clarity and clinicians seeking treatment guidance.
What's become clear is that clinicians and patients need very similar data, just displayed in slightly different ways. The underlying information is the same; the presentation adapts to the use case.
Retention and Lifetime Value
Retention at OOVA varies significantly based on the journey a woman is on. Some users come with a backlog of questions or symptoms, use OOVA to get clarity over a few months, and then move on. Others become long-term users, relying on OOVA for ongoing monitoring, meal planning insights, and tracking that removes the mental load of remembering when things last happened.
The data itself is sticky. While no one enjoys daily testing, the value users get from understanding their hormone profiles keeps them engaged. Amy describes it as making "liquid gold" out of something you're doing anyway.
On the clinical side, OOVA is being embedded into deeper care protocols, which extends patient engagement. The company tracks lifetime value separately for B2B clients and direct-to-consumer users, and even within direct-to-consumer, LTV varies by journey and sub-journey.
Fertility, perimenopause, and hormone imbalance all have different usage patterns and timelines.
Building Clinical Trust from Day One
One of OOVA's strategic advantages is that the company built for clinical use from the beginning. Amy didn't want patients to bring OOVA data to their doctors only to have it dismissed. She wanted clinicians to use the data to inform treatment decisions.
That required rigorous validation, clinical trials, and thoughtful design around how information was presented. OOVA's dashboard needed to be something doctors could read and trust. The company invested in those capabilities years before they became revenue drivers.
When COVID-19 accelerated the shift to remote care, OOVA was ready. The infrastructure, the compliance, the clinical relationships—all of it was already in place. That readiness turned an unexpected crisis into a growth opportunity.
Fundraising Realities and Staying the Course
Amy is open about the challenges of fundraising as a first-time founder in women's health. Female founders receive roughly 2% of venture funding, a statistic that's been repeated so often it risks becoming background noise. Amy's perspective is pragmatic: it's a fact, it's not fair, but complaining doesn't change it. The response is to over-deliver, to meet the higher bar, and to keep pushing the numbers in the right direction.
She also reframes the current moment in women's health. Yes, the landscape is challenging. Yes, there's uncertainty and volatility. But women's health is making headlines. It's on ballots. It's in the news. For Amy, that visibility represents opportunity. Leading a company that's part of this movement feels more exciting than sitting on the sidelines.
She's a self-described forever optimist, and that orientation shapes how she approaches both setbacks and growth.
What's Next for OOVA
The next 6 to 12 months will bring expansion beyond fertility and perimenopause. OOVA is in active conversations about broadening its offerings across additional areas of women's health. Amy is excited about the evolution of digital health from "more data is better" to "more data, but what does it mean?"
OOVA's focus is on shedding light on what data truly means for each woman's journey. That requires not just collection and analysis, but contextualization and personalization. The company's proprietary models, built on tens of thousands of cycles, enable insights that didn't exist before because the data itself didn't exist.
As OOVA scales, Amy sees the company contributing to a broader shift in how women's health is understood and treated. Objective data creates shared language between patients and clinicians. It turns uncertainty into clarity and enables both sides to act with confidence.
Key Takeaways
- Objective data changes care conversations. Moving from subjective symptoms to measurable biology empowers both patients and providers to make informed decisions.
- Personalization matters more than population norms. Women's bodies vary significantly. Tools that learn individual baselines and contextualize data accordingly build trust and deliver value.
- Organic demand can outperform paid channels. If users are finding you without ads, lean into that. Paid marketing works best where you have clear differentiation and less competition.
- Build infrastructure before you need it. OOVA's early investment in HIPAA compliance and clinical dashboards positioned the company to capitalize on unexpected shifts in the market.
- B2B and DTC aren't mutually exclusive. Both channels can coexist and inform each other. The key is understanding which customer segments are best served by each model.
- Founder resilience comes from external support. Conviction matters, but sustained momentum requires advisors, investors, team members, and customers who see potential beyond the immediate data points.
- Reframe challenges as opportunities. The current landscape for women's health is difficult, but visibility and urgency create space for solutions that wouldn't have had traction a decade ago.
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The Growth Layer is a conversation series from Future Digital exploring how real growth happens in health, wellness, and family brands. Each episode pulls back the curtain on the pivots, decisions, and behind-the-scenes discussions that shape category-defining companies. Subscribe for more founder stories and growth lessons from leaders transforming care.
