What Is Your MTP?

Do you have one?

Thirty years ago I met Edmond Desjacques and joined Bioself. My 3rd startup - but this was different; in the first two I was external, an advisor and angel investor – at Bioself I was the CEO, brought in as the “professional” manager to grow a business created by Edmond and financed by his Geneva friends. Edmond was an amazing man – smart, a successful architect, friendly and generous, always thinking of others before himself, a wonderful family man, and he had an MTP, a massively transformative purpose. Edmond didn’t set out to disrupt the world, an industry, a company or a religion, but he wanted to make it easier for women and couples to use natural family planning, for both planned conception and contraception.

Edmond’s mother was one of 14 children; Edmond himself was one of 6. A devout Catholic, but also a man of incredible curiosity, Edmond saw the advances of integrated circuits in the 1970s and asked himself whether the power of the computer could help women use the familiar basal body temperature and calendar methods of family planning more easily and more accurately. Producing his first proof of concept, the Bioself, cost Edmond over $1 million of his own money ($2.5 mio in today’s money), and much more later on. Though he continued to practice as an architect in Geneva, what drove Edmond, his dream, his MTP, was to have a Bioself device in the hands of every woman who was trying to conceive by natural means or who did not want to use the contraceptive pill.

We only partially achieved Edmond’s dream, but today a small company in Zürich, Ava, is on its way to making his MTP a reality.

Much was Accomplished

When I arrived at Bioself in 1987 Edmond had already created a functioning device and was selling some. He’d set up manufacturing in both Geneva and Montréal, and had a relationship with USAID and the WHO, and had approval from the US FDA for over-the-counter sales of the Bioself device. Huge accomplishments for someone who was doing this as a side job. 

Over the following years we created a 2nd generation device that lowered our cost, increased outcome accuracy and device quality, and allowed women to transmit their data over the phone (a precursor to the IoT - we hadn’t yet heard of the Internet), completed clinical trials in Europe and Asia, had articles published in peer-reviewed medical journals, had distribution in 13 countries, received a 2nd FDA approval (including a written apology for taking too long) and we were cash-flow positive. We all believed in Edmond’s dream, his MTP, and worked 24/7 to make it happen. Disruption for Edmond meant helping women and couples all over the world; not becoming a billionaire.

Mistakes Were Made

Though I completed my MBA at IMD in 1984 (formerly called IMEDE), I really earned my MBA in my 5 years working with Edmond at Bioself. I earned it through learning, and I learned through making many mistakes. Today this is accepted as common knowledge - accept failure, fail fast in order to succeed sooner, etc, – but in those days, especially in Switzerland, failure was a taboo. 

We tried to do everything ourselves. We created our algorithm, worked with an external software engineer to put our new algorithm into a chip, and tested it together with Motorola, from whom we ordered the chip. We sourced all the other components, everything from precision machine-tooled temperature sensors (from watch-making companies in Geneva), to the plastic body, to the circuit boards, to the batteries. We outsourced the manufacturing to Valtronic, but did all the final assembly, testing and packaging ourselves (yes, my first two children spent many hours putting Bioself devices into cartons for shipping).  We designed and actively participated in clinical trials. We did training and co-advertising of our distributors. We did our own distribution in Switzerland, including after-sales support (“service” was unheard of in those days by Swiss consumers). The idea of choosing which parts of the value chain were most important to our success, and focusing, never entered our minds. 

We had too much money. Thanks to Edmond’s relationship with the bank, his own wealth and that of his friends, money was rarely a problem. Though we occasionally ran into short-term cashflow problems (when I simply didn’t pay myself and some of the least-important suppliers) we were well-funded, and this caused us to be sloppy, and not ask the hard questions about how things could be done differently. Ease of funding probably robbed us of our creativity.

We thought we understood the US market. Before 1987 Bioself had sold the US rights to an American startup, in order to avoid a lawsuit with this aggressive company that had patents similar to ours. All well and good, but when I arrived I realized that this company had spent everything they had on developing their own device, had failed, and didn’t have the finances necessary to sell our product in the US. As they were publicly quoted on NASDAQ, the Bioself investors thought they saw an opportunity, bought enough shares of the firm to control it, and installed me as President. Eighteen months later I was forced to fire its 12 employees and file for bankruptcy. By the time we shut it down we had invested even more in the US company, trying to create buzz for the Bioself in the US, and totally failing, as we didn’t understand the US consumer. We thought getting mentioned in Playboy, or being invited to speak to Congress, was success. We didn’t understand the drivers for our category in the US market.

We did not have an intellectual property strategy. Our “strategy” was simply to cover all of our 7 patents in every market, plus trademarks. My conversations with our IP lawyers were only about how to cover the tremendous cost of all of this; not our business model and how our IP efforts supported it, nor the opportunities that our IP gave us beyond just selling more devices. All I naïvely understood was the more patents you had the better you were.  

We did not experiment. When the first-generation Bioself was designed, the company assumed that demand would explode, and we’d need to manufacture hundreds of thousands of devices quickly, and thus had to be ready to get our cost down through economies of scale. Contracts were made for large volumes of components before we had any feedback from the market. We were so certain that we’d be a success, and so certain that our first product would be THE product, that we eventually ended up with an inventory of hundreds of thousands of LEDs, resistors, batteries, temperature sensors, etc in a warehouse in Geneva, all of which was eventually donated to an African charity when we moved to the badly-needed 2nd generation Bioself device. 

In addition to not understanding the concept of experimentation, learning through trial and error, we did not understand the cost and complexity of scaling up. Another modern-day buzzword, but one with real meaning.

We knew there were limits to the science.  Through the clinical trials with our 2nd-generation device we knew that we’d reached the theoretical limits of what could be achieved with the technology we had, and yet we knew it probably wasn’t good enough. The use of the device was cumbersome (taking your temperature daily, on waking, either vaginally or orally), and there was still a 4-5% risk of error (and thus unwanted pregnancy). We talked with experts about trying to incorporate other bodily parameters, but the technology to capture the data we needed didn’t exist.

We had the wrong Board. Everyone on Bioself’s Board was smart, rich and successful, but all were from the Geneva real estate industry. No one had ever sold a consumer product. No one had ever been in the life sciences industry. No one had ever done business in the United States, or, for that matter, outside Geneva. But they were rich, successful and wanted to support their friend with his dream.

We had a CEO who was in awe of the Board. Probably the biggest mistake that Bioself made was hiring me, and one of my many mistakes was trusting my Board (I was a Board observer). For example, when the Board took the decision to invest in the US, I calmly explained what I felt was a better alternative, but stood by as they voted to go ahead with taking control of the American firm. I had spent three weeks with the management of the US company, did a thorough due diligence, and knew that it was nothing but a shell, with no assets or competence worth buying. To this day I am certain that if I had climbed onto that beautiful mahogany boardroom table, and demanded or pleaded with them to reconsider, they might have chosen a different path. I didn’t. 

We didn’t have enough money. One day in the early 90s we received a large order from a company in the UK. We didn’t have a distributor there, so I traveled to their office to learn more about them. It turned out to be the new women’s healthcare arm of one of the world’s largest FMCG companies. I spoke with their scientists and managers and understood that they were using our devices to test their own. There were vague discussions about collaboration; it was questionable whether their technology was better than ours, and, as they were already developing a pregnancy test, it seemed natural (to naïve me) that they would adopt our technology for fertility and contraception. Wrong. When they came to market, with marketing and distribution power that we could not even imagine, I knew the dream had ended.

But Today There is Ava

As he passed away several years ago, I have no way of knowing for sure, but given what drove Edmond Desjacques, I believe he’d be happy to see what the founders of Ava and their team of 40 have achieved. I could argue that the technical performance of the Ava device is not quite as good as that of Bioself, but the amazing ease of use is so much better that the accuracy of the prediction of fertile days matters much less. And with the data they’re gathering, I predict that eventually Ava will do even more. And better. 

Ava was recently named the top startup in Switzerland, and for those who don’t know it, it is a bracelet that a woman wears nightly, measuring 9 physiological parameters, including basal body temperature, and which predicts, with 89% accuracy, the woman’s 5.3 fertile days per menstrual cycle. And Ava gathers data which the company hopes will provide additional information to couples, to help during pregnancy, and to eventually serve as a contraceptive. Ava’s first “US baby”, Jace, was born this past summer, but over one thousand have already been born outside the US. The company has raised over CHF 12 mio so far, and is currently trying to raise another CHF 15mio.

Edmond Desjacques was thirty years ahead of his time, but he knew what he wanted to accomplish, though the technology needed to fulfil his dream didn’t yet exist. I predict that Ava will do it. Does the Ava team have a massively transformative purpose to pull them through the difficulties that every startup encounters? Only time will tell.