For international medtech start-ups, entering a new market means learning about the local healthcare system, understanding who makes decisions, working out who pays and finding the right way to make people care. For Aspivix, a Swiss medtech and femtech company founded in 2015, storytelling has become critical to that process. As it brings its women’s health innovation into markets including Europe, the US and beyond, Ikram Guerd, Aspivix’s Chief Marketing Officer, has learned the significant impact that a strong story can have on investors, clinicians and patients.

Aspivix originally planned to enter Europe before moving into the US. How did that strategy change?

As a Swiss company, our goal was to enter Europe first. Back in 2021, we only had seven people in our team, but today we’re 14 from various backgrounds: French, Swiss, Belgian, Italian, American, Indian, Chinese and Greek. Europe seemed to be the right place to gather evidence and build a foundation before bringing the technology to the US. However, we received FDA 510(k) clearance before the CE mark approval, so we shifted our strategy to focus on the US earlier than expected.

One belief European or Swiss companies hold is assuming they can duplicate their local approach in the US, but it can’t be copy-pasted. Customer behaviour, the healthcare system and reimbursement processes are all so different. You cannot treat Europe as a test market and then move to the US thinking everything will be transferable.

Have you looked at entering other markets?

The US remains the biggest market in reproductive health, so that’s our focus, but we are looking at different markets to bring our innovation to women worldwide. In parallel, we’ve started exploring new regions like South Asia, Latin America and the Middle East. These targets were not our primary markets, but they emerged mostly through distributors reaching out to us. Bayer, who was also our early partner in Switzerland, has a subsidiary in Israel interested in bringing our product to their market.

In Brazil, we now have clearance for our product in the market, which has given us access to a successful strategy: gathering clinical evidence at a low cost in high volume. Brazil provides such a large number of IUD placements (our main clinical indications) that, within just one hospital, there can be more than 600 patients who can be enrolled very easily within around six months. This allows us to gather the data and clinical evidence the product needs to become available more widely. That’s something you cannot do easily in the US or in Europe in terms of budget or speed.

What does that mean in practical terms when entering a new country or region?

Entering each country needs a good understanding of the regulatory pathway as well as the healthcare system itself and its key players. Depending on who you’re talking to, the incentives can be very different. One of the bottlenecks for adoption in healthcare is reimbursement. For each country, you’ll need to understand who pays, how and for how long. Understanding the existing codes (CPT codes in the US and others) to see if your product can fit into an existing one or if it needs a new creation is key. But adoption can also come from clinical stakeholders willing to try or adopt your product, usually young doctors can get excited about testing new innovations. In Switzerland, we work with a few university hospitals but also a lot with private offices, a specific target where many can decide more easily to buy and adopt the product themselves. Whereas in the US, hospitals are more concentrated and part of larger health systems, so you need to understand who the key stakeholders are and how to approach them strategically. Altogether, more and more healthcare infrastructures focus on value-based care, so patient experience and satisfaction matter. One thing to keep in mind when you approach the US market is that healthcare is a business and understanding who will pay for your innovation (B2B, D2C, etc.) will help you position your product accordingly.

So what is your business strategy advice?

When you develop your product, you always have to go back to the patient. Their needs may be very different from one market to another.

Then you need to think about how to tell your story: what do you want people to know and remember about you, your product and your company? What makes you unique?

You need a strong hook because you have maybe 30 seconds to make people curious. Having moved from France to the US ten years ago, it has been interesting to see how Swiss or European companies pitch compared to American ones. In Europe, companies often focus on features: ‘We have this great innovation, and our product does this and that.’ Investors in the US care less about the details at first – they want your story. Who are the people behind the company? What’s in it for them financially?

So my top advice is: think carefully about your story, who you are talking to, what makes you unique, how your team is also your superpower and search for the storytelling that will connect with them. People love to connect with other people – that is the beginning of any relationship.

Can a story actually change how you approach your business strategy?

Yes, and sometimes these stories come out of nowhere. About two and a half years ago, we had just secured FDA clearance and trained the first physician in New York City to use our carevix® device. A few days later, a young woman in Philadelphia reached out asking where she could find a physician using it. Three months later, she messaged me on LinkedIn to say she’d had her IUD successfully placed with our device at Columbia University and wanted to thank the company for listening to women’s voices and offering a new gentle solution.

We jumped on a call, and by the end we were both in tears. Her first IUD experience had been horrific: between the pain she experienced and feeling completely dismissed by few healthcare providers with no real solution offered to her.

Determined to avoid the same pain, she drove to New York to have her next IUD placed with our device. The experience made her feel heard, and she became one of our ambassadors without us even asking. That is the kind of story you cannot manufacture: a reminder of the company’s DNA and mission. It proved that we needed to stay authentic and put the company’s mission first.

Is storytelling that powerful when it comes to business growth?

Our recent crowdfunding campaign in 2025 was another ‘aha’ moment: we opened it up to anyone interested in our mission, not just venture capitalists. We aimed for around US$270,000 and almost reached US$1m in less than a month, with around 300 investors: proof that when people connect with a mission, they invest and drive change.

But ultimately, it goes beyond storytelling. In women’s health, it’s also about education. Because most investors are men, you need to involve and educate them as well on what it means to experience the current standard of care. If they cannot relate to our problems, they may not see what needs to change or what’s in it for them. Every time I pitch, I start by showing the current instrument, a tenaculum, which in German means ‘bullet extractor’. More than 135 years ago, it was used to pull bullets out of soldiers on the battlefield; today, we are still using it on women every day in gynaecological care. I ask them to imagine it used on the most sensitive part of their bodies, often with no pain management – making the point that if this procedure was not limited to a women’s health issue, we would probably already have less painful and better solutions. My provocative pitch makes men see the issue differently and prompts conversation also because these men all have daughters, spouses, sisters, mothers and other women in their life they care about.

That is also why we need more women investors. They would relate more easily to women’s health issues and drive change. Money is power; where you put it can influence policy and get problems solved. A huge wealth transfer is coming, and more women will have access to more capital. However, from what we can observe, men tend to invest their capital, while women tend to donate to philanthropic causes. It’s important to initiate a shift and let women know that they can make investments that feel connected to philanthropy, especially in companies that can make a change in areas like women’s health and children’s health.

Are there specific challenges for femtech companies trying to tell their story?

In women’s health overall, there is an obvious lack of investment, lack of data and lack of research. They all go together – if there is no money, there is no research and no data to collect, which makes the story hard to depict and explain to investors.

There are also stigmas and taboos persisting around specific topics in women’s health. Let’s take fertility: it is usually associated to women’s health, but – correct me if I’m wrong – you need sperm and an egg to make a baby, not just an egg – the issue should therefore be a wider concern. Social media can make discussion harder, too: some medical terms get flagged or censored, so we cannot always use the proper words. At the same time, I remain optimistic. Women are talking more openly about pain, IUDs, periods and menopause. And as an illustration, I’m very inspired to see Gen Z very willing to speak more openly about these experiences, and that creates new opportunities for women’s stories to be heard. And we definitely need more of these.