Increased Likelihood of Pregnancy Using an App-Connected Ovulation Test System: A Randomized Controlled Trial

Abstract

Background: Women trying to conceive are increasingly using fertility-tracking software applications to time intercourse. This study evaluated the difference in conception rates between women trying to conceive using an application-connected ovulation test system, which measures urinary luteinizing hormone and an estrogen metabolite, versus those trying without using ovulation testing. Materials and Methods: This home-based study involved 844 volunteers aged 18-40 years seeking to conceive. Volunteers randomized to the test arm were required to use the test system for the duration of the study while those randomized to the control arm were instructed not to use ovulation testing. Pregnancy rate differences across one and two cycles between the two groups were examined. Results: Volunteers in the test (n = 382) and control arms (n = 403) had similar baseline demographics. The proportion of women pregnant after one cycle was significantly greater in the test arm (25.4%) compared with the control arm (14.7%; p < 0.001). After two cycles, there continued to be a greater proportion of women pregnant in the test arm compared with the control arm (36.2% vs. 28.6%; p = 0.026). In the test arm, volunteers had intercourse less frequently per cycle compared with those not using ovulation testing (9 [range: 1-60] vs. 10 [range: 1-50]; p = 0.027), but were more likely to target intercourse to a particular part of their cycle compared with those not using ovulation testing (88.5% vs. 57.8%; p < 0.001).Conclusion: Using the test system to time intercourse within the fertile window increases the likelihood of conceiving within two menstrual cycles.

A scoping review of the information provided by fertility smartphone applications

“…Indeed, 65% of cycles range between 25 and 30 days in length, and a further 7-8.5% of women experience cycles over 35 days in length (Bull et al, 2019b;Grieger & Norman, 2020). In studies where the focus was conception, participants were recruited only if they had 'just started' trying to conceive (Faust et al, 2019), or had been trying for <6 months (or if aged over 35 years, <3 months) (Johnson et al, 2020). A potential bias is thus created, limiting the both participation and applicability of findings to people outside of this range.…”

Sporadic anovulation is not an important determinant of becoming pregnant and time to pregnancy among eumenorrheic women: A simulation study

“…Further, we find that anovulation Though the body of existing data on the impact of timed intercourse is insufficient to draw conclusions, 35 recent observational studies and a trial in couples trying to conceive suggest that timing of intercourse to the fertile window using fertility indicators result in higher fecundability independent of coital frequency, further highlighting the importance of intercourse timing. [36][37][38] A recent study that found that double intrauterine insemination with donor sperm did not increase ongoing pregnancy rates in women without a history of infertility provides additional evidence supporting that increasing frequency matters to cover the fertile window, but does not improve pregnancy rates once the fertile window is already attained. 39 Our simulation supports the principle that unscheduled regular intercourse, averaging every other day, will greatly increase the chances of intercourse occurring within the fertile window, which will, in turn, improve time to pregnancy.…”

“…39 Our simulation supports the principle that unscheduled regular intercourse, averaging every other day, will greatly increase the chances of intercourse occurring within the fertile window, which will, in turn, improve time to pregnancy. However, for a variety of personal reasons, some couples of normal fecundity 35,37,38 may find timing of intercourse to the fertile window a more acceptable approach to increase fecundability, for example among women who experience pain with intercourse. An additional caveat for the strategy of frequent unscheduled intercourse is that one study has suggested that frequent intercourse in the peri-implantation time window may reduce fecundability, 40 though this finding has not yet been confirmed.…”

Luteinizing Hormone Surge More Accurately Correlates With Ultrasound Dating of Early Pregnancy Compared to the Last Menstrual Period

“…In this study, we have demonstrated that compared to the LMP, early pregnancy dating based on the self‐reported urinary LH surge more closely correlates with the CRL. Since urinary LH testing is Food and Drug Administration approved, is readily available over the counter, and has been shown to increase the likelihood of conceiving per cycle, 16 perhaps providers should encourage its use and use the self‐reported date of the urinary LH surge for estimation of GA.…”