Randomized comparison of two Internet-supported fertility-awareness-based methods of family planning

Fehring, Richard J.; Schneider, Mary; Raviele, Kathleen M.; Rodriguez, Dana; Pruszynski, Jessica

doi:10.1016/j.contraception.2012.10.010

Cited by 60 publications

(59 citation statements)

References 30 publications

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“…Severy, Robinson, Findley-Klein, and McNulty (2006) found that there is an increase in satisfaction in use of the fertility monitor in avoiding pregnancy over time and with the use of the monitor to achieve a pregnancy. We did not find any influence of ease of use and acceptability of the method to avoid pregnancy in our earlier comparison study (Fehring, et al, 2012).…”

Section: Discussionmentioning

confidence: 84%

“…We (researchers and professional nurses at Marquette University) have developed a method of NFP that includes an electronic hormonal fertility monitor (EHFM) that measures metabolites of estrogen and luteinizing hormone (LH) in the urine and provides an estimate of the fertile window (Fehring, Schneider, Raviele, & Barron, 2007). Subsequently, we conducted a number of efficacy and effectiveness studies on this new method called the Marquette Method (MM), developed a Web site and automatic online menstrual cycle charting system, and tested the efficacy of a unique method of monitoring fertility during the breastfeeding transition (Fehring, Schneider, & Barron, 2008;Fehring, Schneider, & Barron, 2009: Fehring, Schneider, & Raviele, 2011Bouchard, Fehring, & Schneider, 2012). Efficacy of the MM for couples wishing to avoid pregnancy ranges from 0-3 unintended pregnancies per 100 users over 12 months of use with correct use and 8-13 with typical use.…”

Section: Influence Of Motivation On the Efficacy Of Natural Family Plmentioning

confidence: 99%

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Influence of Motivation on the Efficacy of Natural Family Planning

Fehring

Schneider

Barron

et al. 2013

McN: The American Journal of Maternal/Child Nursing

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Call outs and key words:Call Out 1: A key component in the use of any behavioral focused method of family planning is the motivation of both partners in using the method and avoiding pregnancy.Call Out 2: If only one of the partners is committed to the method it will be difficult to use and the efficacy will most likely be lower.Call Out 3: This study involves measuring the motivation levels of the couple (i.e., the woman and her male partner) before each menstrual cycle of use.Call Out 4: We found that high motivation for both the woman and her male partner has a big impact on the pregnancy outcomes of behavioral focused family planning methods.Call Out 5: Assessing the motivation of both the woman and her partner before recommending behavioral focused family planning methods (and especially natural family planning methods) is recommended.Key words: motivation; natural family planning method; pregnancy rates;rhythm. MOTIVATION, NATURAL FAMILY PLANNING 3 AbstractPurpose: Mutual motivation is recognized as essential for effective behavioral methods of family planning. Few studies have studied this factor in family planning efficacy. The purpose of this study was to determine the influence of mutual motivation on unintended pregnancy rates of couples who used natural family planning (NFP) methods to avoid pregnancy. Study Design and Methods:Using an online taught NFP method, 358women and ( their male partners) indicated "how much" and "how hard" they wished to avoid pregnancy on a scale of 0-10 before each menstrual cycle charted over 12 month of use. This motivation scale is used in the National Survey of Family Growth as a measure of motivation. All pregnancies were verified with an online pregnancy evaluation and urine based pregnancy test. A combined motivation score was used in analysis.Results: There were 28 pregnancies among the low motivation participants (N=60) and 16 among the high motivation participants (N=298). At 12 months of use, there were 75 pregnancies per 100 users for the low motivation group and only 8 for the high motivation group.There was an 80% greater likelihood of a pregnancy with the low motivation group (χ2 = 25.5, p < .001) OR = 1.80; 95% CI = 1.61-1.90).Clinical Implications: High motivation to avoid pregnancy by both the female user of a behavioral method of family planning and her male partner is required for high efficacy.Assessing motivation of both the woman and her male partner before prescribing NFP methods is recommended. MOTIVATION, NATURAL FAMILY PLANNING

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Section: Discussionmentioning

confidence: 84%

Section: Influence Of Motivation On the Efficacy Of Natural Family Plmentioning

confidence: 99%

Influence of Motivation on the Efficacy of Natural Family Planning

Fehring

Schneider

Barron

et al. 2013

McN: The American Journal of Maternal/Child Nursing

Self Cite

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“…For each evidence-based method (Billings, Creighton, two-day, symptothermal, symptohormonal, standard days, and lactational amenorrhea methods), there are Strength of Recommendation Taxonomy level 1 studies that demonstrate that these methods, when used correctly, have rates of effectiveness similar to those of commonly used forms of hormonal birth control. [3][4][5][6] The effectiveness of FABMs depends on women observing and recording fertility biomarkers and following evidence-based guidelines. Apps offer a convenient way to track fertility biomarkers, but only some use evidence-based FABMs.…”

mentioning

confidence: 99%

The Performance of Fertility Awareness-based Method Apps Marketed to Avoid Pregnancy

Duane

Contreras

Jensen

et al. 2016

The Journal of the American Board of Family Medicine

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Introduction:In recent years there has been an explosion in the development of medical apps, with more than 40,000 apps now available. Nearly 100 apps allow women to track their fertility and menstrual cycles and can be used to avoid or achieve pregnancy. Apps offer a convenient way to track fertility biomarkers. However, only some use evidence-based fertility awareness-based methods (FABMs), which with ideal use have rates of effectiveness similar to those of commonly used forms of hormonal birth control. Since having a baby or preventing a pregnancy are important responsibilities, it is critical that women and couples have access to reliable, evidence-based apps that allow them to accurately track their fertility.Methods: We developed a tool to evaluate and rate fertility apps. This tool is specifically designed to help couples avoid pregnancy.Results: Results showed that the majority of fertility apps are not based on evidence-based FABMs or include a disclaimer discouraging use for avoiding pregnancy. However, at least 1 app in each FABM category (except symptohormonal methods) had a perfect score on accuracy.

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“…However, the STM requires training in use, detailed recording of symptoms of self-observation and the application of several calculation rules, all lowering general acceptance rates. With the advancement of technology, other reliable, objective and less user-dependent methods have been introduced, which rely on the analysis of the levels of reproductive hormones measured in urine [26]. The study of hormonal profiles in urine during the menstrual cycle has proved to be very valuable in understanding menstrual cycle dynamics, as well as variability in ovulation [19,27,28].…”

Section: Discussionmentioning

confidence: 99%

Comparison between the different methods developed for determining the onset of the LH surge in urine during the human menstrual cycle

Godbert¹,

Miró²,

Shreeves³

et al. 2015

Arch Gynecol Obstet

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Purpose To determine whether an optimal method exists for the detection of the luteinising hormone (LH) surge onset in research datasets of urinary hormonal profiles of menstrual cycles. Methods The scientific literature was searched to compare published methodologies for detection of the LH surge onset in urine. Their performance was tested using complete hormonal profiles from 254 ovulatory cycles from 227 women attempting pregnancy (normal regular menstrual cycles; no known infertility). Results Three major methodologies to determine the onset of the LH surge in urine were identified. The key difference between these methods is how the cycle days that contribute to LH baseline assessment are determined: using fixed days (method #1), based on peak LH day (method #2), based on a provisional estimate of the LH surge (method #3). Method #1 requires no prior cycle information, whereas methods #2 and #3 need to consider complete cycle data. The most reliable method for calculation of baseline LH was using 2 days before the estimated surge day, plus the previous 4/5 days. Conclusions Different methods for identification of the urinary LH surge can provide very different determinations of LH surge day, thus care must be taken when comparing between studies that apply different methodologies. The optimal method for determining the onset of the LH surge in urine requires retrospective estimation of day of LH surge to identify the most appropriate part of the cycle to consider as the baseline. This method can be adopted for application in population studies.

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Randomized comparison of two Internet-supported fertility-awareness-based methods of family planning

Cited by 60 publications

References 30 publications

Influence of Motivation on the Efficacy of Natural Family Planning

Influence of Motivation on the Efficacy of Natural Family Planning

The Performance of Fertility Awareness-based Method Apps Marketed to Avoid Pregnancy

Comparison between the different methods developed for determining the onset of the LH surge in urine during the human menstrual cycle

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