Breaking News
January 19, 2019 - $14.7 million partnership to supercharge vaccine development
January 19, 2019 - Ian Fotheringham receives Charles Tennant Memorial Lecture award
January 19, 2019 - Brain vital signs detect neurophysiological impairments in players with concussions
January 19, 2019 - Lack of job and poor housing conditions increased likelihood of people attending A&E
January 19, 2019 - Novel targeted drug delivery system improves conventional cancer treatments
January 19, 2019 - Rutgers study finds gene responsible for spread of prostate cancer
January 19, 2019 - Complications Higher Than Expected for Invasive Lung Tests
January 19, 2019 - 3-D printed implant promotes nerve cell growth to treat spinal cord injury
January 19, 2019 - Automated texts lead to improved outcomes after total knee or hip replacement surgery
January 19, 2019 - Poor cardiorespiratory fitness could increase risk of future heart attack, finds new study
January 19, 2019 - Drinking soft drinks while exercising in hot weather may increase risk of kidney disease
January 19, 2019 - Formlabs 3D prints anatomical models
January 19, 2019 - Heart-Healthy Living Also Wards Off Type 2 Diabetes
January 19, 2019 - Teaching Kids to Be Smart About Social Media (for Parents)
January 19, 2019 - Metabolite produced by gut microbiota from pomegranates reduces inflammatory bowel disease
January 19, 2019 - Researchers examine how spray from showers and toilets expose us to disease causing bacteria
January 19, 2019 - Behavioral experiments confirm that additional neurons improve brain function
January 19, 2019 - New study compares performance of real-time infectious disease forecasting models
January 19, 2019 - Obesity can be risk factor for developing renal cell carcinoma, confirms study
January 19, 2019 - New regulation designs on cigarette packs direct smokers’ attention to health warnings
January 19, 2019 - QIAGEN receives first companion diagnostic approval in Japan
January 19, 2019 - Study explores role of Dunning-Kruger effect in anti-vaccine attitudes
January 19, 2019 - Newly identified subset of immune cells may be key to fighting chronic inflammation
January 19, 2019 - New immune response regulators discovered
January 18, 2019 - Poor blood oxygenation during sleep predicts chance of heart-related death
January 18, 2019 - First international consensus on the diagnosis and management of fibromuscular dysplasia
January 18, 2019 - Rapid resistance gene sequencing technology can hasten identification of antibiotic-resistant bacteria
January 18, 2019 - Researchers develop artificial enzymatic pathway for synthesizing isoprenoids in E. coli
January 18, 2019 - Scientists advise caution in immunotherapy research
January 18, 2019 - How children across the world develop language
January 18, 2019 - Columbia Medical Student Receives McDonogh Scholarship
January 18, 2019 - Secretive ‘Rebate Trap’ Keeps Generic Drugs For Diabetes And Other Ills Out Of Reach
January 18, 2019 - Plant based diet could be the best option for the planet says commission
January 18, 2019 - New conservation practice could reduce nitrogen from agricultural drainage, study shows
January 18, 2019 - UIC researchers receive $1.7 million NCI grant to study Southeast Asian fruit
January 18, 2019 - New study determines the fate of DNA derived from genetically modified food
January 18, 2019 - Scientists develop new gene therapy that prevents axon destruction in mice
January 18, 2019 - Study finds critically low HPV vaccination rates among younger adolescents in the U.S.
January 18, 2019 - Brain cells involved in memory play key role in reducing future eating behavior
January 18, 2019 - Risk for Conversion of MS Varies With Different Therapies
January 18, 2019 - Investigational cream may help patients with inflammatory skin disease
January 18, 2019 - Medical school news office receives six writing awards | News Center
January 18, 2019 - County By County, Researchers Link Opioid Deaths To Drugmakers’ Marketing
January 18, 2019 - Research reveals risk for developing more than one mental health disorder
January 18, 2019 - Scientists discover a dramatic pattern of bone growth in female mice
January 18, 2019 - Study finds link between lengthy periods of undisturbed maternal sleep and stillbirths
January 18, 2019 - New nuclear medicine method could improve detection of primary and metastatic melanoma
January 18, 2019 - Combination therapy shows high efficacy in treating people with leishmaniasis and HIV
January 18, 2019 - Health Tip: Don’t Ignore Changes in Skin Color
January 18, 2019 - Dietary Recommendations for Healthy Children
January 18, 2019 - Eliminating the latent reservoir of HIV
January 18, 2019 - Pain From The Government Shutdown Spreads. This Time It’s Food Stamps
January 18, 2019 - Newly discovered regulatory mechanism helps control fat metabolism
January 18, 2019 - New rapid blood tests could speed up TB diagnosis, save the NHS money
January 18, 2019 - Researchers develop intelligent system for ‘tuning’ powered prosthetic knees
January 18, 2019 - Monoclonal antibody pembrolizumab prolongs survival in patients with squamous cell carcinoma
January 18, 2019 - New research detects mosquito known to transmit malaria for the first time in Ethiopia
January 18, 2019 - Researchers identify new genes linked to development of age-related macular degeneration
January 18, 2019 - Computerized method helps better protect pharma patents
January 18, 2019 - New guidelines to make swallowing safer for people in Australian nursing homes
January 18, 2019 - Lumex Instruments’ RA-915AM monitor installed at Hg treatment plant in Almadén, Spain
January 18, 2019 - ACCC survey finds multiple threats to growth of cancer programs
January 18, 2019 - Meeting the challenge of engaging men in HIV prevention and treatment
January 18, 2019 - Furloughed Feds’ Health Coverage Intact, But Shutdown Still Complicates Things
January 18, 2019 - Experts discuss various aspects on health risks posed by fumigated containers
January 18, 2019 - Researchers use gene-editing tool CRISPR/Cas9 to limit impact of parasitic diseases
January 18, 2019 - Alpha neurofeedback training could be a means of enhancing learning success
January 18, 2019 - Innovative ‘light’ method demonstrates positive results in fight against malignant tumors
January 18, 2019 - The cytoskeleton of neurons found to play role in Alzheimer’s disease
January 18, 2019 - New resource-based approach to improve HIV care in low- and middle-income countries
January 18, 2019 - Bedfont appoints Dr Jafar Jafari as first member of the Gastrolyzer Medical Advisory Board
January 18, 2019 - New study shows link between secondhand smoke and cardiac arrhythmia
January 18, 2019 - DZIF scientists reveal problems with available diagnostics for Zika and chikungunya virus
January 18, 2019 - Breast cancers more likely to metastasize in young women within 10 years of giving birth
January 18, 2019 - Over 5.6 million Americans exposed to high nitrate levels in drinking water
January 18, 2019 - Blood vessels can now be created perfectly in a petri dish
January 18, 2019 - Study identifies prominent socioeconomic and racial disparities in health behavior in Indiana
January 18, 2019 - Young-Onset Type 2 Diabetes Tied to Increased Hospitalization Risk
January 18, 2019 - For-profit nursing schools associated with lower performance on nurse licensure test
January 18, 2019 - Considering the culture of consent in medicine
Better studies needed on effectiveness of fertility awareness-based methods for contraception

Better studies needed on effectiveness of fertility awareness-based methods for contraception

image_pdfDownload PDFimage_print
Credit: CC0 Public Domain

A new systematic review provides the most comprehensive assessment to date on the scientific evidence estimating the effectiveness of various fertility awareness-based methods (FABMs) for contraception. “Effectiveness of Fertility Awareness–Based Methods for Pregnancy Prevention: A Systematic Review,” led by UNC’s Rachel Peragallo Urrutia, MD, was published in Obstetrics and Gynecology, also known as The Green Journal. The review shows that the current evidence base on effectiveness for each unique FABM is small and of low to moderate quality, leaving a critical gap in information for current and prospective users.

FABMs help users identify the span of days during each menstrual cycle when intercourse is most likely to result in pregnancy. Users track changes in one or more biomarkers (menstrual dates, basal body temperature, cervical mucus or position, and urinary hormone metabolites) to estimate the fertile window. Different types of FABMs focus on tracking different biomarkers. People who want to avoid pregnancy can avoid intercourse or use additional family planning methods, such as barrier methods, during their fertile window.

The investigators gathered all peer-reviewed studies published in English, French, Spanish, or German which followed women over time to assess how well a given FABM worked to prevent unintended pregnancy. They identified all available studies on 14 different FABMs and rigorously evaluated the quality of each study based on a 13-point list of criteria. Based on that list, each study was rated high, moderate or low quality. Estimates from high-quality studies would be considered the most valid. Of the 53 studies identified, the investigators ranked 0 as high quality, 21 as moderate quality, and 32 as low quality.

“Many women think they are using an effective FABM to avoid pregnancy, when in fact the method they are using has not undergone robust effectiveness testing,” said Urrutia, an obstetrician-gynecologist and assistant professor at the UNC School of Medicine. “For example, there has been a recent rise in popularity of Internet applications or other devices that promote themselves as an effective FABM, yet only a few of them have actually undergone standard effectiveness testing, as clarified in our review.”

People choosing a method of pregnancy prevention need robust evidence on two types of effectiveness—typical use and perfect use. Typical use effectiveness reflects how well a method can work for an average couple who may not always use it correctly or consistently. Perfect use effectiveness reflects how well a method can work when used exactly as specified at all times.

Moderate quality studies estimating typical use effectiveness were identified for 12 out of the 14 different FABMs. Those studies suggested that if 100 women started using the method for one year, between 10 and 33 unintended pregnancies—depending on which FABM was used—would likely occur. These estimates are within a similar range as some barrier methods. The Sensiplan and Marquette Monitor methods may be the most effective with 1.8-6.8 unintended pregnancies per 100 new users in the first year of use. But, all of these estimates were based on a small number of moderate quality studies in specific populations, meaning that additional data are needed to understand if these estimates apply to more diverse populations.

Only seven of the 14 different FABMs had moderate quality studies correctly estimating perfect use effectiveness. Perfect use estimates for most FABMs ranged between 1 and 5 pregnancies per 100 users in one year, except Persona, which had a perfect use estimate of 12 pregnancies per 100 users in one year. The lowest perfect use unintended pregnancy rates were observed for users of Sensiplan or Marquette Monitor, with estimates suggesting one or fewer unintended pregnancies during the first year of use. Thus, most FABMs have perfect use estimates similar to those of male and female condoms. Some FABMs may be more effective, but confirmatory data in diverse populations are needed.

“Our systematic review is a major step towards assessing the extent and quality of existing studies on the effectiveness of fertility awareness-based methods,” said Urrutia. “We hope it helps people better understand their options, in order to support them in choosing the method that best fits their preferences and lives.”


Explore further:
Smartphone apps not so smart at helping users avoid or achieve pregnancy

More information:
Rachel Peragallo Urrutia et al. Effectiveness of Fertility Awareness–Based Methods for Pregnancy Prevention, Obstetrics & Gynecology (2018). DOI: 10.1097/AOG.0000000000002784

About author

Related Articles