Abstract
Objectives: The aim of the study was to retrospectively evaluate the effectiveness of a fertility awareness-based method supported by a mobile-based application to prevent unwanted pregnancies as a method of natural birth control. Methods: In a retrospective analysis, the application’s efficiency as a contraceptive method was examined on data from 4054 women who used the application as contraception for a total of 2085 woman-years. Results: The number of identified unplanned pregnancies was 143 during 2053 woman-years, giving a Pearl Index of 7.0 for typical use. Ten of the pregnancies were due to the application falsely attributing a safe day within the fertile window, producing a perfect-use Pearl Index of 0.5. Calculating the cumulative pregnancy probability by life-table analysis resulted in a pregnancy rate of 7.5% per year (95% confidence interval 5.9%, 9.1% per year). Conclusions: The application appears to improve the effectiveness of fertility awareness-based methods and can be used to prevent pregnancies if couples consistently protect themselves on fertile days.
Highlights
Fertility monitors have become increasingly popular in recent years as a tool to prevent pregnancies, due to rising interest among women to abstain from hormonal contraception.[1,2,3]
It has been demonstrated in a previous study [11] that the algorithm can identify the ovulation day with high precision and that the probability of a green day being falsely attributed within the fertile window, surrounding the ovulation day, is 0.05%
Considering the number of green days given by the application during the course of this study, as well as the probability of conception according to Wilcox et al.,[12] one would expect 22 pregnancies if users only had unprotected intercourse on green days within the fertile window
Summary
Fertility monitors have become increasingly popular in recent years as a tool to prevent pregnancies, due to rising interest among women to abstain from hormonal contraception.[1,2,3] It has been shown that the effectiveness of such devices when correctly used can be high,[3,4,5] competing with hormonal methods of birth control. These devices tell women about their current fertility, enabling them to make informed decisions with regard to family planning. The basic features and functionalities of the application are described and the contraceptive effectiveness is assessed through a retrospective observational study of 4054 women using the application for 2085 woman-years
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