Bouchard, T. P., Fehring, R. J., & Schneider, M. M. (2018). Achieving Pregnancy Using Primary Care Interventions to Identify the Fertile Window. Frontiers in Medicine, 4, 250. https://doi.org/10.3389/fmed.2017.00250
Bouchard TP, Fehring RJ, Schneider MM. Achieving Pregnancy Using Primary Care Interventions to Identify the Fertile Window. Front Med (Lausanne). 2018;4:250. doi:10.3389/fmed.2017.00250
Bouchard, Thomas P., et al. "Achieving Pregnancy Using Primary Care Interventions to Identify the Fertile Window." Frontiers in Medicine, vol. 4, 2018, pp. 250.
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78 of 100 women tracking the fertile window were pregnant by 12 cycles
In a prospective study of 256 women seeking pregnancy, 78 out of 100 became pregnant within 12 cycles of fertile window tracking, and 86 out of 100 by 24 cycles. The women found the window with a hormonal fertility monitor, cervical mucus checks, or both. Women using the monitor alone had 100 pregnancies per 100 women by 24 cycles.
Key Findings
The 256 women had 150 pregnancies in total. The pregnancy rate was 78 per 100 women over 12 menstrual cycles, and it reached 86 per 100 women over 24 cycles.
After 12 cycles of use, pregnancy rates per 100 women were 83 in the hormonal fertility monitor group, 72 with cervical mucus monitoring and 75 with both.
By 24 cycles, the pregnancy rate was 100 per 100 women in the monitor group and 79 per 100 women in the mucus and monitor group.
Of the 80 women who used the fertility monitor, 54 became pregnant, and chi-square analysis showed a significant difference in pregnancy frequency among the three indicator groups (p = 0.028).
Women whose intercourse fell on "High" and "Peak" monitor days had 85 pregnancies per 100 women across 12 months of use, against 1 per 100 women on low days.
Interpretation
A prospective effectiveness study followed 256 women aged 20 to 43, all intending pregnancy, for up to 24 cycles. Nurses reviewed each woman's online form and chart to validate pregnancies. The women included some with proven fertility and some who had not been pregnant. The authors consider a large randomized trial or cohort comparison of frequent intercourse, hormone monitoring and mucus monitoring beneficial.
RRM Context
Restorative reproductive medicine works with the menstrual cycle, and fertility awareness-based methods such as the Marquette Method use the body's own signs to find the fertile window. The authors add that charting can help spot possible fertility problems, such as cycles without ovulation. Such findings support looking for the cause before treatment.
Our editorial summary of this paper, not the article's abstract.
Abstract
Objective
To determine the effectiveness of achieving pregnancy with focused intercourse in the fertile window identified using natural fertility indicators.
Methods
24-cycle prospective effectiveness study.
Setting
A North American web-based fertility monitoring service.
Participants
256 North American women aged 20-43 (mean age 29.2 years) seeking to achieve pregnancy.
Intervention
Participants identified their fertile window with either electronic hormonal fertility monitoring or cervical mucus monitoring, or both, and recorded their observations on an online fertility tracking system.
Main Outcome Measures
Pregnancies were validated by nurses with an online self-assessed pregnancy evaluation form. Survival analysis was used to determine pregnancy rates.
Results
There were 150 pregnancies among the 256 participants with an overall pregnancy rate of 78 per 100 women over 12 menstrual cycles. There were 54 pregnancies (68%) among the 80 women using the fertility monitor, 11 pregnancies (46%) among the 24 women using mucus monitoring, and 90 (63%) among the 143 women using both mucus and monitor. The 12-cycle pregnancy rates per 100 women were 83 (monitor group), 72 (mucus group), and 75 (mucus and monitor group). Pregnancy rates reached 100% at 24 cycles of use for those women using the hormonal fertility monitor.
Conclusion
Use of the hormonal fertility monitor alone seems to offer the best natural estimate of the fertile phase of the menstrual cycle for women wishing to achieve a pregnancy. Focusing intercourse through 24 menstrual cycles can be beneficial for achieving pregnancy.
