Perez Capotosto, M. (2021). An Integrative Review of Fertility Knowledge and Fertility-Awareness Practices Among Women Trying to Conceive. Nursing for women's health, 25(3), 198-206. https://doi.org/10.1016/j.nwh.2021.04.001
Perez Capotosto M. An Integrative Review of Fertility Knowledge and Fertility-Awareness Practices Among Women Trying to Conceive. Nurs Womens Health. 2021;25(3):198-206. doi:10.1016/j.nwh.2021.04.001
Perez Capotosto, Melissa. "An Integrative Review of Fertility Knowledge and Fertility-Awareness Practices Among Women Trying to Conceive." Nursing for women's health, vol. 25, no. 3, 2021, pp. 198-206.
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To synthesize the literature on fertility knowledge and fertility-awareness among women seeking pregnancy.
Data Sources
The search terms "fertility-awareness OR fertility knowledge AND women AND subfertile OR infertile OR seeking pregnancy OR trying to conceive OR pre-conception OR conception NOT contraception NOT birth control" were used via CINAHL, PubMed, and Web of Science. Primary research studies were considered in the search parameters.
Study Selection
Searches yielded 116 studies published between 1978 and 2020. After screening, 43 full-text studies were assessed for eligibility, 35 of which were omitted as not relevant. Nine quantitative studies using cross-sectional designs met this review's inclusion criteria.
Data Extraction
Studies were reviewed for information on the relationship between fertility knowledge/fertility-awareness and pregnancy intention. Studies examining the results of fertility-awareness based method (FABM) efficacy, FABMs for contraception, and provider knowledge regarding FABMs were omitted.
Data Synthesis
Analysis showed low knowledge regarding the identification of the fertile window in the menstrual cycle to optimize pregnancy. There was moderate general knowledge on fertility (e.g., infertility definition, age of fertility decline, etc.). Use of an FABM and education regarding FABMs were infrequent, yet participants recognized that it would be beneficial to use and learn when trying to conceive.
Conclusion
Women seeking pregnancy have low to moderate fertility knowledge. More research is necessary on the relationship between fertility knowledge/fertility-awareness and unexplained infertility. Nurses, nurse practitioners, and nurse-midwives should provide education on FABMs to women when they first report difficulty achieving pregnancy. Clinicians' approaches toward FABM education for women and how to implement FABM education into the preconception visit are important areas for future research.
Capotosto MP et al., 2023·Linacre Q·Free full text on PubMed Central
This pilot qualitative case study was able to elicit rich data enabling a description of how women went through the journey of achieving pregnancy using fertility awareness-based methods. Findings underscore that women preferred using natural ways to detect ovulation and would recommend other women to do so, but with healthcare providers' guidance. The findings of this case study can serve as a starting point to provide a framework to understand women's experiences of enduring trial and error with multiple fertility awareness-based methods before discovering their effective method. Findings emphasize the importance for healthcare providers to guide women in using fertility awareness-based methods.
Eighty women attending for consultation at a tertiary referral fertility unit over a 3-month period were surveyed for their knowledge of fertility awareness and how they used this information to enhance their chances of conception. It was hypothesized that less than 50% of the subjects had an adequate understanding of when the fertile time occurred in their menstrual cycle. A questionnaire was completed anonymously by each subject and these were scored in 3 categories for fertility awareness by 2 independent Natural Family Planning teachers. Scores ranged from 0 for women who had no concept of fertility awareness, to 6 for women who were highly aware. The results showed that 26% (N = 21) of subjects had a score of 4 or greater which was considered as having an adequate understanding. The hypothesis was accepted, giving reason for concern about the effectiveness of consumer education at all levels of fertility investigation.
Iino K et al., 2022·BMC women's health·Free full text on PubMed Central
Recent studies on fertility awareness among the reproductive population have reported the lack of accurate knowledge about fertility and assisted reproductive technologies. However, there has been little information regarding women trying to get pregnant at home. The aim of this study was to explore the prevalence of subclinical infertility among women trying to get pregnant at home, and to evaluate awareness regarding infertility and reasons for not visiting infertility clinics among women who use pregnancy-assist mobile applications to help them conceive. A total of 2084 Japanese women responded to this online survey. We selected 1541 women according to the study criteria. Based on the results of 61 questions, we evaluated knowledge regarding fertility, prevalence of subclinical infertility, and reasons for not visiting the clinic among the participants. Despite the desire to conceive, the participants had an apparent tendency to overestimate the age limit for childbearing. A total of 338 (21.9%) women answered that in general women aged > 45 years could get pregnant. Approximately 40% of the women had possible subclinical infertility and were unaware of the fact. Additionally, about 70% of the women considered themselves to have infertility problems. Women who were aware of the possibility of infertility hesitated to visit the clinic due to unfamiliarity with a gynecologist or clinic, and apprehensions about the gynecologic examination. In our study, some women required treatment for infertility. Nonetheless, they hesitated to visit an infertility clinic. Sexual health education, together with proper accessibility to gynecology clinics, are necessary to reduce involuntary childlessness.
Fertility awareness based methods (FABMs) can be used to ameliorate the likelihood to conceive. A literature search was performed to evaluate the relationship of cervical mucus monitoring (CMM) and the day-specific -pregnancy rate, in case of subfertility. A MEDLINE search revealed a total of 3331 articles. After excluding articles based on their relevance, 10 studies and were selected. The observed studies demonstrated that the cervical mucus monitoring (CMM) can identify the days with the highest pregnancy rate. According to the literature, the quality of the vaginal discharge correlates well with the cycle-specific probability of pregnancy in normally fertile couples but less in subfertile couples. The results indicate an urgent need for more prospective randomised trials and -prospective cohort studies on CMM in a subfertile population to evaluate the effectiveness of CMM in the subfertile couple.
Manhart MD et al., 2013·Osteopathic Family Physician
Each year, over three-fourths of the women of reproductive age in the United States seek family planning services from primary care clinicians. Women and their doctors should be informed of all effective family planning options and their respective effects on a woman's reproductive health. Family physicians are well-trained to support the behavior choices necessary for the successful adoption of any reversible family planning method. However, many are unfamiliar with fertility awareness-based methods (FABM) of family planning or have misconceptions about their effectiveness, complexity, or suitability for their patients. FABM teach women to observe the physical signs and symptoms that follow hormonal fluctuations throughout the menstrual cycle to identify a couple's fertile window, which can be used to avoid or achieve pregnancy. One in 5 women in the United States expressed interest in using FABM when informed about such options. When correctly used to avoid pregnancy, modern FABM have unintended pregnancy rates<5 (per 100 women years). Studies of modern FABM show that their typical unintended pregnancy rates are comparable to those of commonly used contraceptives. This article presents a review of the FABM literature to (1) familiarize the reader with the physiological basis and features of modern FABM, (2) present and utilize a framework to evaluate clinical evidence using the Strength of Recommendation Taxonomy (SORT), which supports the effectiveness of modern FABM for avoiding pregnancy, and (3) serve as a resource for health care professionals offering FABM options to their patients.
Fertility Awareness › Use and Experience › Method Teaching · Body Literacy › Patient Education › Fertility Knowledge and Misconceptions
Melissa Pérez Capotosto
M Capotosto
PMID 33961806 33961806 DOI 10.1016/j.nwh.2021.04.001 10.1016/j.nwh.2021.04.001 Perez Capotosto et al. 2021, Perez Capotosto 2021
Cite this article
Perez Capotosto, M. (2021). An Integrative Review of Fertility Knowledge and Fertility-Awareness Practices Among Women Trying to Conceive. Nursing for women's health, 25(3), 198-206. https://doi.org/10.1016/j.nwh.2021.04.001
Perez Capotosto M. An Integrative Review of Fertility Knowledge and Fertility-Awareness Practices Among Women Trying to Conceive. Nurs Womens Health. 2021;25(3):198-206. doi:10.1016/j.nwh.2021.04.001
Perez Capotosto, Melissa. "An Integrative Review of Fertility Knowledge and Fertility-Awareness Practices Among Women Trying to Conceive." Nursing for women's health, vol. 25, no. 3, 2021, pp. 198-206.
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