Abstract
Background Previous research has demonstrated that women instructed in fertility awareness methods can identify the Peak Day of cervical mucus discharge for each menstrual cycle, and the Peak Day has high agreement with other indicators of the day of ovulation. However, previous studies enrolled experienced users of fertility awareness methods or were not fully blinded.
Objective To assess the agreement between cervical mucus Peak Day identified by fertile women without prior experience on assessing cervical mucus discharge with the estimated day of ovulation (1 day after urine luteinising hormone surge).
Methods This study is a secondary analysis of data from a randomised trial of the Creighton Model FertilityCare(TM) System (CrM), conducted 2003-2006, for women trying to conceive. Women who had no prior experience tracking cervical mucus recorded vulvar observations daily using a standardised assessment of mucus characteristics for up to seven menstrual cycles. Four approaches were used to identify the Peak Day. The referent day was defined as one day after the first identified day of luteinising hormone (LH) surge in the urine, assessed blindly. The percentage of agreement between the Peak Day and the referent day of ovulation was calculated.
Results Fifty-seven women with 187 complete cycles were included. A Peak Day was identified in 117 (63%) cycles by women, 185 (99%) cycles by experts, and 187 (100%) by computer algorithm. The woman-picked Peak Day was the same as the referent day in 25% of 117 cycles, within ±1 day in 58% of cycles, ±2 days in 84%, ±3 days in 87%, and ±4 days in 92%. The ±1 day and ± 4 days' agreement was 50% and 90% for the expert-picked and 47% and 87% for the computer-picked Peak Day, respectively.
Conclusions Women's daily tracking of cervical mucus is a low-cost alternative for identifying the estimated day of ovulation.
cervical mucus peak day accuracy, creighton model ovulation detection, lh surge versus cervical mucus, fertility awareness method validation, woman identified peak day, mucus monitoring effectiveness, ovulation timing cervical discharge, natural family planning accuracy study, biomarker comparison ovulation, blinded lh testing fertility awareness, computer algorithm cervical mucus, self monitored fertility signs
Keywords
Adult, Algorithms, Biomarkers/analysis/urine, Cervix Mucus/physiology, Correlation of Data, Diagnosis, Computer-Assisted/methods, Female, Fertile Period/physiology, Humans, Luteinizing Hormone/analysis/urine, Menstrual Cycle, Ovulation/physiology, Reproducibility of Results, Self-Examination/methods, Time-to-Pregnancy/physiology, Biomarkers, Luteinizing Hormone, Biomonitoring, Cervical Mucus, Creighton Model Fertilitycare System, Fertility, Ovulation