Fehring, R. J., & Raviele, K. (2018). Current Medical Research: Winter/Spring 2017. The Linacre Quarterly, 85(1), 74-85. https://doi.org/10.1177/0024363918756392
Fehring RJ, Raviele K. Current Medical Research: Winter/Spring 2017. Linacre Q. 2018;85(1):74-85. doi:10.1177/0024363918756392
Fehring, R. J., and K. Raviele. "Current Medical Research: Winter/Spring 2017." The Linacre Quarterly, vol. 85, no. 1, 2018, pp. 74-85.
Correct-Use Pregnancy Rates Stay Low With Online Fertility Charting
A doctor reviewed 2016 and 2017 fertility studies. One study followed 1,530 women who charted their cycles with an online tool to find fertile days. Correct-use pregnancy rates reached 3.4 per 100 users after 24 cycles of charting.
Key Findings
The online charting program's correct-use pregnancy rate was 2.5 per 100 women at 12 cycles and 3.4 per 100 at 24 cycles, among 1,530 participants.
A subgroup of 663 non-breastfeeding women had a correct-use pregnancy rate of 1.6 per 100 women at both 12 and 24 months of use.
A national fertility committee found most couples, 80 percent, become pregnant within six months of trying, and female fertility declines notably by age 35.
A meta-analysis of 10 trials in women with unexplained recurrent miscarriage found progestogens may lower miscarriage risk (RR 0.72, CI 0.53-0.97) and raise live births (RR 1.07, CI 1.02-1.15).
A Cochrane review of 8 trials (55,157 participants) found no school-based sexual education program improved STIs or pregnancy; the authors found little evidence for curriculum programs.
Interpretation
This is a doctor's review of several separate 2016 and 2017 studies. The featured online program study enrolled women who signed up on their own through NFP groups. Most were Catholic, college-educated, and of European-American background, which makes it hard to know how well the pregnancy rates apply to other groups of women. The reviewer also adds personal opinions next to each study summary; some lines are the reviewer's own opinions, separate from the study's findings. The miscarriage and sex-education findings come from other trials and reviews, unrelated to the charting study.
RRM Context
This review is part of the fertility awareness research that RRM clinicians use. The charting study tested an online-only NFP method and did not test care from a NaPro-trained doctor. The fertility guideline and miscarriage findings come from general reproductive medicine, separate from fertility awareness studies. They add a wider backdrop for this kind of care.
Our editorial summary of this paper, not the article's abstract.
Bouchard TP et al., 2026·Journal of ovarian research·Free to read
Reproductive hormones of the fertile window are often referenced to women in regular cycles, but this may not be representative of the hormonal profiles of women in different circumstances like polycystic ovarian syndrome, the postpartum period, and the perimenopause transition. This observational cohort study sought to identify the variability in the reproductive hormones in various clinical circumstances and to establish potential thresholds for each category based on hormone measurements with the Mira urinary hormone monitor. A total of 57 women (ages 22-51) in various circumstances (regular cycles, polycystic ovarian syndrome, postpartum and perimenopause) tracked Mira urine hormone measurements (estrone-3-glucuronide, luteinizing hormone, pregnanediol glucuronide), contributing 444 cycles of data. Using additive mixed models, hormone values were stratified by the four different reproductive categories. The perimenopause and polycystic ovarian syndrome groups demonstrated relative hypoestrogenic states, while the perimenopause group showed low luteal pregnanediol glucuronide and the polycystic ovarian syndrome/polyendocrine metabolic ovarian syndrome (PCOS/PMOS) group showed high luteal pregnanediol glucuronide. The perimenopause group had significantly higher luteinizing hormone values throughout the whole cycle. The fertile window hormone thresholds vary depending on a woman's specific reproductive category. Women in different circumstances should not necessarily use the same hormonal thresholds for the fertile window and ovulation. A larger dataset with ultrasound correlation to ovulation is required to delineate the fertile window with more precision. Hormone differences across the menstrual cycle could be used for targeted treatments in polycystic ovarian syndrome and perimenopause women.
Malliou-Becher MN et al., 2026·Human reproduction (Oxford, England)
What are the variations in ovulation time and menstrual cycle characteristics among and within various individuals over the course of 12 menstrual cycles? There are considerable variations in both cycle length and ovulation time, with pronounced intra-individual variability over a 12-cycle observation period. Although it is commonly believed that healthy women have regular cycles with a predictable mid-cycle ovulation, more recent research shows a significant variation in cycle length and ovulation time. Previous studies have focused only on cycle length, often excluding cycles outside the 25-35-day range, thus limiting the understanding of natural variation; they have also lacked precise ovulation diagnostics or included small sample sizes, making it difficult to capture the full scope of cycle and ovulation variability. Similarly, a recent big data study, while valuable, was limited by a self-selected group and the absence of accurate ovulation diagnostics, reducing its generalizability. STUDY DESIGN, SIZE, This study was designed as a prospective long-term observational study, which involved collecting data from 1923 women with a total of 43 999 menstrual cycles from January 1985 to July 2019. After fulfilling the inclusion criteria, the main group consisted of 1051 women, all of whom contributed data for 12 cycles (12 612 cycles), including 420 conception cycles. PARTICIPANTS/MATERIALS, SETTING, Participants in the study were between 18 and 44 years of age at study entry and did not take any reproductive hormones. Women who were postpartum, breastfeeding, amenorrheic, or within a 3-month period after stopping hormonal contraception were excluded. Participants agreed to keep cycle records according to the symptothermal method, 'Sensiplan'. Ovulation time was determined using an evidence-based algorithm based on evaluating cervical mucus patterns and basal body temperature shifts, with ovulation time defined as the day before the temperature rise. Data analysis was descriptive, using absolute and relative frequencies, standard deviation, percentiles, and ranges. Age dependency was assessed using unpaired sample t-tests and one-way ANOVA. Linear regression was used to assess long-term trends. MAIN In 62.4% of women, cycle lengths varied by 1 week or more within 12 cycles. Accordingly, the time of ovulation varied by 1 week or more within 12 cycles in 54.8% of women, with 96.5% experiencing fluctuations of 4 days or more over the 12 months. The median spontaneous cycle length was 28 days, with a mean of 29.66 days (SD = 7.55). Only 52.7% of women consistently had cycle lengths between 23 and 35 days across all 12 cycles. Ovulation occurred most frequently between Days 12 and 16, with almost half of conceptions (45.7%) occurring after Day 16. A one-way analysis of variance revealed a significant reduction in mean cycle length with increasing age (P < 0.001), showing the shortest median cycle length of 27 days being in women aged 40-44 years. Age also impacted ovulation time, with women aged 35-39 years showing more stable ovulation patterns compared to younger women. Over the 34-year study period, average cycle length increased slightly but significantly (β = 0.0161, P = 0.0306), corresponding to approximately half a day. Intra-individual variability also showed a slight, but non-significant, upward trend (β = 0.0262, P = 0.2173). LIMITATIONS, Comorbidities such as hyperprolactinemia, obesity, and PCOS were not systematically excluded. However, by including only women with at least 12 cycles, the study largely avoided severe hormonal disorders. This study highlights the considerable individual variation of ovulation time and cycle length over 12 menstrual cycles. These findings contribute to a better understanding of fertility awareness, and highlight the implications for family planning and reproductive health management. STUDY FUNDING/COMPETING INTEREST(S): The authors declare no conflicts of interest. No funding was provided. N/A.
Bouchard TP et al., 2025·Preprints.org·Free to read
Background/Objectives: Quantitative urine monitors are increasingly being used for a personalized approach to improve menstrual cycle knowledge and to manage fertility. Although several studies have evaluated urine fertility monitors in regular cycles, there is limited research in the use of quantitative monitors in reproductive disorders, such as polycystic ovarian syndrome (PCOS). Urine hormone data was collected with the Mira monitor from 20 participants, 10 of whom had PCOS and a matched group who had regular cycles. The main aim of this study was to evaluate the levels of luteinizing hormone (LH), estrone-3-glucuronide (E13G), and pregnanediol glucuronide (PDG) in PCOS menstrual cycles compared to regular cycles. Women with PCOS had higher BMI than regular cycling women (p=0.02). PCOS cycles were longer (p<0.05), peak day was later in the menstrual cycle (p<0.001), and luteal length was shorter (p < 0.01) compared to regular cycles. In whole cycle comparisons, E13G was found to be lower in PCOS cycles (p<0.01) and PDG was found to be higher in PCOS cycles (p<0.05). E13G was also lower in the follicular phase of and late luteal phase of PCOS cycles (p<0.00001). The results of this study demonstrate the feasibility of detecting hormonal differences in PCOS compared to regular cycles with at-home measurements with the Mira monitor. The metabolic dysregulation of PCOS is a possible factor in these hormone changes. Larger studies with different sub-types of PCOS will be needed to further clarify these changes and to understand the pathophysiology behind these hormonal changes.
Manhart MD et al., 2025·Linacre Q·Free full text on PubMed Central
A one-day meeting was held as a pre-conference to the Catholic Medical Association Annual Educational event in 2024. A panel of eighteen physicians, scientists, and researchers involved in NFP work was convened to review the available evidence in four topical areas: (i) evidence for effectiveness of NFP methods to postpone and achieve pregnancy, (ii) evidence for effectiveness in the postpartum and perimenopause transition periods, (iii) evaluate the current state of technology in NFP (specifically app and quantitative hormone monitoring), and (iv) evidence examining the impact of NFP on marital relations. In each topical area, the panel worked to reach a consensus opinion on the currently available evidence and identified priorities for further research. Results from these discussions and a set of priorities for further work are presented here.
An expert panel was convened to review the current evidence supporting use of NFP in various settings, utilization of new technology, and the impact of NFP on marital dynamics. Results from these discussions and a set of priorities for further work are presented here.
Fehring RJ et al., 2018·Linacre Q·Free full text on PubMed Central
This issue of Current Medical Research (CMR) includes studies that provide evidence that use of natural family planning (NFP) can be helpful for subfertile couples wishing to achieve a pregnancy, the effectiveness of a method of NFP during breastfeeding, and the effects of using NFP on marital relationships. This review also includes evidence on predicting the sex of a baby by timing intercourse, evidence that brain injuries can be reflected in changes in the menstrual cycle, and that women prefer methods of family planning that have no side effects. The issue ends with an in-depth review of new technologies that aid in the use of NFP. Topics covered include subfertile couples, breastfeeding, marriage, predicting the sex of a baby, brain injuries, and new technologies.
Rick Fehring, Dick Fehring, Rich Fehring, R Fehring, K Raviele
PMID 29970939 29970939 DOI 10.1177/0024363918756392 10.1177/0024363918756392 Fehring et al. 2018, Fehring 2018
Cite this article
Fehring, R. J., & Raviele, K. (2018). Current Medical Research: Winter/Spring 2017. The Linacre Quarterly, 85(1), 74-85. https://doi.org/10.1177/0024363918756392
Fehring RJ, Raviele K. Current Medical Research: Winter/Spring 2017. Linacre Q. 2018;85(1):74-85. doi:10.1177/0024363918756392
Fehring, R. J., and K. Raviele. "Current Medical Research: Winter/Spring 2017." The Linacre Quarterly, vol. 85, no. 1, 2018, pp. 74-85.