To summarize best available prospective data on typical and perfect use effectiveness of fertility awareness-based methods for avoiding pregnancy.
DATA SOURCES: We conducted a systematic review of studies published in English, Spanish, French, or German by June 2017 in MEDLINE, EMBASE, CINAHL, Web of Science, and ClinicalTrials.gov. METHODS OF STUDY SELECTION: We reviewed 8,755 unique citations and included 53 studies that contained 50 or greater women using a specific fertility awareness-based method to avoid pregnancy, calculated life table pregnancy probabilities or Pearl rates, and prospectively measured pregnancy intentions and outcomes. We systematically evaluated study quality. TABULATION, INTEGRATION, AND
Results
Of 53 included studies, we ranked 0 high quality, 21 moderate quality, and 32 low quality for our question of interest. Among moderate-quality studies, first-year typical use pregnancy rates or probabilities per 100 woman-years varied widely: 11.2-14.1 for the Standard Days Method, 13.7 for the TwoDay Method, 10.5-33.6 for the Billings Ovulation Method, 4-18.5 for the Marquette Mucus-only Method, 9.0-9.8 for basal body temperature methods, 13.2 for single-check symptothermal methods, 11.2-33.0 for Thyma double-check symptothermal methods, 1.8 for Sensiplan, 25.6 for Persona, 2-6.8 for the Marquette Monitor-only Method, and 6-7 for the Marquette Monitor and Mucus Method. First-year perfect use pregnancy rates or probabilities among moderate-quality studies were 4.8 for the Standard Days Method, 3.5 for the TwoDay Method, 1.1-3.4 for the Billings Ovulation Method, 2.7 for the Marquette Mucus Method, 0.4 for Sensiplan, 12.1 for Persona, and 0 for the Marquette Monitor.
Conclusion
Studies on the effectiveness of each fertility awareness-based method are few and of low to moderate quality. Pregnancy rates or probabilities varied widely across different fertility awareness-based methods (and in some cases, within method types), even after excluding low-quality studies. Variability across populations studied precludes comparisons across methods.
fertility awareness based methods pregnancy prevention effectiveness systematic review, typical use perfect use pregnancy rates natural family planning, Sensiplan effectiveness pregnancy prevention, Marquette Monitor method pregnancy rate, Standard Days Method TwoDay Method effectiveness comparison, Billings Ovulation Method typical use pregnancy rate, symptothermal method effectiveness systematic review, Stanford Polis fertility awareness contraceptive effectiveness, Peragallo Urrutia fertility awareness pregnancy prevention, basal body temperature method pregnancy rate prospective studies, natural family planning life table pregnancy probabilities, fertility awareness method quality of evidence review
PMID 30095777 30095777 DOI 10.1097/AOG.0000000000002784 10.1097/AOG.0000000000002784
Cite this article
Peragallo Urrutia, R., Polis, C. B., Jensen, E. T., Greene, M. E., Kennedy, E., & Stanford, J. B. (2018). Effectiveness of Fertility Awareness-Based Methods for Pregnancy Prevention: A Systematic Review. Obstetrics and gynecology, 132(3), 591-604. https://doi.org/10.1097/AOG.0000000000002784
Peragallo Urrutia R, Polis CB, Jensen ET, Greene ME, Kennedy E, Stanford JB. Effectiveness of Fertility Awareness-Based Methods for Pregnancy Prevention: A Systematic Review. Obstet Gynecol. 2018;132(3):591-604. doi:10.1097/AOG.0000000000002784
Peragallo Urrutia, R., et al. "Effectiveness of Fertility Awareness-Based Methods for Pregnancy Prevention: A Systematic Review." Obstetrics and gynecology, vol. 132, no. 3, 2018, pp. 591-604.
Keywords
Awareness, Family Planning Services, Female, Fertility, Humans, Pregnancy, Reproductive Techniques
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