Helping Patients to Predict and Confirm Ovulation with the Use of Combined Urinary Hormonal and Smartphone Technology: A Proof-of-Concept Retrospective Descriptive Case Series
Leiva, R., & Ecochard, R. (2024). Helping Patients to Predict and Confirm Ovulation with the Use of Combined Urinary Hormonal and Smartphone Technology: A Proof-of-Concept Retrospective Descriptive Case Series. Seminars in reproductive medicine. https://doi.org/10.1055/s-0044-1791702
Leiva R, Ecochard R. Helping Patients to Predict and Confirm Ovulation with the Use of Combined Urinary Hormonal and Smartphone Technology: A Proof-of-Concept Retrospective Descriptive Case Series. Seminars in reproductive medicine. 2024. doi:10.1055/s-0044-1791702
Leiva, Rene, and Rene Ecochard. "Helping Patients to Predict and Confirm Ovulation with the Use of Combined Urinary Hormonal and Smartphone Technology: A Proof-of-Concept Retrospective Descriptive Case Series." Seminars in reproductive medicine, 2024.
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110 women paired smartphone LH and mucus charting with progesterone
In a retrospective case series, 110 women used a smartphone protocol that pairs urinary LH tracking and cervical mucus charting with timed serum progesterone testing for ovulation prediction and confirmation. No unintended pregnancies occurred among the 15 women using it to avoid pregnancy. Thirteen out of those 15 women still use the method.
Study at a glance, retrospective descriptive case series of 110 women: 110 women paired smartphone LH and mucus charting with progesterone. Source: Leiva R et al., 2024, PMID 39379045.
Key Findings
The chart review included 110 women aged 13–50: 95 attended for infertility assessment or treatment, and 15 attended for family planning advice.
Most women chose to combine cervical mucus and LH testing (86 of 110). Among the 15 women avoiding pregnancy, 5 used mucus alone, 4 used LH only and 6 used both.
Among the 15 women avoiding pregnancy, confirmation with progesterone testing was needed in a median of 13 cycles per woman (range: 4–54).
Thirteen out of 15 women still use the methods to avoid pregnancy. Three had pregnancies intentionally while using them, and no unintentional pregnancies occurred.
All cycles among the 95 women trying to conceive were confirmed with progesterone. Within that group, most women had three to four or more reasons for use, such as ovulation identification.
Interpretation
The report is a retrospective descriptive case series. The chart review yielded counts of method choice, tested cycles and pregnancies, and a patient questionnaire described the experience of the method, including blood testing. The 15 women using the protocol for family planning supply the pregnancy outcomes. The authors note that biases may arise from the observational design, from patient self-reporting and from reliance on chart review. They conclude that further prospective studies, with improved smartphone applications linked to urine hormone tests, are warranted.
RRM Context
Cervical mucus charting, as taught in the Billings Method and the Creighton Model Fertility Care System, is one option in the protocol, alongside LH tracking. The authors call confirmation of ovulation a cornerstone of the infertility workup. This agrees with the restorative principle of evaluation before treatment. Charting lets women and clinicians time hormone tests to the phase of the cycle.
Our editorial summary of this paper, not the article's abstract.
Abstract
Smartphone-based fertility awareness methods with home-based urinary hormonal testing are gaining popularity for fertility tracking. In our university-affiliated family practice, we integrated a previously developed ovulation tracking application into a protocol for monitoring urinary sex hormones and cervical secretions. Serum progesterone was used to confirm the luteal phase, with levels ≥ 15.9 nmol/L ensuring confirmation. Data from 110 women seen for infertility treatment (n = 95) or family planning advice (n = 15) and using our ovulation prediction protocol showed that most opted for a combination of cervical mucus and luteinizing hormone testing (n = 86). Among those using it for family planning, the median usage among women spanned 56 cycles, and 13 cycles per woman required progesterone testing for confirmation. Thirteen patients are still using the method without unintended pregnancies. No unintended pregnancies occurred. Confidence in tests based on serum progesterone was high (93%). For infertility, the method helped in the identification of anovulation, evaluating treatment response, and in diagnosing subfertility causes. This proof-of-concept retrospective descriptive case series suggests the potential for smartphone-based monitoring in fertility management, urging further studies for application enhancements and prospective validation.
