Hilgers, T. W. (2020). The Identification of Postovulation Infertility with the Measurement of Early Luteal Phase (Peak Day +3) Progesterone Production. The Linacre Quarterly, 87(1), 78-84. https://doi.org/10.1177/0024363919885551
Hilgers TW. The Identification of Postovulation Infertility with the Measurement of Early Luteal Phase (Peak Day +3) Progesterone Production. Linacre Q. 2020;87(1):78-84. doi:10.1177/0024363919885551
Hilgers, Thomas W. "The Identification of Postovulation Infertility with the Measurement of Early Luteal Phase (Peak Day +3) Progesterone Production." The Linacre Quarterly, vol. 87, no. 1, 2020, pp. 78-84.
No pregnancies observed in 605 cycles using Peak Day +3 progesterone
No pregnancies were observed in 605 cycles with follow-up in a 13-year study of 105 women using the Creighton Model FertilityCare System. Each woman had a serious reason to avoid pregnancy or lacked confidence in the system. Progesterone was drawn on Peak Day +3, and two case summaries report 124 and 45 cycles without a pregnancy.
Study at a glance, 13-year observational study of 105 women: No pregnancies were observed in 605 followed cycles. Source: Hilgers TW, 2020, PMID 32431450.
Key Findings
The study followed 632 cycles from 105 women between 2004 and 2016, excluded women with known infertility, and included participants aged 23 to 45 years.
Pregnancy follow-up was available for 605 of the 632 cycles (95.7 percent), contributed by 83 women, and no pregnancies were observed in those cycles.
The remaining 27 cycles (4.3 percent), from 22 women, lacked definitive follow-up. All 27 had results the study classifies as ovulation having passed, and 23 fell in the highest category.
A repeat "double draw" occurred in 40 of the 632 cycles (6.33 percent).
Two case summaries describe women with serious reasons to avoid pregnancy. One used the approach for 124 cycles and the other for 45, and neither became pregnant during that time.
Interpretation
The report is a 13-year observational study of women using the Creighton Model FertilityCare System. Each woman had a serious reason to avoid pregnancy or lacked confidence in the system, and women with known infertility were excluded. The author describes a Peak Day +3 progesterone rise as a marker that ovulation, if it occurred, has passed. The author notes that 27 cycles from 22 women lacked definitive pregnancy follow-up and that none of those women reported a pregnancy.
RRM Context
Cycle-charting-informed care begins with a woman's own observations. The Creighton Model FertilityCare System, developed by Dr. Thomas W. Hilgers, identifies the Peak Day from cervical mucus and times a blood test to that day. NaProTechnology likewise uses the charted cycle to time hormone measurements, and restorative reproductive medicine treats the charted cycle as clinical information.
Our editorial summary of this paper, not the article's abstract.
Abstract
This study reports on 632 cycles from 105 women who were using the CREIGHTON MODEL FertilityCare™ System to avoid pregnancy and had either a serious reason to avoid pregnancy or some degree of a lack of confidence. A progesterone level was drawn on the third day after the Peak Day as they were charting, and if the progesterone level was 2.3 ng/mL or greater, then ovulation was determined to have passed. If the level was greater than 3.0 ng/mL, this indicated that an absolute period of infertility had begun. In these cases, no pregnancies were observed. In the 27 cycles in which a specific follow-up relative to pregnancy could not be definitively determined, the progesterone levels in all cases were 2.3 ng/mL or greater with 23 of the 27 cycles being 3.1 ng/mL or greater. It is highly unlikely that any of those became pregnant as well. These cycles were collected over thirteen years (2004-2016). Two case presentations are also a part of this article of two families in which the couples had very serious reasons to avoid pregnancy. In these two couples, each of the women was multi-gravid and had no evidence of subfertility or infertility. They used the family planning progesterone level (the Peak Day +3 progesterone level) for a total of 167 cycles over a number of years successfully without a subsequent pregnancy.
Summary
This article presents a thirteen-year effort to evaluate the serum progesterone level on the third day after the Peak Day as observed by women charting the CREIGHTON MODEL FertilityCare™ System. It is known that the Peak Day is associated with ovulation, and if the progesterone reaches a certain level, then an absolute period of infertility should follow. In fact, this is what this study reflects.
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