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PubMed1981

Overview of the biological aspects of the fertile period.

The fertile period of the human menstrual cycle consists of those days on which sexual intercourse can result in a pregnancy. Its duration is determined by the functional life span of the gametes within the female reproductive tract. Various mechanisms control gamete transport and survival in the reproductive tract of the human female. The ovarian hormones estradiol and progesterone have an important role in regulating these mechanisms. The nature of cervical mucus and its governing influences on sperm transport and survival following coitus are of prime importance in defining the fertile days of the menstrual cycle. Man's early concepts of the fertile period were often based on erroneous theories of the female reproductive cycle. It is only since the late 1920's that a true understanding of ovulation and the menstrual cycle has evolved. Current approaches in natural family planning to recognizing the fertile and infertile days of the menstrual cycle are discussed and evaluated.

Cervix Mucus↗
PubMedDate not supplied

Physicians' views of periodic abstinence methods: a study in four countries.

A study of the knowledge, perceptions, and behavioral intentions of physicians regarding periodic abstinence (PA) methods was undertaken in Mauritius, Peru, the Philippines, and Sri Lanka. Most respondents considered PA to be useful, although even the PA providers prescribed mainly non-PA methods. Detailed knowledge of PA methods was not evident, but most physicians were willing to initiate general discussion about PA with patients. Physicians favored methods perceived as "scientific" and "modern," which primarily prevent pregnancy and secondarily avoid other health risks. When carefully presented as "scientific" and "modern," methods presented to medical audiences may find acceptance and be more likely to result in referral.

Adult↗
PubMedDate not supplied

What nurses should know about natural family planning.

Two common natural family planning (NFP) methods are the ovulation method based on characteristics of cervical mucus and the symptothermal method based on changes in cervical mucus, basal body temperature, and the cervix. Both methods are effective when used correctly. Nurses should understand the principles of NFP and introduce these methods in discussions of family planning options. Interested clients should be referred to a certified NFP instructor for education and supervision.

Body Temperature↗
PubMed1994

Contraceptive application of the Bioself fertility indicator.

The Bioself fertility indicator is a hand-held electronic device that combines the basal body temperature and calendar methods for planning or preventing pregnancy. A study was undertaken in three centers in the province of Québec, Canada, to evaluate the Bioself device as a contraceptive aid. Eighty-three women were recruited; they accumulated 745 cycles of use. Six unplanned pregnancies occurred from unprotected intercourse during the fertile phase of the cycle, as indicated by the Bioself device. The pregnancy rate was 9.02 per 100 women-years and the one-year discontinuation rate was 32.5%. The low pregnancy rate is attributed to the women's experience in natural family planning, reinforced, in 51% of the cycles, by protection from additional barrier methods. It was concluded that the Bioself device is an effective contraceptive aid for couples who are aware of the pros and cons of natural family planning and desire a noninvasive means of contraception.

Adult↗
PubMed1991

An evaluation of the Bioself 110 electronic fertility indicator as a contraceptive aid.

The Bioself 110 is a hand-held electronic device that combines the BBT and calendar methods of fertility regulation for planning or preventing pregnancy. A pilot study was undertaken in three centers in the United Kingdom to evaluate the Bioself 110 as a contraceptive aid. This paper deals with 1238 cycles from 131 women. Only one unplanned pregnancy occurred where a volunteer correctly used the Bioself 110 and had intercourse on a supposedly "safe" day. A second pregnancy was experienced by a volunteer who incorrectly used the device and had intercourse on what she though was a "safe" day. Another 11 unplanned pregnancies occurred due to barrier method failures, as well as 11 pregnancies where the volunteers knowingly had unprotected intercourse during the fertile phase. There were five planned pregnancies. The Bioself 110 was correctly used in 71% of the cycles studied. Eighty-four percent of the volunteers indicated that they were satisfied with the Bioself 110 after six to twelve cycles of use. It was concluded that the Bioself 110 can serve as an effective family planning aid and should be added to the menu of contraceptive methods available to women today.

Adolescent↗
PubMed1995

Timing of conception and the risk of spontaneous abortion among pregnancies occurring during the use of natural family planning.

OBJECTIVE: Our purpose was to ascertain the effects of timing of conception on the risk of spontaneous abortion. STUDY DESIGN: To assess these effects, women who conceived while using natural family planning were identified in five centers worldwide between 1987 and 1993. Timing of conception was determined from 868 natural family planning charts that recorded day of intercourse and indices of ovulation (cervical mucus peak obtained according to the ovulation method and/or basal body temperature). Conceptions on days - 1 or 0 with respect to the natural family planning estimated day of ovulation were considered to be "optimally timed," and all other conceptions were considered as "non-optimally timed." The rate of spontaneous abortions per 100 pregnancies was examined in relation to timing of conception, ages, reproductive history, and other covariates with bivariate and multivariate statistical methods. RESULTS: There were 88 spontaneous abortions among 868 pregnancies (10.1%). The spontaneous abortion rate was similar for 361 optimally timed conceptions (9.1%) and 507 non-optimally timed conceptions (10.9%). However, among 171 women who had experienced a spontaneous abortion in a prior pregnancy, the rate of spontaneous abortion in the index pregnancy was significantly higher with non-optimally timed conceptions (22.6%) as compared with optimally timed conceptions (7.3%). This association was not observed among 697 women with no history of pregnancy loss. The adjusted relative risk of spontaneous abortion among women with non-optimally timed conceptions and a history of pregnancy loss was 2.35 (95% confidence intervals 1.42 to 3.89). The excess risk of spontaneous abortion was observed with both preovulatory and postovulatory conceptions. CONCLUSIONS: Overall, there is no excess risk of spontaneous abortion among the pregnancies conceived during natural family planning use. However, among women with a history of pregnancy loss, there is an increased risk of spontaneous abortion associated with preovulatory or postovulatory delayed conceptions.

Abortion, Spontaneous↗
PubMed2005

Interpretation of the BBT chart: using the "Gap" technique compared to the Coverline technique.

OBJECTIVE: The aim of the study was to compare the accuracy of the Gap and Coverline techniques of interpreting the basal body temperature chart. METHODS: We compared the proportion of menstrual cycles for which the Gap and Coverline techniques accurately identified the post-ovulatory final fertile phase (FFP) and the initial infertile phase (IIP) and the median number of days each overestimated the fertile period, using urinary LH testing as the gold standard. RESULTS: The Gap and Coverline techniques identified the FFP within +/-1 day of that identified by LH testing in 13/33 (39%) and 10/33 (30%) cycles (chi2=0.6; p=.44), respectively, and the IIP within +1 day of that of LH testing in 13/33 (55%) and 4/33 (12%) cycles, respectively (chi2=13.4; p<.001). The Gap and Coverline techniques overestimated the fertile period by 1 and 4 days, respectively (p=.0002). CONCLUSION: Based on this small study, the Gap technique appears to be more accurate than the Coverline technique in identifying the post-ovulatory IIP.

Adult↗
PubMed1987

Natural family planning.

It is now well accepted that a woman can conceive from an act of intercourse for a maximum of only about 7 days of her menstrual cycle. The reliability of natural family planning depends on identifying this window of fertility without ambiguity. Several symptomatic markers, cervical mucus and basal body temperature, have been used extensively and with considerable success in most women but failures occur. Ovarian and pituitary hormone production show characteristic patterns during the cycle. Urinary estrogen and pregnanediol measurements yield reliable information concerning the beginning, peak, and end of the fertile period, provided that the assays are accurate and performed on timed specimens of urine. We have developed such enzyme immunoassays for urinary estrogen and pregnanediol glucuronides that can be performed at home. In the early versions of the assays, enzyme reaction rates were measured by eye, but more recently, a simple photoelectronic rate meter has been used. The final problem to be solved is not technologic but whether women are sufficiently motivated to expend the same time and effort each day for 10 days a month, with less cost, on fertility awareness as they spend on making a cup of tea.

Adult↗
PubMed1981

Some properties of rectum and vagina as sites for basal body temperature measurement.

The choice of site for body temperature measurement and consistency in positioning the thermometer are important in achieving reliable and interpretable basal body temperature graphs in women. The distribution of temperatures in vagina (TV) and rectum (TR) were measured in women upon awakening. There were no significant differences between TR and TV at insertion depths of 5, 9, or 13 cm. Estimation of deep body temperature was not improved by inserting a thermojunction beyond 5 cm in vagina or rectum. Rates of change in TV following ingestion of a 300-ml iced drink were significantly greater than rates of change in TR.

Adult↗