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PubMed1988

Demographic study on the family planning behaviour of the German population: the importance of natural methods.

A total of 1,267 women in the F.R.G., aged from 15 to 45 years, were interviewed about their family planning behavior and the importance of natural methods of family planning (NFP) in a representative demographic study. It was found that 19.6% of the respondents were not sexually active. The others used various methods, as follows: pill, 38.4%; IUD, 10.3%; condom, 5.9%; diaphragm, 2.1%; spermicides, 0.8%; withdrawal, 3.4%; NFP methods, 3.9%. The main reason for rejecting a method was a possible medical risk. Of the responding women, 73% had some previous knowledge about NFP; 47% of them found such methods to be interesting, and approximately 20% indicated a high probability of the use of NFP methods in the future.

Adolescent↗
PubMed1985

The ageing gamete in relation to birth control failures and Down syndrome.

Some indirect relationships between contraception failures and offspring with a pathological condition are reviewed, and a causal connection between them is suggested. This hypothesis is supported by the decreasing incidence of Down syndrome (DS) in general in recent years, and the increase among the younger maternal age categories as well as the effect of birth order. A more than doubled incidence of DS children among young Catholic mothers and the fact that conceptions of children with DS are preceded by unusually long periods of abstinence are emphasised and discussed. These data offer circumstantial evidence that the conceptions that occur despite application of the so called "natural" family planning methods in particular are at high risk. The impact of reproductive biological failures ("nature") and of reproductive behaviour ("nurture") on the human gametes can be disentangled by thorough studies of the epidemiology of major and minor congenital anomalies.

Adult↗
PubMed1999

The TwoDay Algorithm: a new algorithm to identify the fertile time of the menstrual cycle.

Women who monitor their fertility signs and recognize when they are fertile can use this knowledge to conceive or to avoid pregnancy. Studies have shown that there is a rather small fertile window of several days during each menstrual cycle. Established methods of identifying the fertile window, such as the Ovulation and the Symptothermal methods of Natural Family Planning, can be very effective in helping couples avoid pregnancy. A new algorithm for identifying the fertile window has been developed, based on monitoring and recording of cervical secretions. The TwoDay Algorithm appears to be simpler to teach, learn, and use than current natural methods. A large existing data set from a World Health Organization study of the Ovulation Method, along with Natural Family Planning charts from women using the Ovulation Method and the Symptothermal Method, were used to determine the potential effectiveness of the TwoDay Algorithm in identifying the fertile window. Results suggest that the algorithm can be an effective alternative for low literacy populations or for programs that find current Natural Family Planning methods too time consuming or otherwise not feasible to incorporate into their services. Further studies are needed to determine the efficacy of the TwoDay Algorithm in avoiding pregnancy and to assess its acceptability to users and providers.

Adult↗
PubMed1981

Catholic perspectives on populations issues II.

This Bulletin discusses the history and current status of the population problem from a Roman Catholic viewpoint. While upholding human rights and admitting the right of couples to control the size of their families, the Catholic Church continues to prohibit the use of artificial methods of contraception as sinful. This position hinders the Church, with its some 750 million adherents, from taking an effective lead in confronting the growing threat of global overpopulation. Rhythm has been permitted since 1930 but Pope Pius 12 in 1958 forbade contraceptive use of the pill. Despite the liberal spirit engendered by Vatican Council 2 and against the recommendation of a papal birth control commission, Pope Paul 6 in his 1968 Encyclical Humanae vitae reaffirmed the ban on artificial contraception, apparently convinced that this was necessary to combat growing sexual immorality, family breakdown, and materialism. This stance has been upheld by Pope John Paul 2 and the 1980 Synod of Bishops. The decision ignores the pleas of a number of responsible churchmen speaking for their people at the Synod and of a growing majority of Catholic theologians and laity, that Church teaching must be updated to take account of the facts of modern life. Surveys reveal that Catholic married couples increasingly find Church-approved natural family planning methods unsatisfactory and feel obliged to turn to artificial methods to regulate their family size. On the world scale, Pope John Paul 2 and the Vatican, while insisting on human rights and the need for a reordering of unjust economic, social, and political structures, seem to be neglecting the threat of civilizational breakdown that looms with the prospect of too many people in too little space with too few resources.

Abortion, Induced↗
PubMed2001

The relationship between cervical secretions and the daily probabilities of pregnancy: effectiveness of the TwoDay Algorithm.

BACKGROUND: The TwoDay Algorithm is a simple method for identifying the fertile window. It classifies a day as fertile if cervical secretions are present on that day or were present on the day before. This approach may be an effective alternative to the ovulation and symptothermal methods for populations and programmes that find current natural family planning methods difficult to implement. METHODS: We used data on secretions from a large multinational European fecundability study to assess the relationship between the days predicted to be potentially fertile by the TwoDay Algorithm and the day-specific probabilities of pregnancy based on intercourse patterns in 434 conception cycles from the study. RESULTS: The days around ovulation that had the highest fecundability were the days most likely to be classified as fertile by the TwoDay Algorithm. In addition, intercourse on a particular day in the fertile interval was twice as likely to result in a pregnancy if cervical secretions were present on that day or the day before. CONCLUSIONS: The TwoDay Algorithm is effective, both in identifying the fertile days of the cycle and in predicting days within the fertile interval that have a high pregnancy rate. Our data provide the first direct evidence that cervical secretions are associated with higher fecundability within the fertile window.

Algorithms↗
PubMed2002

Changes with age in the level and duration of fertility in the menstrual cycle.

BACKGROUND: Most analyses of age-related changes in fertility cannot separate effects due to reduced frequency of sexual intercourse from effects directly related to ageing. Information on intercourse collected daily through each menstrual cycle provides the data for estimating day-specific probabilities of pregnancy for specific days relative to ovulation, and these estimates allow unconfounded analysis of ageing effects. METHODS: A total of 782 healthy couples using natural family planning methods contributed prospective data on 5860 menstrual cycles. Day of ovulation was based on basal body temperature measurements. Estimates of day-specific probabilities of pregnancy and the length of the fertile window were compared across age groups. RESULTS: Nearly all pregnancies occurred within a 6 day fertile window. There was no evidence for a shorter fertile window in older men or women. On average, the day-specific probabilities of pregnancy declined with age for women from the late 20s onward, with probabilities of pregnancy twice as high for women aged 19-26 years compared with women aged 35-39 years. Controlling for age of the woman, fertility was significantly reduced for men aged >35 years. CONCLUSIONS: Women's fertility begins to decline in the late 20s with substantial decreases by the late 30s. Fertility for men is less affected by age, but shows significant decline by the late 30s.

Adult↗
PubMedDate not supplied

An assessment of the nine-month lactational amenorrhea method (MAMA-9) in Rwanda.

This report presents a secondary data analysis based on prospectively collected records gathered during a field assessment that was carried out in Rwanda in August 1993. The assessment used service statistics and follow-up interviews to evaluate the efficacy of a modified lactational amenorrhea method (LAM) as a nine-month introductory postpartum natural family planning method. The program, carried out by Action Familiale Rwandaise (AFR), reflects high efficacy of the method in a compliant sample that sought this method followed by another form of family planning. These results are promising and provide guidance for the extended use of LAM past six months. Programmatic findings suggest that studies be conducted of the contribution of extended LAM to improved weaning practices, the high efficacy of continued reliance on substantial lactation and amenorrhea beyond nine months, and male involvement in LAM and breastfeeding.

Algorithms↗
PubMed2005

Heterogeneity, the masked part of reproductive technology success rates.

BACKGROUND: Heterogeneity in women and men's fecundity is a well-established fact. The selection process of men and women treated for infertility might bias the success rates of reproductive technology. Bias may also arise from frequency and timing of intercourse with respect to the day of ovulation. METHODS: Several datasets were collected and analysed. They concern normally fertile couples who used natural family planning methods and infertile couples treated by artificial insemination with husband or donor's spermatozoa. The effects of heterogeneity on the success rates of treatment cycles are described and solutions are proposed as to data collection and statistical analysis in this specific field. RESULTS: The decrease in the success rates along successive cycles of assisted reproduction is a consequence of heterogeneity. The probability of conception varies among women and among men. After a first success, the probability of another success is higher. After a failure, the probability of success is lower. The most specialised centres treat the less fecund couples. There is a negative correlation between men and women's fertility in case of oligo/azoospermia. The fecund window cannot be correctly located by calendar calculations, but more appropriately by assessment of cervical mucus at the vulva. The variability of this location is wide. The decrease in the success rate with men and women's age results from a complex mixture of an increase in the proportion of sterile patients and a decrease in fecund patients' fecundity. CONCLUSION: Care should be taken to limit the bias due to patient selection and specific statistical methods should be used to allow for the progressive selection of patients during fertility studies and for the variability of the frequency and the timing of intercourse or insemination relative to ovulation.

Data Interpretation, Statistical↗
PubMed1990

The correlation between Chlamydia antigen, antibody, vaginal colonization and contraceptive method in young unmarried women.

In a group of 55 unmarried women, mean age 25 years, attending a family planning clinic and having minor gynecological complaints, the correlation between Chlamydia trachomatis (CT) antigen, CT antibodies, vaginal colonization by Candida or bacteria and the method of contraception was investigated. The correlation between CT antigen and CT antibodies (IgG) was significant in oral contraceptive users (p = 0.003), as was the correlation with vaginal colonization by Candida and potential pathologic bacteria. In the group using the natural family planning method, a statistically significant correlation was found between CT antigen, IgG (p = 0.002), IgA (p = 0.02) antibodies, and vaginal candidiasis (p = 0.002), but not with bacterial colonization (p = 0.90). The discrepancy between CT antigen and antibodies is discussed. Differences in the prevalence of Chlamydia trachomatis infection were found among groups using different birth control methods, indicating an association between Chlamydia infection and the contraceptive method used.

Adolescent↗
PubMed1996

A comparison of the ovulation method with the CUE ovulation predictor in determining the fertile period.

The purpose of this study was to compare the CUE Ovulation Predictor with the ovulation method in determining the fertile period. Eleven regularly ovulating women measured their salivary and vaginal electrical resistance (ER) with the CUE, observed their cervical-vaginal mucus, and measured their urine for a luteinizing hormone (LH) surge on a daily basis. Data from 21 menstrual cycles showed no statistical difference (T = 0.33, p = 0.63) between the CUE fertile period, which ranged from 5 to 10 days (mean = 6.7 days, SD = 1.6), and the fertile period of the ovulation method, which ranged from 4 to 9 days (mean = 6.5 days, SD = 2.0). The CUE has potential as an adjunctive device in the learning and use of natural family planning methods.

Adult↗
PubMed1994

[Contraception among adolescents].

Adolescence is a period of which the contraception is difficult, because of lower compliance of the teenagers to this methods. The authors were observed the contraceptive uses in 792 pregnant adolescent girls, 264 of which with abortions (group A) and 528 teen-age mothers (group B). Only 12.88% of all patients have used birth control methods, usually with low and middle effects. We founded only 15 patients (1.89%) practiced hormonal contraception and 1 case (0.13%) with Intrauterine devise. The condoms for men was the most popular and useful in teenagers (4.23%), and Natural family planning methods were practiced from 52 (6.57%) patients. There was the statistically differences between adolescent girls included in group A and B about their contraceptive behaviors and live standards (p < 0.01). By the kind of contraceptive methods, there was a high differences in the teenagers with a hormonal uses (p < 0.05).

Adolescent↗
PubMed1995

The provision of family planning services by family doctors in a health board region.

A survey was carried out to ascertain the extent of family planning services provided by family doctors. Of the 134 doctors surveyed, 119 (88.8%) replied. Of these 97 (81.5%) were male, 30 (25.2%) were aged less than 40 and 22 (18.5%) were greater than 60. Sixty-four (53.8%) worked in single-handed practices, 52(43.7%) were vocationally trained, 101 (84.9%) had the MICGP or equivalent and 42 (35.3%) had a family planning certificate. Of the 119 respondents, 99 (83.2%) give instruction in natural family planning methods, 114 (95.8%) prescribe oral contraceptives, 102 (85.7%) prescribe the "morning after pill", 40 (33.6%) fit diaphragms and 17 (14.3%) fit intrauterine devices. Only 3 (2.5%) perform male sterilisations. Doctors aged less than 60 years were 1.3 times more likely to prescribe oral contraceptives (p < 0.0001), and were four times more likely to fit diaphragms (p < 0.01). Doctors who hold a family planning certificate were 2.4 times more likely to fit diaphragms (p < 0.001) and were 2.5 times more likely to fit intrauterine devices. As to who should provide these services, the family doctor was the preferred option for 95 (79.8%) with regard to natural family planning, 107 (89.9%) for the contraceptive pill, 76 (63.9%) for the diaphragm, 58 (48.7%) for the intrauterine device, 45 (37.8%) for male sterilisations and 4 (3.4%) for female sterilisations. Younger doctors and those with a family planning certificate were more likely to say that family doctors should provide these services.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1980

The adjustment of basal body temperature measurements to allow for time of waking.

During one menstrual cycle, each of eleven volunteer student nurses at Northwick Park Hospital recorded their vaginal temperature on waking and noted the clock time. Waking times varied between 0530 hours and 1100 hours. Regression analysis revealed significant linear relation between temperature and time of waking, with a slope of 0.086 degrees C/hour (SE, 0.009 degrees C/hr) in the postmenstrual (hypothermal) phase. A rounded adjustment factor of 0.1 degrees C/hour is shown to improve the interpretability of basal body temperature (BBT) charts in a group of seven women regularly using natural family planning methods. The adjustment factor is simple to apply and only involves counting one square on a BBT chart for each hour that the waking time differs from normal.

Body Temperature↗
PubMed1989

Ovulation prediction by monitoring salivary and vaginal electrical resistance with the PEAK Ovulation Predictor.

We investigated the ability of the PEAK Ovulation Predictor to predict the expected date of ovulation in 21 infertile, spontaneously ovulating women. A nonsignificant correlation (R = 0.15; P = .51) existed between the predicted date of ovulation and the day of the serum LH peak. A moderately strong correlation (R = 0.61; P less than .01) was observed between the day of the salivary electrical resistance peak and that of the serum LH peak. However, the serum LH peak occurred between 4-9 days after an identified peak in salivary electrical resistance. Twice-daily urine LH testing correlated strongly with both the serum LH peak (R = 0.93; P = .0001) and the ultrasound-detected day of ovulation (R = 0.81; P = .0001). A statistically significant peak in the mean salivary or vaginal electrical resistance on a particular day relative to the day of the serum LH peak could not be demonstrated. When identified, the nadir in vaginal electrical resistance occurred no earlier than 2 days before the serum LH peak and thus may mark the endpoint of the fertile period for natural family planning methods. We conclude that, whereas the PEAK Ovulation Predictor is of little value in accurately predicting ovulation, measurements of salivary and vaginal electrical resistance may be helpful in timing inseminations. However, for detection of the serum LH surge, twice-daily urine LH testing demonstrated a stronger correlation and narrower frequency distribution than did those determinations based on electrical resistance.

Adult↗
PubMed1995

Effect of occupation on menstrual cycle length: causal model.

The effect of occupational stress on menstrual cycle length was studied prospectively. The hypothesis that occupational stress has a direct or indirect effect on cycle length was tested using path analysis. Twice the number of women involved in active farm, craft, or household work had significantly longer cycle lengths than sedentary beedi workers and clerks. We conclude that occupational stress has a direct effect on menstrual cycle length and that that effect is similar to the effect of exercise on cycle length. The impact of longer cycles on fertility, fertility regulation, and natural family planning methods are also discussed.

Algorithms↗