CC BY-NC-ND 4.0 · Semin Reprod Med 2024; 42(02): 090-099
DOI: 10.1055/s-0044-1791702
Review Article

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

1   Department of Family Medicine, Bruyere Research Institute, University of Ottawa, Ottawa, Ontario, Canada
,
Rene Ecochard
2   Hospices Civils de Lyon, Universite de Lyon, Lyon, France
3   Laboratoire de Biometrie et Biologie Evolutive, Centre National de la Recherche Scientifique, Equipe Biostatistique-Sante, Universite Lyon 1, Villeurbanne, France
› Author Affiliations
Funding None.

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.

Supplementary Material



Publication History

Article published online:
08 October 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Stanford JB, Willis SK, Hatch EE, Rothman KJ, Wise LA. Fecundability in relation to use of mobile computing apps to track the menstrual cycle. Hum Reprod 2020; 35 (10) 2245-2252
  • 2 Duane M, Contreras A, Jensen ET, White A. The performance of fertility awareness-based method apps marketed to avoid pregnancy. J Am Board Fam Med 2016; 29 (04) 508-511
  • 3 Johnson S, Marriott L, Zinaman M, Glei D. Smartphone apps for fertility tracking: How do they measure up?. Journal of Contraception and Reproductive Health Care 2018; 23 (04) 265-270
  • 4 Freis A, Freundl-Schütt T, Wallwiener LM. et al. Plausibility of menstrual cycle apps claiming to support conception. Front Public Health 2018; 6: 98
  • 5 Blair DL, Morgan HM, McLernon DJ. Women's perspectives on smartphone apps for fertility tracking and predicting conception: a mixed methods study. Eur J Contracept Reprod Health Care 2021; 26 (02) 119-127
  • 6 van de Roemer N, Haile L, Koch MC. The performance of a fertility tracking device. Eur J Contracept Reprod Health Care 2021; 26 (02) 111-118
  • 7 Berglund Scherwitzl E, Gemzell Danielsson K, Sellberg JA, Scherwitzl R. Fertility awareness-based mobile application for contraception. Eur J Contracept Reprod Health Care 2016; 21 (03) 234-241
  • 8 Pearson JT, Chelstowska M, Rowland SP. et al. Natural cycles app: contraceptive outcomes and demographic analysis of UK users. Eur J Contracept Reprod Health Care 2021; 26 (02) 105-110
  • 9 Hilgers TW. The identification of postovulation infertility with the measurement of early luteal phase (peak day +3) progesterone production. Linacre Q 2020; 87 (01) 78-84
  • 10 Leiva R, Bouchard T, Boehringer H, Abulla S, Ecochard R. Random serum progesterone threshold to confirm ovulation. Steroids 2015; 101: 125-129
  • 11 Leiva R, DiRienzo L. Combination of home-based hormonal and mobile technology for virtual monitoring of menstrual cycles. Ann Fam Med 2021; 19 (02) 180
  • 12 A prospective multicentre trial of the ovulation method of natural family planning. I. The teaching phase. Fertil Steril 1981; 36 (02) 152-158
  • 13 Stanford JB, Smith KR, Dunson DB. Vulvar mucus observations and the probability of pregnancy. Obstet Gynecol 2003; 101 (06) 1285-1293
  • 14 Leiva R, Burhan U, Kyrillos E. et al. Use of ovulation predictor kits as adjuncts when using fertility awareness methods (FAMs): a pilot study. J Am Board Fam Med 2014; 27 (03) 427-429
  • 15 Gibbons T, Reavey J, Georgiou EX, Becker CM. Timed intercourse for couples trying to conceive. Cochrane Database Syst Rev 2023; 9 (09) CD011345
  • 16 Practice Committee of the American Society for Reproductive Medicine. Electronic address: asrm@asrm.org, Practice Committee of the American Society for Reproductive Medicine. Fertility evaluation of infertile women: a committee opinion. Fertil Steril 2021; 116 (05) 1255-1265
  • 17 Practice Committees of the American Society for Reproductive Medicine and the Society for Reproductive Endocrinology and Infertility. Diagnosis and treatment of luteal phase deficiency: a committee opinion. Fertil Steril 2021; 115 (06) 1416-1423
  • 18 Evans-Hoeker E, Pritchard DA, Long DL, Herring AH, Stanford JB, Steiner AZ. Cervical mucus monitoring prevalence and associated fecundability in women trying to conceive. Fertil Steril 2013; 100 (04) 1033-1038.e1
  • 19 Martyn F, McAuliffe FM, Wingfield M. The role of the cervix in fertility: is it time for a reappraisal?. Hum Reprod 2014; 29 (10) 2092-2098
  • 20 Écochard R, Leiva R, Bouchard T, Boehringer H, Iwaz J, Plotton I. Descriptive analysis of the relationship between progesterone and basal body temperature across the menstrual cycle. Steroids 2022; 178: 108964