Grant Title

Randomized Comparison of Two Internet-Supported Methods of Natural Family Planning

Document Type

Grant Materials

Publication Date



Studies consistently show that women want safe, effective, easy to use, and convenient methods of family planning (Arévalo,1997; Severy 2001). Although Natural Family Planning (NFP) methods are free of side effects, they are often ineffective and complex to learn and use (Grimes et al. 2005). Efforts have occurred over the past 10 years to simplify the teaching and use of NFP methods and increase their efficacy. These efforts include the development of low tech calendar-based methods (Arévalo et al. 2004), simplifying instructions (Frank-Herrmann et al. 2005), and developing accurate biological markers of fertility (Guida et al. 1999).

A new high-tech electronic method to monitor fertility has recently been developed to help women determine their fertile window with ease, convenience, and accuracy (May 2001). This high-tech electronic hormonal fertility monitor (EHFM), called the ClearBlue Easy Fertility Monitor (Swiss Precision Diagnostics), measures urinary metabolites of estrogen and LH and provides the user with a daily indication of “low,” “high” and “peak” fertility. A recent cohort study demonstrated that EHFM was effective when used as an aid to avoid pregnancy along with cervical mucus monitoring (CMM) as a second marker of fertility (Fehring, et al., 2007) and users reported high satisfaction with the method (Severy et al. 2006).Despite this promising research, there is one task that has not yet been accomplished. There are no randomized comparison studies of EHFM NFP methods with NFP methods that utilize traditional biological markers of fertility (i.e., the Ovulation Method with cervical mucus monitoring and/or the symptom-thermal method with basal body temperature and cervical mucus monitoring combined).

Other recent efforts to increase the ease of use and convenience of NFP methods are the use of internet support for NFP instructions and automated online fertility charting (Fehring 2004; Fehring 2005; Weschler 2005). Although there have been studies to determine the knowledge base of an online hormonal contraceptive program, there have been only one pilot study to determine the efficacy of internet-based instructions for NFP methods used to avoid pregnancy (Kaskowitz et al. 2007; Fehring et al., 2011) and to determine the efficacy and satisfaction of using an online fertility charting system for NFP purposes (Fehring, et al., 2011).