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The purpose of this research study is to compare the effectiveness of two natural family planning (NFP) methods that are provided over the internet by the Marquette University Institute for Natural Family Planning. One of the NFP methods is the use of a hand held electronic hormonal fertility monitor. The other method involves the self-observation of cervical mucus to track fertility. Both of the methods will involve placing information about fertility into an online charting system that automatically displays the days of fertility and infertility. The investigators are also interested in the influence of mutual motivation by the woman and her partner in using these methods to avoid pregnancy. The investigators hypothesize that there will be lower unintended pregnancy rates among those couples who use the electronic hormonal fertility monitor and among those couples who have a strong motivation to avoid pregnancy.
The Office of Population Affairs (OPA) of the Department of Human Development recently submitted a call for proposals for research on methods of natural family planning (NFP). The department chairs of OPA have recognized that relatively few women in the United States use natural methods of family planning, especially in the Title X Family Planning programs and clinics. They wanted researchers to develop studies to help increase the use and the efficacy of these methods, and, furthermore, wanted to understand why the methods are not used more. Reasons why only about 0.2% of US women use natural methods of birth control are they are often difficult to use, they are relatively ineffective, and there is a lack of access to properly trained NFP teachers. At Marquette University we have developed simple methods of NFP that utilize an electronic fertility monitor that measures female reproductive hormones, self cervical mucus monitoring that estimates the fertile window, and a simple fertility formula to help estimate the beginning and end of the fertile window. We also have developed a Web site that offers easy access to information on NFP, electronic charting, and professional nurses with specialization in teaching NFP.
The specific purpose of our study is to determine the efficacy, satisfaction, ease of use, and motivation in using an internet based NFP method that utilizes an electronic hormonal fertility monitor plus a simple fertility formula (i.e., EHFM-NFP) within an online professional-nurse supported system. Since there are few studies that compare methods of NFP, another aim of this study is to compare an internet based EFHM-NFP method with an internet based traditional cervical mucus monitoring (CMM) NFP method - both methods were developed at Marquette University. Please note that we have 3 published efficacy studies of the Marquette Method.
The specific research questions that will be asked are:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Electronic hormonal fertility monitoring | Experimental | Use of an electronic hormonal fertility monitor that measures urinary estrogen and LH and provides users with low, high, or peak fertility readings. |
|
| Cervical mucus monitoring | Active Comparator | Self-monitoring of externally observed cervical mucus to determine level of fertility. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Electronic hormonal fertility monitoring | Behavioral | Use of an electronic hormonal fertility monitor that provides three levels of fertility; low, high, and peak. Monitor is based upon urinary levels of E3G (estrogen) and LH. Monitor readings are placed in an electronic charting system on the Internet. |
| Measure | Description | Time Frame |
|---|---|---|
| Unintended Pregnancies | Survival analysis of based on unintended pregnancies and correct use menstrual cycles (for perfect use analysis) and typical use (based on total number of menstrual cycles) -- to be calculated at 1, 3, 6, and 12 months of use. A Kaplan-Meier survival curve over that time period will be displayed to show change. | 1, 3, 6, and 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| user satisfaction, ease of use, mutual motivation | To determine if there is significant change from baseline (at 1 month) to 3, 6 and 12 months in the outcome measure of "satisfaction and ease of use" - repeated measure analysis (ANOVA) will be used. Change in motivation to avoid pregnancy from baseline (i.e., before charting the first menstrual cycle) through 12 months of use will also be analyzed for changes by repeated measure analysis. We will also use repeated measure analysis to determine differences in the outcome measures between the two study groups. |
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For Female participants
Inclusion Criteria:
Exclusion Criteria:
For Male Participants
Inclusion criteria:
Exclusion criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Richard J Fehring, PhD | Marquette University College of Nursing | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Marquette University College of Nursing | Milwaukee | Wisconsin | 53201-1881 | United States | ||
| Marquette University |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 18997569 | Background | Fehring RJ, Schneider M, Barron ML. Efficacy of the Marquette Method of natural family planning. MCN Am J Matern Child Nurs. 2008 Nov-Dec;33(6):348-54. doi: 10.1097/01.NMC.0000341254.80426.32. | |
| 17371516 | Background | Fehring RJ, Schneider M, Raviele K, Barron ML. Efficacy of cervical mucus observations plus electronic hormonal fertility monitoring as a method of natural family planning. J Obstet Gynecol Neonatal Nurs. 2007 Mar-Apr;36(2):152-60. doi: 10.1111/j.1552-6909.2007.000129.x. |
| Label | URL |
|---|---|
| Marquette NFP Institute Research Web page | View source |
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| ID | Term |
|---|---|
| D036881 | Long-Term Synaptic Depression |
| D015190 | Blood Glucose Self-Monitoring |
| D010061 | Ovulation Detection |
| ID | Term |
|---|---|
| D009473 | Neuronal Plasticity |
| D009424 | Nervous System Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
| D001774 | Blood Chemical Analysis |
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|
|
| Self-monitoring | Behavioral | Self-monitoring of externally observed cervical mucus to determine level of fertility. |
|
|
| 1, 3, 6 and 12 months; mutual motivation monthly |
| Milwaukee |
| Wisconsin |
| 53201-1881 |
| United States |
| 19370902 | Background | Fehring RJ, Schneider M, Barron ML, Raviele K. Cohort comparison of two fertility awareness methods of family planning. J Reprod Med. 2009 Mar;54(3):165-70. |
| 23153900 | Derived | Fehring RJ, Schneider M, Raviele K, Rodriguez D, Pruszynski J. Randomized comparison of two Internet-supported fertility-awareness-based methods of family planning. Contraception. 2013 Jul;88(1):24-30. doi: 10.1016/j.contraception.2012.10.010. Epub 2012 Nov 12. |
| D019963 | Clinical Chemistry Tests |
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D003940 | Diagnostic Techniques, Endocrine |
| D008991 | Monitoring, Physiologic |
| D000085263 | Self-Testing |
| D012648 | Self Care |
| D013812 | Therapeutics |
| D008919 | Investigative Techniques |
| D010050 | Ovarian Function Tests |
| D003944 | Diagnostic Techniques, Obstetrical and Gynecological |
| D012099 | Reproductive Techniques |