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Updated: Jun 17, 2025

Methods for Studying Uterine Contributions to Pregnancy Establishment in an Ovariectomized Mouse Model
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Evaluating Pregnancy Rates in Fertility Awareness-Based Methods for Family Planning: Simulated Comparison of Correct

Joseph B Stanford1, Marguerite Duane1,2, Rebecca Simmons3

  • 1Office of Cooperative Reproductive Health, Division of Public Health, University of Utah School of Medicine, Salt Lake City, UT, US.

The Linacre Quarterly
|August 6, 2024
PubMed
Summary

Fertility awareness-based methods (FABMs) effectiveness is best measured by the correct use pregnancy rate. This metric accurately reflects user behavior, unlike the method-related pregnancy rate, which can be misleading.

Keywords:
Correct usefertility awarenessfertility awareness-based methodsmethod effectivenessnatural family planningperfect usepregnancy ratessimulation study

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Area of Science:

  • Reproductive Health
  • Contraception
  • Biostatistics

Background:

  • Fertility awareness-based methods (FABMs) rely on user behavior to prevent pregnancy.
  • Accurate effectiveness measures are crucial for informed decision-making by couples and clinicians.
  • Existing studies often report method-related pregnancy rates, but their accuracy is questioned.

Purpose of the Study:

  • To quantitatively evaluate the relationship between method-related pregnancy rates and correct use pregnancy rates in FABM studies.
  • To demonstrate the bias in method-related pregnancy rates due to inconsistent method use.
  • To propose essential elements for assessing correct use cycles in FABM research.

Main Methods:

  • A simulation study was conducted to compare two effectiveness measures: method-related pregnancy rate and correct use pregnancy rate.
  • The simulations analyzed how variations in user behavior (correct use, intermediate use, targeted use) affect pregnancy rate calculations.
  • The study focused on the cumulative proportion of pregnancies in relation to different denominators representing user adherence.

Main Results:

  • The method-related pregnancy rate is artificially lowered when users exhibit intermediate or inconsistent method use.
  • Conversely, the correct use pregnancy rate provides an unbiased estimate of FABM effectiveness, remaining constant regardless of intermediate use.
  • Increased intermediate use leads to a higher total pregnancy rate but an artificially lower method-related pregnancy rate.

Conclusions:

  • The correct use pregnancy rate is a more reliable metric for assessing the true effectiveness of FABMs.
  • Method-related pregnancy rates can be misleading due to inconsistent user adherence.
  • Standardizing the assessment of correct use cycles is vital for accurate FABM effectiveness reporting.