This Op-Ed was previously published on Huffington Post:
I vividly remember the excitement of my initial doctor’s appointment after finding out I was pregnant with my first son. The doctor pulled out a circular piece of paper and “based on the date of my last period” confidently declared my son’s due date.
I immediately knew the date he concluded was incorrect. As a result of a number of personal circumstances, I was aware of the exact day I conceived. Despite being certain about his inaccuracies, at the time I had little confidence to refute his expert opinion. Needless to say, my son arrived 14 days later than what the doctor had predicted.
Technology has advanced tremendously since that memorable day at my doctor; and women can now track their reproductive health on their mobile devices using specialized fertility apps. So it surprised me when I came across a recent medical study that portrayed fertility apps as generally ineffective. Especially since the study focused solely on the calendar method- the same, outdated fertility method that left me questioning my doctor 10 years ago.
With progress in in our understanding of women’s reproductive health and new, proven apps that cater to individual cycles, why do some choose to focus on the single most outdated method that assumes all women’s menstrual cycles are the same? I believe the first step when attempting to overcome Trying To Conceive (TTC) challenges should be for women to gain a deep understanding of their own reproductive cycle before jumping into costly (and sometimes unnecessary) medical interventions.
The Office of Women’s Health, a branch of the US Department of Health and Human Services, lists “Natural Family Planning/Rhythm Method” as a single combined method of contraception. As a woman of science, I find this overly simplified view to be outdated and misleading.
The Rhythm Method is a calendar-based method where women physically chart their cycle on a calendar and count days until ovulation. The idea is that with a presumed 28-day cycle, a woman would ovulate on day 15 every month, like clockwork.
Unfortunately, this method doesn’t take into consideration that menstrual cycles vary from person to person and month to month, and often fluctuate based on numerous internal and external factors. In fact, based on the cycles of a representative sample from the 100,000 women currently tracking their periods in the Kindara app, we see that less than 25% of women ovulate on day 15 (information gathered on September 10th, 2016). Counting days on a calendar to estimate ovulation based on national averages is ineffective.
Instead, we should be focusing on educating women about the scientifically-proven-and effective fertility methods, most of which have been employed by fertility apps for years. The Symptothermal Method, for example, considers multiple data points specific to the user to best determine when ovulation occurs. This method has been shown to be 99.4% effective at avoiding pregnancy when properly used. Additionally, 76% of women with normal fertility become pregnant in the first month using the Symptothermal Method (compared to 75% of women who are pregnant within 6 months without the method).
Take, for example, a recent study conducted by Setton et al. where they concluded fertility apps are ineffective because they did not predict the fertile window based on standard data entry. Yep, they proved yet again that the calendar method doesn’t work.
What Setton’s study completely missed is the importance of apps that utilize the Symptothermal method. We developed Kindara specifically to help women chart Basal Body Temperature (BBT) and Cervical Fluid (CF) for optimal understanding of fertility. The accuracy and utility of this method is far superior to standard calendar entry. While the Setton article has good intent (apps should indeed be tested for their effectiveness) it misses the point by not utilizing all of the features of these apps to do a true test.
Through charting BBT and CF a woman can tell if she has actually ovulated during a particular cycle, since it is possible to have a period without ovulating. Charting can also help a woman determine if she is having a short luteal phase (post-ovulatory phase of the cycle), which could make it difficult to carry a pregnancy to term. The information from these specific in-app charts can help doctors differentiate if a woman is having difficulty becoming pregnant, or if she is becoming pregnant and having early stage miscarriages.
No two women are the same, and fertility apps aim to help women receive the best individualized care based on each individual’s specific data. Well-designed apps that incorporate the proven science of the Symptothermal Method can bridge communication between women and their healthcare providers, and provide a clearer view of the user’s total reproductive health.
If a fertility app existed when I conceived my first son, I could have shared my personal chart with my doctor as evidence of when my ovulation actually occurred. I would have had a more accurate due date, and most importantly the confidence to speak up and be a partner in my personal reproductive health plan.
How well do you know your body? As the old saying goes, knowledge is power, and the more you know about your body the better equipped you will be to reach your fertility goals and communicate with your healthcare provider.