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Abstract
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<h5 class="section-title" id="d3698147e173">Objectives</h5>
<p id="P1">The Natural Cycles application is a fertility awareness-based contraceptive
method,
which uses dates of menstruation and basal body temperature to inform couples whether
protected intercourse is needed to prevent pregnancies. Our purpose with this study
is to investigate the contraceptive efficacy of the mobile application by evaluating
the perfect- and typical-use Pearl Index.
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<h5 class="section-title" id="d3698147e178">Study Design</h5>
<p id="P2">In this prospective observational study, 22,785 users of the application
logged a
total of 18,548 woman-years of data into the application. We used these data to calculate
typical- and perfect-use Pearl Indexes, as well as 13-cycle pregnancy rates using
life-table analysis.
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<h5 class="section-title" id="d3698147e183">Results</h5>
<p id="P3">We found a typical-use Pearl Index of 6.9 pregnancies per 100 woman-years
(95% CI:
6.5–7.2), corrected to 6.8 (95% CI: 6.4–7.2) when truncating users after 12 months.
We estimated a 13-cycle typical-use failure rate of 8.3% (95% CI: 7.8–8.9). We found
that the perfect-use Pearl Index was 1.0 pregnancies per 100 woman-years (95% CI:
0.5–1.5). Finally we estimated that the rate of pregnancies from cycles where the
application erroneously flagged a fertile day as infertile was 0.5 (95% CI: 0.4–0.7)
per 100 woman-years. We estimated a discontinuation rate over 12 months of 54%.
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<h5 class="section-title" id="d3698147e188">Conclusions</h5>
<p id="P4">This study shows that the efficacy of a contraceptive mobile application
is higher
than ususally reported for traditional fertility awareness-based methods. The application
may contribute to reducing the unmet need for contraception.
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