No abstract

A prospective study of the reliability of the CUE Fertility Monitor to identify the fertile time of the menstrual cycle was conducted. The device provides a digital measurement of the electrical resistance of saliva (SER) and vaginal secretions (VL). The readings of the device were compared with the fertile time detected by ultrasonography of the growing follicle and estimation of the LH surge to detect ovulation. Thirteen women participated in the study. Sixteen cycles contained both signals (SER, VL) for the beginning and the end of the fertile period. In 2 cycles a CUE signal could not be found by the device. Using a computerized algorithm for evaluation of the CUE signals, the beginning of the fertile period was accurately detected in 14 cycles; in 2 cycles the signal was found less than five days prior to ovulation. The last day of fertility was identified correctly by the CUE Fertility Monitor in 10 cycles; in 6 it was incorrectly identified during the time when the woman was still fertile. This suggests that the CUE Fertility Monitor utilizing the algorithm on which it currently is based cannot be recommended for natural family planning. However, we think that the algorithm for evaluation should be improved as useful signals in the menstrual cycle are detected.

A report on the result of a representative survey of family planning behavior in the Federal Republic of Germany in 1985. Interviewers from the EMNID Institute questioned 1267 German women aged between 15 and 45. Of the women interviewed, 6.1% had been sterilized, while in 1.3% of cases, their partner had been sterilized. Regarding the use of reversible methods of contraception, the following figures were established: pill, 37.1%; IUD, 10.3%; condom, 5.9%; rhythm method, 3.9%; withdrawal 3.4%; vaginal diaphragm, 2.1%; mini-pill, 1.3%; locally effective chemical substances, 0.8%. A few women (1.9%) stated that they used a mixture of methods. No information about family planning methods was offered by 13.4% of the women interviewed. The figures obtained were further differentiated according to age, marital status, school education, religion, number of children, desire for more children, profession, and net income. The authors' own questions concerned the early use of contraceptives, the reasons for abandoning a particular method, the reasons for choosing a certain type of contraceptive, sources of information about family planning, the frequency of changes from one type of contraceptive to another, and opinions about the rhythm method. Finally, the result of the EMNID survey is compared with that of known studies both at home and abroad.

A survey on the family planning behaviour in the Federal Republic of Germany was conducted by interviewers of the EMNID institute in 1985 (n = 1267) and 1989 (n = 950). The survey was carried out with women of 15 to 45 years of age. It was the aim of the 1989 study, to look into changes of the last four years generally and with regard to the increasing knowledge about AIDS. As the use of a combination of family planning methods has significantly increased in 1989, the overall percentage went very much beyond 100% (1985: 106.1% vs 1989: 138.5%). Hence, for comparison of the figures, we omitted any sociodemographic weighting. For each method, the percentage of the users is reported independently of any additional method used. The figures (%) for use of reversible methods of contraception 1985 vs 1989 were as follows: the pill (52.2/61.9), condom (10.0/24.8), IUD (14.1/10.8), withdrawal (5.8/6.6), mini-pill (1.7/6.5), NFP (8.8/6.0), locally applied chemical device (2.6/5.2), vaginal diaphragm (3.0/3.0). The frequency of sterilisation was 6.9 vs 5.7%; the frequency of unwanted pregnancies 26.6 vs 20.9%. 12.3% of the women aged 18-45 years stated, that family planning behaviour has changed in the last two years. 1/3 of these declared, that AIDS has played an important part in their decision. Answers to other questions are compared 1985 vs 1989, like "reasons for selecting a particular method", "need for use of contraceptives", "frequency of unwanted pregnancies" and "importance of natural methods".

A large prospective long-term study with users of natural family planning (NFP) methods has been conducted to analyze the relation between unintended pregnancy rates and sexual behavior with special reference to barrier method use in the fertile phase. Seven hundred and fifty eight NFP beginners, 19-45 years of age, 14870 cycles, 28 unintended pregnancies were studied. Of the couples, 54.2% use NFP only or predominantly and 45.9% use mixed methods (additional barrier method use in the fertile phase in 55.7% of the cycles). The overall pregnancy rate after 12 cycles of exposure is 2.2% according to the actuarial method. There is no significant difference between NFP users and mixed methods users and also no significant effect of duration of use in the first 5 years of exposure. During "perfect use" the pregnancy rate at 12 months is 0.63%. When only protected intercourse takes place in the fertile phase the pregnancy rate is 0.45%. The symptothermal method of NFP is most unforgiving for imperfect use (unprotected intercourse in the fertile phase). However, it is extremely effective when either abstinence or protected intercourse is used in the fertile phase.