Enrollment, Childbearing Motivations, and Intentions of Couples in the Creighton Model Effectiveness, Intentions, and Behaviors Assessment (CEIBA) Study

Stanford, Joseph B.; Porucznik, Christina A.

doi:10.3389/fmed.2017.00147

Cited by 13 publications

(16 citation statements)

References 28 publications

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“…The CrM has standardised protocols for teaching women how to observe, record, and interpret daily vaginal discharge from bleeding and cervical fluid on a daily diary, called a CrM chart, and to use these standardised observations to identify the estimated time of ovulation and days when intercourse is likely to result in pregnancy. [9][10][11][12][13][14][15] The cohorts included: "Creighton Model Effectiveness, Intentions, and Behaviours Assessment" (CEIBA) (2009-2013), a prospective cohort of women without known subfertility, aimed to evaluate and classify pregnancy rates and pregnancy intentions during use of the CrM 16 ; "Creighton Model MultiCenter Fecundability Study" (CMFS) (1990)(1991)(1992)(1993)(1994)(1995)(1996), a retrospective cohort of presumably fertile and subfertile women using CrM, aimed to assess the relationship between vulvar mucus observations and the day and cycle-specific probabilities of conception 17 ; and "Time to Pregnancy in Normal Fertility" (TTP) (2003)(2004)(2005)(2006), a parallel-randomised trial, which aimed to assess the impact of CrM use on time to pregnancy in couples of proven fertility trying to conceive. 13 From CEIBA, all participants (293 women); from CMFS, only data from the presumably fertile new users of CrM (309 women); and from TTP, only participants in the CrM intervention group (68 women) were included for this study (Table S1).…”

Section: Me Thodsmentioning

confidence: 99%

“…Earlier exit could occur due to withdrawal from study, loss to follow-up, pregnancy, or beginning hormonal contraception. 13,16,17 For two of the original studies (CMFS and CEIBA), women were required at entry to the study to be seeking to avoid pregnancy; however, they were able at any point during the study follow-up to seek pregnancy, without exiting the study; 26% and 42% conceived, respectively. 16,17 For TTP, women were required at entry to the study to be intending to conceive; 78% conceived.…”

Section: What This Study Addsmentioning

confidence: 99%

“…13,16,17 For two of the original studies (CMFS and CEIBA), women were required at entry to the study to be seeking to avoid pregnancy; however, they were able at any point during the study follow-up to seek pregnancy, without exiting the study; 26% and 42% conceived, respectively. 16,17 For TTP, women were required at entry to the study to be intending to conceive; 78% conceived. 13 Self-reported demographic information and reproductive, medical, and surgical history of women were obtained primarily from the CrM general intake form.…”

Section: What This Study Addsmentioning

confidence: 99%

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Menstrual bleeding, cycle length, and follicular and luteal phase lengths in women without known subfertility: A pooled analysis of three cohorts

Najmabadi

Schliep

Simonsen

et al. 2020

Paediatric Perinatal Epid

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Background: There is variability between women for days of menstrual bleeding, cycle lengths, follicular phase lengths, and luteal phase lengths, related to age and parity.Objective: To describe total cycle length; anovulatory cycles; follicular and luteal phase lengths; and days and intensity of menstrual and non-menstrual bleeding in women without known subfertility over the course of 1 year.Methods: 581 women (3,324 cycles) with no known subfertility (18-40 years of age) were followed for up to 1 year. Women recorded vaginal bleeding and mucus discharge daily. We used the peak day of cervical mucus as the estimated day of ovulation and the last day of the follicular phase. We used generalised linear mixed models stratified by age and parity to describe menstrual cycle parameters. Results:The majority of women were <30 years of age (74.5%), non-Hispanic White (88.6%), and nulliparous (70.4%). The mean menses length was 6.2 (1.5) days, median 6; cycle length 30.3 (6.7) days, median 29; follicular phase length 18.5 (6.5) days, median 17; and luteal phase length 11.7 (2.8) days, median 12. Nulliparous women aged ≥30 years vs nulliparous women aged < 30 had shorter cycles (29.2 days, 95% confidence interval (CI) 27.8, 30.7 vs 31.5 days, 95% CI 30.8, 32.2) and shorter follicular phases (17.6 days, 95% CI 16.2, 18.9 vs 19.6 days, 95% CI 18.9, 20.2). Among all women, within-woman differences between the longest and shortest menses length >3 days, total cycle length >7 days, follicular phase >7 days, and luteal phase >3 days were found in 11.6%, 43.0%, 41.7%, and 58.8% of women, respectively. Conclusions:Our findings confirm variability between women of menstrual cycle parameters related to age and parity, and also highlight within-woman variability in the follicular and luteal phases. K E Y W O R D S follicular phase, luteal phase, menstrual cycle, menstruation, ovulation, peak day A commentary on this paper appears on pages 328-330 Additional supporting information may be found online in the Supporting Information section. How to cite this article: Najmabadi S, Schliep KC, Simonsen SE, Porucznik CA, Egger MJ, Stanford JB. Menstrual bleeding, cycle length, and follicular and luteal phase lengths in women without known subfertility: A pooled analysis of three cohorts.

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Section: Me Thodsmentioning

confidence: 99%

Section: What This Study Addsmentioning

confidence: 99%

Section: What This Study Addsmentioning

confidence: 99%

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Menstrual bleeding, cycle length, and follicular and luteal phase lengths in women without known subfertility: A pooled analysis of three cohorts

Najmabadi

Schliep

Simonsen

et al. 2020

Paediatric Perinatal Epid

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“…This study is a pooled analysis of three cohorts of heterosexually active women who received instruction in the Creighton Model FertilityCare System (CrM) through CrM centers across USA and Canada, including 'Creighton Model Effectiveness, Intentions, and Behaviors Assessment' (CEIBA; 17 centers in 13 US states and Toronto, Canada; 2009-2013), a prospective cohort of women without known subfertility, aimed to evaluate and classify pregnancy rates and pregnancy intentions during use of the CrM (Stanford and Porucznik, 2017); 'Creighton Model MultiCenter Fecundability Study' (CMFS;6 centers in 4 US states;1990-1996, a retrospective cohort of presumably fertile and subfertile women using CrM, aimed to assess the relationship between vulvar mucus observations and the day and cyclespecific probabilities of conception (Stanford et al, 2003); and 'Time to Pregnancy in Normal Fertility' (TTP; single center in Utah;-2006, a parallel-randomized trial, which aimed to assess the impact of CrM use on time to pregnancy in couples of proven fertility trying to conceive (Stanford et al, 2014). For CEIBA and CMFS, women were required at entry to the study to be seeking to avoid pregnancy; however, they were able at any point during the study follow-up to seek pregnancy (Stanford et al, 2003;Stanford and Porucznik, 2017).…”

Section: Study Design Data Source and Settingmentioning

confidence: 99%

Cervical mucus patterns and the fertile window in women without known subfertility: a pooled analysis of three cohorts

et al. 2021

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STUDY QUESTION What is the normal range of cervical mucus patterns and number of days with high or moderate day-specific probability of pregnancy (if intercourse occurs on a specific day) based on cervical mucus secretion, in women without known subfertility, and how are these patterns related to parity and age? SUMMARY ANSWER The mean days of peak type (estrogenic) mucus per cycle was 6.4, the mean number of potentially fertile days was 12.1; parous versus nulliparous, and younger nulliparous (<30 years) versus older nulliparous women had more days of peak type mucus, and more potentially fertile days in each cycle. WHAT IS KNOWN ALREADY The rise in estrogen prior to ovulation supports the secretion of increasing quantity and estrogenic quality of cervical mucus, and the subsequent rise in progesterone after ovulation causes an abrupt decrease in mucus secretion. Cervical mucus secretion on each day correlates highly with the probability of pregnancy if intercourse occurs on that day, and overall cervical mucus quality for the cycle correlates with cycle fecundability. No prior studies have described parity and age jointly in relation to cervical mucus patterns. STUDY DESIGN, SIZE, DURATION This study is a secondary data analysis, combining data from three cohorts of women: ‘Creighton Model MultiCenter Fecundability Study’ (CMFS: retrospective cohort, 1990–1996), ‘Time to Pregnancy in Normal Fertility’ (TTP: randomized trial, 2003–2006), and ‘Creighton Model Effectiveness, Intentions, and Behaviors Assessment’ (CEIBA: prospective cohort, 2009–2013). We evaluated cervical mucus patterns and estimated fertile window in 2488 ovulatory cycles of 528 women, followed for up to 1 year. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants were US or Canadian women age 18–40 years, not pregnant, and without any known subfertility. Women were trained to use a standardized protocol (the Creighton Model) for daily vulvar observation, description, and recording of cervical mucus. The mucus peak day (the last day of estrogenic quality mucus) was used as the estimated day of ovulation. We conducted dichotomous stratified analyses for cervical mucus patterns by age, parity, race, recent oral contraceptive use (within 60 days), partial breast feeding, alcohol, and smoking. Focusing on the clinical characteristics most correlated to cervical mucus patterns, linear mixed models were used to assess continuous cervical mucus parameters and generalized linear models using Poisson regression with robust variance were used to assess dichotomous outcomes, stratifying by women’s parity and age, while adjusting for recent oral contraceptive use and breast feeding. MAIN RESULTS AND THE ROLE OF CHANCE The majority of women were <30 years of age (75.4%) (median 27; IQR 24–29), non-Hispanic white (88.1%), with high socioeconomic indicators, and nulliparous (70.8%). The mean (SD) days of estrogenic (peak type) mucus per cycle (a conservative indicator of the fertile window) was 6.4 (4.2) days (median 6; IQR 4–8). The mean (SD) number of any potentially fertile days (a broader clinical indicator of the fertile window) was 12.1 (5.4) days (median 11; IQR 9–14). Taking into account recent oral contraceptive use and breastfeeding, nulliparous women age ≥30 years compared to nulliparous women age <30 years had fewer mean days of peak type mucus per cycle (5.3 versus 6.4 days, P = 0.02), and fewer potentially fertile days (11.8 versus 13.9 days, P < 0.01). Compared to nulliparous women age <30 years, the likelihood of cycles with peak type mucus ≤2 days, potentially fertile days ≤9, and cervical mucus cycle score (for estrogenic quality of mucus) ≤5.0 were significantly higher among nulliparous women age ≥30 years, 1.90 (95% confidence interval (CI) 1.18, 3.06); 1.46 (95% CI 1.12, 1.91); and 1.45 (95% CI 1.03, 2.05), respectively. Between parous women, there was little difference in mucus parameters by age. Thresholds set a priori for within-woman variability of cervical mucus parameters by cycle were examined as follows: most minus fewest days of peak type mucus >3 days (exceeded by 72% of women), most minus fewest days of non-peak type mucus >4 days (exceeded by 54% of women), greatest minus least cervical mucus cycle score >4.0 (exceeded by 73% of women), and most minus fewest potentially fertile days >8 days (found in 50% of women). Race did not have any association with cervical mucus parameters. Recent oral contraceptive use was associated with reduced cervical mucus cycle score and partial breast feeding was associated with a higher number of days of mucus (both peak type and non-peak type), consistent with prior research. Among the women for whom data were available (CEIBA and TTP), alcohol and tobacco use had minimal impact on cervical mucus parameters. LIMITATIONS, REASONS FOR CAUTION We did not have data on some factors that may impact ovulation, hormone levels, and mucus secretion, such as physical activity and body mass index. We cannot exclude the possibility that some women had unknown subfertility or undiagnosed gynecologic disorders. Only 27 women were age 35 or older. Our study participants were geographically dispersed but relatively homogeneous with regard to race, ethnicity, income, and educational level, which may limit the generalizability of the findings. WIDER IMPLICATIONS OF THE FINDINGS Patterns of cervical mucus secretion observed by women are an indicator of fecundity and the fertile window that are consistent with the known associations of age and parity with fecundity. The number of potentially fertile days (12 days) is likely greater than commonly assumed, while the number of days of highly estrogenic mucus (and higher probability of pregnancy) correlates with prior identifications of the fertile window (6 days). There may be substantial variability in fecundability between cycles for the same woman. Future work can use cervical mucus secretion as an indicator of fecundity and should investigate the distribution of similar cycle parameters in women with various reproductive or gynecologic pathologies. STUDY FUNDING/COMPETING INTEREST(S) Funding for the three cohorts analyzed was provided by the Robert Wood Johnson Foundation (CMFS), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (TTP), and the Office of Family Planning, Office of Population Affairs, Health and Human Services (CEIBA). The authors declare that they have no conflict of interest. TRIAL REGISTRATION NUMBER N/A

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“…Retirando las publicaciones en los EUA, la producción encontrada se presentó de la siguiente manera: Europa: 10; Asia: 6; África: 3 y Oceanía: 2. También se encontraron cuatro estudios transculturales realizados en: 1) Camerún, Costa Rica, Alemania y China (Chasiotis, Bender, & Hofer, 2014); 2) Inglaterra y Grecia (Cassidy & Sintrovani, 2008); 3) Canadá, EUA y Francia (Jungert et al, 2014) y 4) EUA y Canadá (Stanford & Porucznik, 2017). No se encontraron estudios sobre MP en países Latinoamericanos.…”

Section: Aspectos Generales De Los Estudiosunclassified

Revisión sistemática del estudio de las motivaciones para la parentalidad

Varas

Borsa

2019

revispsi

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La presente revisión sistemática busca identificar, evaluar y sintetizar los estudios empíricos sobre Motivaciones para la Parentalidad publicados en ocho bases de datos electrónicas previamente escogidas. Producto de la combinación de descriptores en inglés, portugués y español se hallaron 1345 artículos que fueron evaluados a través de criterios de exclusión. La muestra final estuvo constituida por 49 artículos que fueron analizados en nueve categorías divididas entre aspectos generales y resultados de las investigaciones. Los resultados muestran un interés creciente en el estudio de las MP desde diferentes teorías pero se constató la carencia de estudios sobre esa temática en el contexto latinoamericano. El modelo TDIB de Warren Miller presentó una mayor aceptación para la instigación y medición del constructo. Se encontraron variables personales, culturales y contextuales relacionadas al estudio de las motivaciones para a parentalidad. Finalmente se describe diferentes limitaciones metodólogas que fueron mencionadas por los investigadores.

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Enrollment, Childbearing Motivations, and Intentions of Couples in the Creighton Model Effectiveness, Intentions, and Behaviors Assessment (CEIBA) Study

Cited by 13 publications

References 28 publications

Menstrual bleeding, cycle length, and follicular and luteal phase lengths in women without known subfertility: A pooled analysis of three cohorts

Menstrual bleeding, cycle length, and follicular and luteal phase lengths in women without known subfertility: A pooled analysis of three cohorts

Cervical mucus patterns and the fertile window in women without known subfertility: a pooled analysis of three cohorts

Revisión sistemática del estudio de las motivaciones para la parentalidad

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