fertility awareness
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BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e051710
Author(s):  
Sze Ling Chan ◽  
Julian Thumboo ◽  
Jacky Boivin ◽  
Seyed Ehsan Saffari ◽  
Shanqing Yin ◽  
...  

IntroductionBirth rates have been declining in many advanced societies including Singapore. We designed two interventions with vastly different resource requirements, which include fertility education, personalised fertility information and a behavioural change component targeting modifiable psychological constructs to modify fertility awareness and childbearing intentions. We aim to evaluate the effect of these two interventions on knowledge, attitudes and practice around childbearing compared with a control group among young married couples in Singapore and understand the implementation factors in the setting of an effectiveness-implementation hybrid type 1 three-arm randomised trial.Methods and analysisWe will randomise 1200 young married couples to no intervention (control), Fertility Health Screening group (FHS) or Fertility Awareness Tools (FAT) in a 7:5:5 ratio. Couples in FHS will undergo an anti-Mullerian hormone test and semen analysis, a doctor’s consultation to explain the results and standardised reproductive counselling by a trained nurse. Couples in FAT will watch a standardised video, complete an adapted fertility status awareness (FertiSTAT) tool and receive an educational brochure. The attitudes, fertility knowledge and efforts to achieve pregnancy of all couples will be assessed at baseline and 6 months post-randomisation. Birth statistics will be tracked using administrative records at 2 and 3 years. The primary outcome is the change in the woman’s self-reported intended age at first birth between baseline and 6 months post-randomisation. In addition, implementation outcomes and cost-effectiveness of the two interventions will be assessed.Ethics and disseminationThis study has been reviewed and approved by the Centralized Institutional Review Board of SingHealth (2019/2095). Study results will be reported to the study funder and there are plans to disseminate them in scientific conferences and publications, where authorship will be determined by the International Committee of Medical Journal Editors guidelines.Trial registration numberNCT04647136; ClinicalTrails.gov Identifier.


2021 ◽  
Author(s):  
Bola Grace ◽  
Jill Shawe ◽  
Geraldine Barrett ◽  
Nafisat Ohunene Usman ◽  
Judith Stephenson

Abstract Introduction The importance of improving men’s and women’s knowledge of sexual and reproductive health has been emphasised in numerous global health policies. Fertility awareness literature highlights a disproportionately higher number of articles related to pregnancy-prevention compared to pregnancy-planning, which is justifiable in many contexts. However, the recent concerted effort to improve fertility awareness warrants a closer investigation of basic terminologies in the field. For example, although the term family planning encompasses attaining the desired number of children and spacing pregnancies, it is typically attributed to the practice of limiting the number of children.MethodsWe conducted 35 qualitative in-depth interviews on men, women and healthcare professionals who were sampled from a UK cross-sectional survey. We asked participants about terms such as ‘family planning’ and ‘family building’ to elicit views and explored the appropriateness of the term “family building.” Data were transcribed and analysed via Framework analysis. Results When asked what ‘family planning’ meant to them, study participants stated that the term meant the avoidance of pregnancy. They viewed it as an “umbrella term for the use of contraception methods,” that “paradoxically, the term family planning almost has a negative connotation regarding having a family,” but could not state similar terminology for planning a family. Reasons cited for this perspective include the focus of school education and usage in clinical settings. Conclusions In the absence of an explicit definition in literature, we generated a new definition for family building as follows: “Family building refers to the construction or formation of a family, which can include steps or actions taken by an individual towards having children. In contrast to family planning, the intent focuses on pregnancy planning and childbearing rather than pregnancy prevention. However, it can also include actions taken to space the number of children one has.” Some balance in the global public health messages, including bridging the gap in reproductive health literature, may contribute to the effort to improve fertility knowledge. Additionally, this has implications for promotion of preconception and optimising reproductive health in order to enable men and women achieve their desired fertility intentions, whatever they may be.


2021 ◽  
Vol 5 (2) ◽  

Introduction: The FemCap is an FDA, and CE mark approved barrier contraceptive device. To our surprise, it was found to apply to several basic unmet reproductive health needs for women. a) The FemCap is time tested hormone-free contraceptive device, b) It offers an alternative delivery system to the traditional vaginal applicator, c) It provides a safe and effective non-surgical treatment for stress urinary incontinence (SUI), d) It enhances the fertility awareness methods. Methodology: We conducted several pilot studies to explore the potential of the FemCap. We compared the retention and distribution of stained vaginal gel if inserted with the FemCap versus the same amount of gel when inserted by the vaginal applicator. We compared the safety and effectiveness of the FemCap with a vaginal pessary that treats stress urinary incontinence. We collected the fertile cervical mucous (Spinnbarkeit) with the FemCap to determine the time of ovulation to enhance the fertility awareness method. Results: The FemCap is a well-established, safe, and effective non-hormonal contraceptive. The retention and distribution of stained vaginal gel inserted with the FemCap is more efficient than the vaginal applicator. The FemCap’s unique storage groove for microbicides can potentially be utilized to treat sexually transmitted infections (STIs) topically. FemCap is also found to be substantially equivalent to the incontinence pessary in controlling stress urinary incontinence (SUI). The FemCap did also help to collect fertile cervical mucous (Spinnbarkeit) when using fertility awareness methods. Conclusion: The multipurpose FemCap would be an ideal tool for nurse practitioners, midwives, and physicians to provide women with safe and effective, hormone-free contraception. It also provides an efficient delivery system for spermicide/microbicides. It is much safer for non-surgical management of stress urinary incontinence. It is useful for the enhancement of fertility awareness methods. It is non-invasive and can be inserted and removed by the woman without professional help.


2021 ◽  
pp. 395-446
Author(s):  
Shelley Raine

This chapter begins with the principles of contraception (choice, access, measures of effectiveness) and a risk/benefit analysis and eligibility of different types. It explains emergency contraception. The chapter goes on to discuss different formulations, preparations, methods of use (or administration and insertion). This includes the combined oral contraceptive pill (COCOP), the transdermal patch, intra vaginal rings, progestogen-only pills, the subdermal implant, injectables, intra-uterine devices and systems, barrier methods for both male and female use, and spermicides. Finally it covers fertility awareness, and the sterilization of women and men.


2021 ◽  
pp. 293-307
Author(s):  
Florence Pasche Guignard

Author(s):  
Carlotta Favaro ◽  
Jack T. Pearson ◽  
Simon P. Rowland ◽  
Anne Marie Jukic ◽  
Magda Chelstowska ◽  
...  

2021 ◽  
Vol 116 (3) ◽  
pp. e269-e270
Author(s):  
Michael Schenk Dr ◽  
Nina Reinschissler ◽  
Helene Schenk ◽  
Gregor Weiss Dr
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