Note from the Editor: FACTS co-founder Dr. Marguerite Duane and Dr. Alison Contreras (both WSFT members!) coauthored a groundbreaking study on the effectiveness of fertility apps. Media spin on the study is that these apps don’t work, therefore fertility awareness based methods don’t work- but that’s not the real story! Dr. Duane and Dr. Contreras explain their findings to WSFT, in their own words:
Why we did the study:
Our organization published a paper in 2013 that looked at all of the research done on the effectiveness of fertility awareness-based methods (FABMs) for avoiding pregnancy. At that time, we found that there were a number of smartphone apps out there to help women chart their cycles. Many women were using these apps, some were even downloaded over a million times!
So, we wondered, what happens if a woman is using a poorly designed app to avoid pregnancy—and the women gets pregnant unexpectedly? Our concern was that even if the problem was with the app, a woman’s not going to say: “Oh, the app doesn’t work.” They’re going to say fertility awareness based methods don’t work, further perpetuating myths about their ineffectiveness.
What we did:
In 2013, we assembled a team of physicians and experts to develop a rating tool to evaluate fertility awareness apps that women could use to avoid pregnancy. Our rating system was based on one developed by the Family Practice Management journal to evaluate medical apps.
Interestingly, another group of OB/Gyn physicians at Columbia University recently published a review of fertility apps. But they only rated free apps, and then they evaluated them on the basis of six cycles that were all exactly 28 days long. Well, no woman—even with the most regular cycles—has six consecutive cycles that are 28 days long!
Our study used the seven same cycles of women’s observations of fertility signs to evaluate each app. These cycles varied in length and presence of fertility signs one would expect to see in naturally occurring cycles.
What we learned:
We looked at over 95 apps. In the end there were only six apps that had a perfect score in accuracy— meaning they exactly predicted the fertile window, or they did not include any days labeled as infertile that were actually fertile. Apps that did not predict the fertile window still performed well if they advised women to learn how to use an FABM before using the app. You can look at our ratings of the apps here.
Bottom line: can a fertility app help you?
We don’t want to discourage women from using apps! An app can be a very useful tool to help women track their fertility. Many women have their smartphone with them all the time, so it’s easy for them to enter their observations throughout the day.
But, while a woman can use the app to assist her in tracking her signs, she should never rely on it alone. To use a fertility awareness-based method effectively—women should learn from a qualified teacher.
Women are smart – smarter than smartphones. So, encourage women to learn how to make their observations and how to interpret those observations with the guidance from a trained instructor, and use the app as a tool to track those signs.
If there are discrepancies—for example, if you are identifying days of fertility that the app says are not fertile—then perhaps you should follow-up with your teacher, to make sure you are understanding it correctly. Or, maybe you need to look at the app, and make certain it is one of our highly-rated apps!
To find links to qualified teachers who can help you successfully use an FABM, please visit our website.
Dr. Marguerite Duane, a board certified family physician and Adjunct Associate Professor at Georgetown University, is co-founder and Executive Team Leader of FACTS – the Fertility Appreciation Collaborative to Teach the Science.
Dr. Alison Contreras, Director of Programs at FACTS, is also certified as a Fertility Care Practitioner and Sympto-Thermal educator.