Frank-Herrmann P, Jacobs C, Jenetzky E, Gnoth C, Pyper C, Baur S, Freundl G, Goeckenjan M, Strowitzki T
Department of Gynecological Endocrinology and Fertility Disorders, University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.
Department for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center, Langenbeckstr. 1, 55131, Mainz, Germany.
Arch Gynecol Obstet. 2017 Apr;295(4):1015-1024. doi: 10.1007/s00404-017-4294-z. Epub 2017 Feb 9.
To analyze cumulative pregnancy rates of subfertile couples after fertility awareness training.
A prospective observational cohort study followed 187 subfertile women, who had received training in self-observation of the fertile phase of the menstrual cycle with the Sensiplan method, for 8 months. The women, aged 21-47 years, had attempted to become pregnant for 3.5 years on average (range 1-8 years) before study entry. Amenorrhea, known tubal occlusion and severe male factor had been excluded. An additional seven women, who had initially been recruited, became pregnant during the cycle immediately prior to Sensiplan training: this is taken to be the spontaneous pregnancy rate per cycle in the cohort in the absence of fertility awareness training.
The cumulative pregnancy rate of subfertile couples after fertility awareness training was 38% (95% CI 27-49%; 58 pregnancies) after eight observation months, which is significantly higher than the estimated basic pregnancy rate of 21.6% in untrained couples in the same cohort. For couples who had been seeking to become pregnant for 1-2 years, the pregnancy rate increased to 56% after 8 months. A female age above 35 (cumulative pregnancy rate 25%, p = 0.06), couples who had attempted to become pregnant for more than 2 years (cumulative pregnancy rate 17%, p < 0.01), all significantly reduce the chances of conceiving naturally at some point.
Training women to identify their fertile window in the menstrual cycle seems to be a reasonable first-line therapy in the management of subfertility.
分析生育力意识培训后亚生育夫妇的累积妊娠率。
一项前瞻性观察队列研究对187名亚生育女性进行了为期8个月的随访，这些女性接受了使用Sensiplan方法自我观察月经周期生育期的培训。这些女性年龄在21 - 47岁之间，在研究开始前平均尝试怀孕3.5年（范围1 - 8年）。排除了闭经、已知输卵管阻塞和严重男性因素。另外7名最初招募的女性在Sensiplan培训前的周期中怀孕：这被视为该队列在没有生育力意识培训情况下每个周期的自然妊娠率。
生育力意识培训后，亚生育夫妇在8个观察月后的累积妊娠率为38%（95%可信区间27 - 49%；58例妊娠），显著高于同一队列中未接受培训夫妇估计的21.6%的基础妊娠率。对于尝试怀孕1 - 2年的夫妇，8个月后的妊娠率升至56%。35岁以上女性（累积妊娠率25%，p = 0.06）、尝试怀孕超过2年的夫妇（累积妊娠率17%，p < 0.01），在某些时候都会显著降低自然受孕的几率。
培训女性识别月经周期中的生育窗口似乎是亚生育管理中合理的一线治疗方法。
