Fertility Awareness-Based Methods for Family Planning: A Systematic Review.

Fertility awareness-based methods (FABMs) have been used for a long time for family planning. This systematic review evaluates the efficacy and outcomes of various FABMs used for family planning. For this systematic review, a literature search was carried out in PubMed, Web of Science, CINAHL Ultimate, and Google Scholar. The inclusion criteria included women aged 18-49 undergoing FABMs for either contraception or to conceive. The search was limited from 2014 to 2024. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) and the Revised Cochrane risk of bias tool for randomized trials (ROB2). A total of 16 studies, including 20,339 participants, were included. The age of the participants ranged from 18 to 47 years. Regarding study design, 11 were prospective, two were retrospective, two were randomized, and one was a longitudinal study. The average success rate of all FABMs was 69.5%. In five studies, the success rate was above 90%. Among factors that influenced the success rate were the timing of intercourse and adherence to method protocols. FABMs are effective tools for enhancing the success rate of family planning. However, FABMs when enhanced with digital technology are particularly effective for both contraception and conception. Adequate user education and consistent application are essential to optimize outcomes.