What Does Tg Mean in Natural Family Planning

Open access peer-reviewed chapter

The Role of Information Technologies in Natural Family Planning

Submitted: October 3rd, 2019 Reviewed: March 16th, 2020 Published: Apr 22nd, 2020

DOI: x.5772/intechopen.92136

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Abstruse

Liberty is needed in family unit planning and in the decision on how many children the couple will take, non to be influenced past a third person, political situations, or religious conviction. In that location is a need for information, instruction, and communication about possibilities in natural family unit planning, in order to exist able to choose the correct way, because there are many options fifty-fifty without side effects. Nowadays, we tin can add to these traditional possibilities of natural family planning also data technologies and electronic devices, which are increasingly available to a large portion of the population. Their reliability, with right usage, is comparable to the barrier methods and in some cases to hormonal contraceptive methods. Adjacent development of these devices can more increment their reliability. Of course, the agile approach of users is needed.

Keywords

• natural family planning
• basal body temperature
• cervical fungus
• symptothermal method
• information technologies
• electronic devices
• digitized records
• application
• evaluation
• reliability
• cost

• Zuzana Judáková*

  • Faculty of Electric Engineering and Information Engineering science, Department of Electromagnetic and Biomedical Engineering, University of Žilina, Žilina, Slovak Republic

*Address all correspondence to: zuzana.judakova@feit.uniza.sk

1. Introduction

"Natural family unit planning (NFP) is a term used to describe methods of planning or preventing pregnancy based on observation of naturally occurring signs and symptoms of the fertile and infertile phases of the menstrual bicycle. People who use NFP to avoid or delay pregnancy abstain from intercourse on potentially fertile days. Those wanting to achieve pregnancy use NFP to identify the fertile phase and hence maximize the probability of pregnancy. Techniques include the basal body temperature method, the cervical mucus (Billings') method, the symptothermal method, and the calendar or rhythm method (Ogino-Knaus). It is important to note that NFP is not a method of contraception but rather a technique for determining the fertile menses; abstinence during this period is what prevents pregnancy. The methods are thus likely to be of interest to people who, for any reason, do not wish to apply mechanical or pharmacological contraceptives" [1]. This is the definition given past the World Health Organization in their publication about NFP. To this definition, some additional notes have to exist added: NFP is a manifestation of a responsible attitude towards family and own health, and it helps a adult female to know how her torso works, which has many benefits not only in family planning. The homo body is the complex sensitive organisation. If the woman knows her ain body and makes regular cocky-monitoring, she knows when everything is alright and when it is needed to seek expert help. Nosotros must not forget either the psychological side of NFP, because the intercourse is non only a physiological human action but it influences an individual's psychological state or soul and a mutual relationship, specially in marriage. If both partners identify the employ of NFP methods, this strengthens their common bond. The use of these methods is becoming a lifestyle. No known side furnishings and no external factors that affect or damage this sophisticated, naturally designed fertility mechanism are also a do good. The disadvantages include more than demanding, merely not impossible, use during nonstandard situations such as breastfeeding, menopause, the medications affecting the menstrual bike, previous contraception use, and irregular cycles. The solution of some disadvantages and increase in the comfort of using NFP methods bring information technologies in the form of electronic devices and applications.

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ii. Natural family planning methods

Natural family planning methods are those that don't use a chemical or mechanical contraceptive. The footing of their apply is the observation of fertility symptoms and conclusion of fertile and infertile windows and periodical abstinence practice. Each method uses another symptom singly or a combination of symptoms.

two.1 Cervical fungus method

This method is known as the Billings Ovulation Method (BOM). The method is based on the ascertainment of the structure and density of cervical mucus. Cervical mucus is a normal, healthy secretion of the cervix formed past the effects of estrogen hormones, unremarkably appears on the genitals a few days before ovulation and at the time of ovulation, and is usually lost after ovulation. The cervical mucus is a very positive sign of fertility as it provides the sperm with nutrition and a suitable environment for movement. Observations are indicated in Figure one to obtain an accurate record of the grade of the cycle and the onset of fertile days. The method has iv rules: three preovulatory rules and 1 subsequently ovulation rule—the dominion of the peak. Method requirements are an authentic ascertainment, authentic records, and motivation and cooperation of the couple. Past post-obit the rules of the method to delayed conception, efficiency is greater than 99% [i]. Another modification of this cervical mucus method is Creighton Model FertilityCare System (CrMS); nevertheless, it uses a different picture show lexicon (PD) and standardized terminology. CrMS forms the basis for Natural Procreative Technology (NaProTECHNOLOGY) successfully used for achieving pregnancy in infertility problems and miscarriage. In improver, NaProTECHNOLOGY uses a series of sonographic examinations during dissimilar parts of the cycle and repeated claret tests to identify the causes of infertility. The primary idea of this type of infertility treatment is a minimal intervention in the female wheel and the endeavour to avoid hormonal stimulation or in vitro fertilization (IVF), in accordance with NFP [ii].

Figure 1.

BOM record table.

2.ii Basal temperature method

Basal body temperature (BBT) is the temperature of a relaxed human trunk measured in a moment after waking upwards after a minimum of 6 h of night sleep, unaffected past food, drink, or physical exertion. Later ovulation, the ruptured follicle becomes a yellow corpus luteum and begins to produce the hormone progesterone, which causes a postovulatory increment in BBT. This ascension lasts until the next menstruation. Two-level temperature curves are therefore typical for a healthy fertile woman, as shown in Effigy 2. There are precise rules to record the temperature curve; temperature is measured to a minimum of two decimal places. The BBT shift typically occurs ane 24-hour interval afterwards the day of ovulation, and so the fertile phase can be determined 5 days before the temperature shift and 2 days after it. This calculation of fertile window includes twofold ovulation and sperm life span. Approximately 1 twenty-four hours before ovulation, a decrease of BBT can exist observed typically [3].

Figure ii.

BBT records.

2.3 Symptothermal method

The combination of both previous methods, cervical mucus and basal temperature method, is the symptothermal method that was developed by Austrian Dr. Josef Rötzer [iv]. As the name itself suggests, the method used to menstrual bike evaluation basal torso temperature and symptoms of fertility, viz., cervical mucus and cervix changes. Another symptom can be used too, e.thousand., chest tenderness and lower abdominal pain. All observed fertile symptoms are recorded in special record tabular array and evaluated by 11 rules—4 rules for specifying infertility earlier ovulation and 7 rules for specifying postovulatory infertility. For evaluating one cycle, it is not needed to utilize every rule. The most appropriate rule applies. The reliability of the method was determined by the Pearl Alphabetize, PI 0.4 [5, 6].

two.4 Calendar/rhythm method

The calendar method (sometimes chosen the Ogino-Knaus method) assumes that a woman will have a regular menstrual wheel. The observed symptom is only the starting time 24-hour interval of menstruation. From the length of the previous cycles (shortest and longest), it determines the get-go and finish of the fertile period of the following cycle according to certain rules (each writer states slightly different rules). This method is obsolete and unreliable mainly for irregular cycles. Pearl Index of this method was estimated on 18.v + ane.8 [7].

The successful use of NFP methods clearly involves a thorough study of the rules of a particular method and their consistent adherence. The success rate decreases significantly with careless use and application of the rules. Human gene failure is the most common cause of an unplanned pregnancy. Therefore, there are many books, courses, and professional person teacher pairs, with a certificate for each method, that teach the rules of using NFP methods and usually offer costless evaluation support of fertility symptoms. The practical experience of instructor couples using a particular method is very helpful.

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3. Information technologies and electronic devices

New technologies are likewise inbound NFP. At that place is a hope that information technology will brand it possible to reduce the length of the required forbearance to the necessary fourth dimension. These include, in the first place, devices for measuring hormone levels in the urine (e.1000., Persona, ClearBlue Easy Fertility Monitor). The preliminary results of their testing in practice are encouraging, only their effectiveness has not yet exceeded the level achieved by the symptothermal method. At that place are too minicomputers that measure and evaluate the basal torso temperature (e.m., Lady-Comp, Daysy, iFertracker, OvuSense) or the temperature and luteinizing hormone content in the urine and cervical mucus (Cyclotest myWay). Their advantage is that the woman does not have to go along records because they are stored in the estimator retention but otherwise in principle practise not differ from the temperature method. Miniature microscopes for monitoring saliva crystallization (e.g., Lady Q) have proven unreliable and can just be recommended to couples who wish to conceive.

3.i Cyclotest myWay

For evaluating fertile days by Cyclotest (Figure 3) the basis is the measurement of the basal body temperature. For increasing the prophylactic of this device, the 2 fertile symptoms can be included—ovulation test or quality of cervical mucus. The bicycle computers follow exactly the symptothermal methodology. Even an irregular bicycle that is still within the normal range can be reliably evaluated, and information technology is possible to record the cycle length from 23 to 45 days. When irregularities occur, the temperature should non exist measured. Alternatively, keep measuring and manually notation the results for that particular twenty-four hours as a disruption. After pregnancy the device can be used as soon as the menstruation is regular again and woman is not nursing at nighttime.

Figure iii.

Cyclotest myWay device and information on screen [eight].

The cycles can exist saved every bit a PDF file via Cyclotest mySoftware, the software comes for free. The reckoner alerts of possible ovarian insufficiency in the concluding 12 cycles are stored and offer boosted function skincare, which shows what type of cream is most applicable for which days of the cycle. The settings can be switched between the two modes—child planning and cycle command. One computer tin be used for two objectives. In the child planning mode, the post-obit boosted functions will exist activated:

• Indication of possible luteal phase deficiency

• Pregnancy display

• Birth planner

• Display of the highly fertile days

Apart from that, the card only differs in coloration. In the "child planning" mode, the dominant colour is magenta, and in the "wheel control" mode, it is violet. The price of these devices on the manufacturer's website is $ 333, and replacement of measuring probe costs $ 56. In terms of reliability, manufacturers refers to the reliability of the symptothermal method; they exercise not specify reliability in per centum or Pearl Index for this device particularly [eight].

3.2 Lady-Comp

Lady-Comp is an intelligent fertility tracker/minicomputer designed to make up one's mind fertile and infertile days past morn BBT in the oral fissure 60 s every morning. The Lady-Comp works on the basis of more than 1 one thousand thousand cycles with statistical data to determine fertile and infertile days, with an accuracy of 99.3% [9], and the day of ovulation. Lady-Comp observes the individual cycle and determines fertility for the next 24 h. It correctly evaluates complicated and irregular cycles and identifies and eliminates unlikely temperature measurements, due east.grand., fever. The device displays temperature, catamenia, fertility: carmine, fertile day; green, infertile day; and yellowish, learning stage or uncertainty. It offers the possibility to write personal data into the calendar, download and print raw data or upload information technology into the website, and go a full analysis of cycle, all averages, and a lot of interesting charts and graphs. Lady-Comp tin be upgraded to Lady-Comp Infant, which works with over 5 one thousand thousand bike data and has extra features to programme a baby naturally:

• CLI (depression corpus luteum function)

• Forecast hits for twenty cycles

• Documentation of intercourse

• Indication of possible pregnancy after 4–5 days

• Indication of likely pregnancy later fifteen days

• Formulation date and birth appointment

Pearly is a simpler and less expensive solution from the aforementioned manufacturer. Pearly is a modest fertility tracker working on the same way as Lady-Comp; however, information technology has fewer functions. Fertility status is evaluated via color lights, as well as in Lady-Comp (Figure 4). The cost of these devices ranges from $ 375 for Pearly, $ 455 for Lady-Comp to $ 545 for Lady-Comp Infant. Replacement of measuring probe costs $ 56 [xi].

Figure 4.

(a) Lady-Comp, (b) Lady-Comp baby, and (c) Pearly [ten].

3.3 Daysy

Daysy uses the same evaluating algorithm as Lady-Comp and has the same reliability of 99.3%. Thermometer with accuracy 0.01°C records the BBT every forenoon in 60 due south. The device itself does not accept a display; it has only i activation push and 3 control lights. Information about fertility are separate—past data are only in the phone app, and actual fertility status is displayed in the device equally color low-cal. Daysy (Figure v) is CE certified and is a Course I medical device. It has infrequent blueprint and appearance, but for more detailed information, it is necessary to apply the mobile application. The manufacturer's price is $ 333, and the awarding is for free [12].

Figure 5.

Daysy device [13].

iii.4 iFertracker

The iFertracker is applicable for both the fertility awareness method (FAM) and the symptothermal method of natural family planning. The device itself is actually a thermometer that captures core temperature opposed to the skin or ecology temperature which is stuck to the armpit by means of double-sided medical record. iFertracker monitors temperature continuously overnight and collects 20,000 data points with an accuracy of 0.01°C in a unmarried dark. The device identifies invalid data, such as getting up in the middle of the night, and works effectually dissimilar sleeping schedules to provide flexibility without disturbing the integrity of data. It is necessary to transport information from the thermometer to the mobile app every morning via Bluetooth. The application automatically charts information and provides a daily fertility snapshot. The application likewise offers notifications for when the pair should try to conceive and allows exporting the BBT chart from direct within the app. The manufacturer recommends keeping track of factors like sexual practice, stress, cervical fungus quality, and slumber to increase the accuracy of ovulation prediction. Change in these habits tin cause natural BBT fluctuation and impact the menstrual cycle. The price of iFertracker and xc double-sided adhesive patches is $ 129.00, threescore pieces of replacement disposable medical patches cost $ fourteen.99, and the application is for free. The manufacturer does not written report reliability or whatever scientific studies on their product [fourteen].

On the market other thermometers are also available which mensurate continuous cadre body temperature (CCBT) on the shoulder or on the wrist like a watch (Termdrop, Ava bracelet) or in the ear (YONO); the hiMAMA monitor works on a similar principle to iFertracker but has a lower purchase price and does not use disposable patches. Although they offer many boosted measurements such equally heart rate or respiratory rate, their reliability could exist much discussed equally they do not measure basal body core temperature. Their applicability is ofttimes express to regular cycles (Figure 6).

Figure 6.

iFertracker thermometer [15].

3.5 OvuSense

OvuSense is a fully certified medical device, clinically proven in over 50,000 cycles of employ. It measures cadre torso temperature using a specially designed vaginal sensor, which is used overnight only, and data are downloaded to the dedicated OvuSense app each morning (Figure seven). OvuSense provides alive updates predicting ovulation up to 24 hours in advance using current wheel information, then confirming the date of ovulation. At the kickoff of each wheel, OvuSense provides a full 8-day fertile window. Vaginal sensor needs to be worn for a minimum of iv hours during residuum or slumber. It is essential to remove the sensor before using a bathroom or before going to accept sex. OvuSense can exist used alongside fertility medications and procedures; it has intelligent filtering systems that remove the temperature spikes exterior of that range which is caused by illness or other exceptional situations. It is a form of medical device which is tested and conforms to strict medical standards. The sensor is made of antibacterial medical grade silicone, simply cleaned daily with warm water and soap. If the adult female has completely regular ovulation, the live prediction has a positive predictive value of 96% and authentic ovulation confirmation of 99%. OvuSense Starter Pack 2-month subscription cost is $ 129 and its 1-yr subscription cost is $ 210 [15, xvi].

Figure 7.

OvuSense vaginal sensor and OvuSense app [17,18].

Another device which continuously collects body temperature from inside the torso not simply at night but during the day as well is Priya—an intravaginal band—equally a fertility sensor. The band measures the core body temperature every vi min and sends the data wirelessly to a paired smartphone for monitoring and interpretation. The Priya Sensor is not yet bachelor for sale. The express release plan started in tardily 2019 [17].

3.6 Persona

Persona is a diagnostic tool for domicile use. Persona records hormone levels (it measures the changes in estrogen-3-glucuronide (E3G) and luteinizing hormone (LH) concentrations) that back-trail the ovulatory phase of the woman'due south menstrual cycle and considers the life span of sperm. The test stick captures hormones from morning urine, and the device then reads, records, and uses this information to tell you if yous have a fertile day when you lot can get pregnant (a crimson calorie-free) or an infertile day when y'all cannot get meaning (a green light) (Effigy 8). The device determines 8 exam days in each cycle, so the woman needs viii exam sticks (simply in the first cycle the test is performed sixteen times). Persona cannot be used by every woman, specifically women:

• Who cannot accept the possibility of pregnancy associated with the use of Persona (reliability confirmed by independent studies is 94%)

• With a wheel of less than 23 days

• With a bike greater than 35 days

• Who have symptoms of menopause

• Who are breastfeeding

• Who employ hormonal therapy, e.g., hormonal contraception, infertility treatment, hormone replacement therapy

• Who use any other treatment that affects their cycle

• Who use antibiotics containing tetracycline

• Who have reduced liver, kidney role, or polycystic ovary syndrome (PCOS) [18]

Effigy viii.

Persona device and displayed information [18,20].

Persona is manufactured by SPD Swiss Precision Diagnostics GmbH in Switzerland. ClearBlue Easy Fertility monitor works on the same principle, only it is particularly used to place high-fertility days and achieve pregnancy. The price per Persona starts from $ 45; additional components or programs are not necessary, except for test sticks [xix] (Figure 8).

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4. Applications for natural family planning

The trends of the modern world are mobile applications; they are useful and hands bachelor, and they can be used at any fourth dimension with our mobile phone or tablet. The area of natural family planning did not as well avoid the arrival of mobile applications. For the purpose of NFP, a lot of applications are available. Some offer reliable and quality results, merely some are not recommended for apply. However, all applications demand input data, which are obtained past measuring basal body temperature, ovulation test outcome, or ascertainment—the onset of flow, cervical fungus quality, etc. BBT tin exist measured by an ordinary thermometer with an accuracy of 0.01°C and enter values into the application manually. The second solution is measured values by digital Bluetooth basal thermometer—values are automatically written to the app when connected to a mobile phone, and the app also creates graphs, notifications, and statistical data. The following section will first draw wireless thermometers with custom applications and then stand-alone applications.

4.1 Cyclotest mySense

Cyclotest mySense is used to track the menstrual wheel without much effort, using Bluetooth technology. The basal temperature values measured each morning in four-hour measuring window are transmitted wirelessly and directly to the smartphone. The thermometer is a Class IIb medical product, CE-certified, and thus approved for natural contraception. In the calculation of fertility, one of the observation data as cervical mucus quality or the result of an ovulation test (LH) tin can be included. The fertile phase is adamant automatically in the application and offers a transparent view of the temperature curve and all additional inputs at all times. The awarding has ii modes, fertility wish style and contraception fashion. The fertility algorithm is based on the symptothermal method and uses the algorithm of cyclotest myWay. The more recorded bicycle the cyclotest mySense App has, the more accurate the forecast volition exist. If the measured temperature could be falsified by external influences, it should be excluded from the calculation directly in the awarding. Cyclotest mySense is suitable for cycles between 16 and 45 days, and the luteal phase should not be less than eleven days. The cyclotest mySense app is available for complimentary, and the thermometer costs $ 122 (Figure 9).

Effigy 9.

Cyclotest mySense thermometer and app [21].

4.two Biolight PregAid

Biolight basal thermometer is a device designed for daily temperature measurement and monitoring. The thermometer is able to store measured data and transfer it to PregAid application. The application is able to evaluate the measured information and thus determine fertile and infertile days, flow arrival even in an irregular wheel, or the possibility of pregnancy. This is ideal for women who are trying to conceive and have an irregular bike. The thermometer is piece of cake to utilize; simply plow on the thermometer every morning after waking upward, and measure out the temperature nether tongue for 3 minutes. Past turning on the application, data volition be saved and synchronized with the cloud. The toll of the device is $ 39.

The following products tin also exist included in the same user and toll group of thermometers with own application as Biolight: Ovy, Kindara thermometer, TempCue, Femometer, PrecisionTemp, Xiaomi Mijia, and others.

4.iii Natural cycles

The natural birth control app uses a statistical algorithm that learns a woman'due south unique bike from the BBT temperatures. Once Natural Cycles has analyzed the temperature curve, information technology can discover ovulation, learn fertile window, and determine the phase of the menstrual bicycle. Natural Cycles offers a personalized fertility status every 24-hour interval. The application requires measurement of temperature at least v days a calendar week within a 4-60 minutes window. Nevertheless, the fewer data are added, the more than red days the app will requite, hence recommending to apply protection. Nature Cycles offers to add together farther information such every bit ovulation test results, premenstrual syndrome symptoms, and unprotected sexual activity. The more than data are put into the app, the more dark-green days are going to become dorsum. For irregularities every bit thyroid weather condition, PCOS, or length of cycle out of range of 21–35 days, the app does not become any less effective. Natural Cycles is a handy tool for keeping rails of irregularities in the cycle, but it gets more ruby-red days. The reliability declared past the manufacturer is 93% constructive with typical utilize and 98% effective with perfect use (sexual forbearance or using condoms on red days).

Natural Cycles is in Europe the showtime CE-marked Class II medical device (CE0123) for use every bit a method of nascency control, and in 2018 the Usa Food and Drug Assistants (FDA) cleared Natural Cycles every bit a medical device for use as a digital method of birth command. The annual subscription (with thermometer) costs $ 71.76, and the monthly subscription costs $ 9.93 [22, 23].

iv.iv OvuView

The application has no official website. Information can only be drawn from the Google Play Store and from the user experience or your own feel with the awarding.

OvuView offers 3 modes: (a) simple menstrual calendar, (b) achievement conception that highlights days with a high probability of pregnancy, and (c) preventing pregnancy. The app displays the menstrual cycle from which the twenty-four hours of the cycle, the number of days to menstruation, the first of fertile days, and the expected ovulation tin be read, equally well as the current stage of the wheel. Standard symptoms such as BBT and fungus symptoms are entered into the application. However, optional and intrinsic symptoms, e.1000., mood, weight, PMS, and ovulation examination tin can be recorded. When entering the ascertainment of mucus, more symptoms of the predefined options tin can be selected at a fourth dimension. Observation of fungus and the neck is automatically rewritten into international symbols. The "Agenda" function displays clearly a calendar with evaluated and predicted values ​​of flow and fertile days. The "Graph" function displays the temperature bend along with other recorded symptoms. OvuView evaluates symptoms based on the following rules:

• Rule 21/20 (six cycles recorded, no fungus)

• Döring rule (six recorded cycles, mucus)

• Rule B (temperature, mucus)

• Dominion R (temperature, mucus)

• Rule Thousand (temperature, mucus)

• Dominion C or O (temperature, fungus)

• Rule of 5 dry days (mucus)

• Rule of four high temperatures (temperature)

• Dominion of v high temperatures (temperature),

• Marshall rule (temperature)

• Last dry out twenty-four hour period rule (mucus, six cycles recorded, min. of 5-day long mucus episode)

Each method indicates what symptoms it needs for the evaluation, the rule's effectiveness, and the symbol, which indicates the phases tin evaluate for a particular method. Each method can be switched on or off (eastward.g., a woman later taking a contraceptive can limit the evaluation only to the 5 T rule). The paid version costs $ v and offers extended functionalities: marking of low-temperature level and ovulation on the twenty-four hour period when temperature increased; backup data to Google account (the free version tin be backup to an SD card); sending information by e-mail and exporting graphs, password protection, widgets, ain symptoms, alerts, e.1000., mucus tracking, ovulation reminder, full movie mode, cycle management (pregnancy); removal of advertisements; and method pick/configuration.

To make the results every bit reliable equally possible, OvuView offers the choice to enter custom cycle lengths (longest and shortest) or to rely on general cycle lengths [24, 25, 26, 27, 28], which of course reduces reliability. If nothing is chosen, the application evaluates simply based on the recorded cycles. Information tin be imported from previously used some other awarding.

Co-ordinate to the description on Google Play, the awarding evaluates using the symptothermal method besides equally other methods. The clarification claims to be implementing 14 evaluating methods. In our opinion, this is a vague terminology, since the mentioned methods are actually the rules of the symptothermal method, of course, in add-on to two trivial calendar calculation methods. Even so, it is not clear what precise didactic transposition of symptothermal method the app is. Compared to the newspaper course of evaluation, there are several differences in the electronic version. The reliability of the application depends on the accuracy and thoroughness of the entered data [29].

4.five SymptoPlus

The SymptoPlus is not a medical device but an electronic learning tool to take charge of fertility. Application evaluation algorithm is based on a combination of 3 NFP methods—NFP-sensiplan (symptothermal method), Billings Ovulation Method (cervical mucus method), and Rötzer/Northwest Family unit Servis (NWFS, the American Rötzer version, symptothermal method). SymptoPlus is not an exactly didactic transposition of 1 item method.

This stand up-lonely app doesn't require an Internet connectedness for its basic features. An Internet connection is only needed for syncing to secure admission, fifty-fifty if losing the telephone. To verify an business relationship, become to sympto.org. After verifying an eastward-mail service address, the xv days gratis of accuse of personal follow-upwardly with a symptothermal expert without whatever commitment is bachelor. After a xv-day trial, the SymptoPlus must be purchased in the Google Play Store for a nominal fee. A free version is also available, but SymptoPlus is faster and simpler to view than SymptoFree. The app is bachelor in several languages and offers an internal bulletin box which allows the client to communicate directly with her adviser.

For guaranteed contraceptive effectiveness, it is needed to use the app properly and use Sympto for 6 months with a counsellor (Daisy PLUS) or enter half-dozen past cycles verified past Sympto. To interpret a cycle correctly, Sympto has defined a minimum of 10 crucial information in order: the beginning of the cycle which is triggered past the 3 red drib icons, a minimum of four depression temperatures within six days to specify the comprehend line, the mucus tiptop day indication (ii signs), and the iii right loftier temperatures [24, 25] (Figure 10).

Effigy 10.

SymptoPlus application tape tabular array [26].

The market offers a number of similar applications, e.g., myNFP, LilyPro, CycleProGo, Lady Cycle, etc. Some are more functional, others are less, and some can be used only as a tape table without evaluating or with not reliable evaluating. The applications for NFP have a huge potential, but thorough inquiry is needed. Medical doctor, developers, proficient of didactic transpositions, learning specialists, teacher pairs for a specific method, and women using the app should piece of work together to create the app. From this cooperation arise a quality application, which however must be subjected to in-depth testing on a sufficient number of cycles. Entered data must be accurate and obtained in accordance with the knowledge of symptothermal bike observation.

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5. SymRec

Applications and IT tools for NFP are an interesting enquiry surface area, and based on how they were mentioned higher up, they take great potential. On the ground of these facts, we besides decided to create a web site for evaluating the menstrual cycle according to symptothermal method (STM). The It tool SymRec is an accurate didactic transposition of rules of STM used in Slovakia with some restriction listed below. We followed the rules outlined in the book Handbook of Symptothermal Methods published past Couple to Couple League in Slovakia [27].

The goal of the work was to create an Information technology tool—electronic record table (ERT)—like to the printed tape table used for symptothermal observation. ERT serves for daily information entry, storage data, and evaluating menstrual cycle according STM rules. Access to data is possible for every device continued to the Internet. ERT is available on the website: http://symrec.judak.eu/.

v.1 Didactic transposition of STM rules

Didactic transposition is the isolation of certain terms and properties from the environment in which they originated and their adaptation to the context in the new environment. In fact, information technology is the transfer of the regularities of the teaching or learning process (rules of some NFP method) from the analogue environment (transmission paper method) to the digital surround (awarding, IT tool). It is an interpretation of NFP rules in the digital globe using programming code. The original manual STM has been transformed into an electronic version by transcription to PHP lawmaking. ERT evaluates the record co-ordinate to these rules:

1. Evaluation of the first stage of preovulatory infertility:

   • Terminal dry out day rule

   • Doctors experience rule

   • Rule twenty/21 days

   • Döring rule

2. Evaluation of the third stage of postovulatory infertility:

   • Rules R, B, and K—double-symptom rules (cervix mucus, basal body temperature)

   • 4 T, five T, and Marshall dominion—i-symptom rules (BBT)

   • 5DMD—one-symptom dominion (neck mucus)

ERT expects that but valid temperatures are entered. Evaluation does not offering a possibility as "planning down" and averaging the temperatures, which are possible in manual evaluation in case of nonstandard temperature curves. To verify each dominion, software checks at to the lowest degree six previous cycles and a maximum of thirteen cycles. According to the number of cycles in the recorded history of ERT, the evaluation is performed for the 8th recorded wheel, and a unlike evaluation rule is used for the 13th recorded wheel. It follows that for validation of all possibilities of evaluation, 27 rules accept to be created. For evaluation of the kickoff phase preovulatory infertility, it is necessary to have recorded at to the lowest degree six previous cycles—the STM rules require user experience with at least 6 previous cycles to allow for a reliable assessment of the current cycle. If at that place are not enough records in the recorded history of ERT, the evaluation for the first phase will not run, and the report with the alert to this situation is displayed.

The evaluation is possible until fulfilment at least one evaluation condition, e.thousand., for evaluation of the beginning phase, only enter the occurrence of cervical mucus, and the last dry day rule is activated. The accuracy of the evaluation depends on the corporeality of data collected, not just in the current bike but too in previous cycles. The overall reliability of the ERT cannot be determined as the testing did not run with a statistically meaning data prepare. As information technology is a precise didactic transposition of the rules and if accurate and clean information are entered, we presume reliability comparable to that of the symptothermal method. All the same, further testing with sufficient data is necessary to confirm this assumption.

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six. Word

In this office of the paper, we discuss the issues associated with the use of NFP methods: the sense of using methods, determining reliability, and measuring basal body temperature.

The human body is an "unstable system," and when we talk nigh fertility, women respond very sensitively to diverse stimuli. Every organism is unique; no two cycles of the tens of thousands of observed cycles are identical. Due to the current rapid lifestyle, sedentary piece of work, bogus lighting, or lack of physical exertion, menstrual cycle irregularities are more mutual than in the by, not to mention other reproductive health problems, e.thou., polycystic ovary syndrome, myomas, pre-menstruation syndrome, etc. No device tin predict in advance that at that place volition be any irregularities in the current wheel that will shorten or extend the bike. Nothing in the menstruation bicycle can be predicted at a hundred percent. At the same time, there are periods in women'due south lives—east.g., before the start menstruation, after delivery, or in climacterium—when hormonal conditions can properly disrupt the bicycle. From the experience of lecturers teaching NFP methods, it tin exist argued that in these cases the devices or applications cannot reliably evaluate the course of the bike and pairs take to rely on prolonged sexual abstinence or apply of barrier contraception due to inaccurate device estimation.

The accuracy of the outputs of the technical aids depends non but on the quality of the components they are made of but likewise on the software that makes the evaluation itself. Even the finest instruments and the most sophisticated software for determining fertile and infertile days have their limits, and information technology is not expert to rely blindly on them. Even those who welcome technical innovations are brash to supplement the information from the device with their personal assessment of fertility symptoms (at least one symptom). Users will avoid unnecessary disappointment from possible failure, especially during nonstandard situations. Learning to understand some NFP methods is not as difficult as it may seem. Indeed, one of the prerequisites of NFP methods is knowing your own torso, not mechanically thoughtless entering information into device/application.

The determination of the reliability of NFP methods can have a discussion for a long time. Information technology is hard to decide the evaluation criteria that will deliver the most relevant results. The nearly commonly used Pearl Alphabetize (PI) is under criticism because of the fact that different PI values are found in the literature for one method [xxx]. Primal parameters that are field of study to comparability should be used to calculate the reliability of the method:

1. Frequency of sexual intercourse—the difference is in recording 1 unwanted pregnancy for five years at 1 intercourse as 1 pregnancy for 5 years at 300 (or more) intercourses.

2. Sample size—no sample size is specified for PI determination. The larger the sample, the more accurate the upshot.

3. Age of women—fertility is different at every woman's age. The risk to excogitate naturally in a twenty-year-quondam adult female is significantly higher than in a 38-yr-old woman. Also, men'south fertility rates refuse by historic period [31].

4. The period of application of the method—unexpected pregnancies usually come in the first months of using a detail method. The longer the couples apply the method, the more they are trained, and the number of unexpected pregnancies decreases.

5. User fault—if an unexpected pregnancy occurs as a result of a conscious fault past the user (e.yard., situations where the partners accept sexual intercourse during a period they know is fertile or apply a barrier contraception during the fertile period), this situation should be recorded and should not be taken into account in establishing rate reliability.

6. BMI—overweight and obese women accept a significant human relationship between body mass index, spotting, menstrual cycle length, menstrual haemorrhage, and passing clots [30].

7. Diseases/medicaments/residue contraceptives.

A certain solution is to determine the reliability of typical use and perfect utilise, simply the criteria mentioned above must be considered in this example likewise. Either, the private approach of women to the use of a particular method should not be forgotten. Every woman is different; there is no universal solution for all women; however, solutions can exist found for groups with similar method requirements. It is worth reminding that none of the NFP methods is 100% reliable (perfect utilize). In preventing unplanned pregnancy, only three methods of conceiving regulation take 100% reliability:

• 100% sexual abstinence (no genital contact).

• Removal of both testes.

• Removal of both ovaries.

All other methods of conceiving command have some degrees of failure. Failures of NFP, e.1000., symptothermal method, in the nearly cases are caused past inconsistent observation and recording of fertility symptoms, the use of bulwark methods in the fertile stage of the cycle, and the conscious reliance on chance [27].

The basal temperature measurement time frame is a topic that we supposedly should be giving due consideration too. Basal body temperature assessment is well described and practical. However, the fourth dimension range of basal temperature measuring remains a trouble. This range is differently ready for devices (Cyclotest myWay ±2 hours, Lady-Comp ±3 hours, Daysy no timeframe) and applications (Cyclotest mySense ±2 hours, Natural Cycles ±2 hours). Of course, this problem is eliminated in continuous temperature monitoring (iFertracker, OvuSense), although a system for determining a detail temperature, e.g., from 100 measured values, can exist discussed. The question remains how much are the objective results of the measured basal temperature in an interval of vi hours. Under normal circumstances, BBT reaches its everyman in the early morn hours and then rises by about 0.05°C every half hour. Thus, the BBT measured outside the tolerated range of xxx minutes may non exist authentic. Dr. Rötzer states in his work that basal temperatures measured outside the tolerance range (±30 minutes) later on 7:30 am tend to have a greater effect on the temperature curve than deviations measured in the early morning hours [32]. So wide fourth dimension frame is naturally comfy for users, simply the most authentic results can be achieved by measuring at the aforementioned time every twenty-four hours. The condition of daily measurement also plays an important role in the degree of reliability.

The task of experts is to find a solution in the field of NFP that confirms the words by Volition Sacks, which aptly described the present country of fertility control with words: "I think the last century was virtually solving health bug with pills and synthetics, and this century is nearly solving health bug with software and data. The pill was an enormous boon for the previous generation. It set women free in and then many ways, but it besides came with side effects that a lot of women nowadays are finding unacceptable. Fertility Awareness is effective, low-price, and side-issue-free and then I think women and couples are finding information technology an attractive option. I also happen to think that Fertility Sensation is a consciousness-raising tool—it helps women tune into and feel powerful and in control of their wellness, and it helps male partners better understand the feminine. As consciousness and mindfulness increase globally, using constructed hormones to command fertility is becoming less acceptable, and Fertility Awareness, which is the do of living in harmony with your bike, is becoming more obvious" [33].

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7. Conclusion

The paper provides an overview of technical devices and applications used for evaluating the menstrual cycle and determining fertile and infertile days. In the first part, the principle of using and evaluating the four most normally used NFP methods is briefly described. The next role is devoted to currently bachelor information technologies and electronic devices designed to evaluate the menstrual cycle in terms of NFP methods. The conditions of use, reliability, price, and limitations for the six devices and v applications are described. Finally, our proposed arrangement of fertility assessment based on STM in the form of a website is described. The word critically evaluates the possibilities of use and weaknesses of the described technical devices and information ways.

It follows that the success of the utilize of electronic devices or applications needs to exist strengthened past some caste of knowledge and feel in assessing self-fertility. Although manufacturers written report loftier reliability of their products, there is no demand to blindly rely on the device and application results and evaluation should be complemented with own judgment. For a successful creation of quality and reliable application or device, cooperation from experts in diverse fields of science is needed, and inquiry and experiences of practical users is necessary.

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Written By

Zuzana Judáková

Submitted: October 3rd, 2019 Reviewed: March 16th, 2020 Published: April 22nd, 2020

© 2020 The Writer(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution three.0 License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Source: https://www.intechopen.com/chapters/71898

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