RESUMEN
PURPOSE: To investigate if generic Wondfo ovulation sticks (WLH) are sufficiently sensitive to the luteinizing hormone (LH) surge in urine when used with the Marquette Fertility Algorithm. The electronic hormonal fertility monitor (EHFM) is highly accurate in detecting the LH surge but cost of the monitor and the accompanying test sticks has increased over the last several years. The EHFM is sensitive to detect the LH surge at 20 milli-international units per milliliter (mIU/mL); the WLH sticks are slightly less sensitive at 25 mIU/mL. STUDY DESIGN AND METHODS: A convenience sample of women using the Marquette Method of Natural Family Planning with the EHFM to avoid pregnancy were recruited (N = 54). Each participant used the EHFM every morning after cycle day 6 and tested morning and evening urine with the WLH stick until the day following detection of the LH surge on the EHFM. RESULTS: Forty-two women provided 219 cycles. Frequency of LH surge detection was 182/219 (83.1%) for EHFM and 203/219 (92.7%) for WLH sticks. Agreement between the EHFM and the WLH on the day of the LH surge was 97.7%. High fertility readings providing a warning of peak fertility at least 5 days before peak was 67% for the WLH; the EHFM was 47.7%. Paired sample correlations for high fertility was .174 (p = .014) and paired sample differences t was -4.729 (p = .000). CLINICAL IMPLICATIONS: The WLH stick is sufficiently sensitive to use in place of the EFHM for determining peak fertility and with the Marquette Fertility algorithm. Even with minimal use, WLH sticks cost about half the price of the monitor strips and provide more flexibility of use. Cost differences increase with the number of sticks used per cycle. Further research with a larger sample is needed to verify results.
Asunto(s)
Diseño de Equipo/normas , Fertilidad , Hormona Luteinizante/análisis , Monitoreo Fisiológico/instrumentación , Métodos Naturales de Planificación Familiar/instrumentación , Adulto , Femenino , Humanos , Hormona Luteinizante/orina , Monitoreo Fisiológico/métodos , Métodos Naturales de Planificación Familiar/métodos , Embarazo , Factores de TiempoRESUMEN
INTRODUCTION: The postpartum period is a challenging time for family planning, especially for women who breastfeed. Breastfeeding delays the return of menses (lactational amenorrhea), but ovulation often occurs before first menses. For this reason, a protocol was developed to assist women in identifying their return of fertility postpartum to avoid pregnancy. METHODS: In this prospective, 12-month, longitudinal cohort study, 198 postpartum women aged 20 to 45 years (mean age, 30.2 years) were taught a protocol for avoiding pregnancy with either online or in-person instruction. A hand-held fertility monitor was used to identify the fertile period by testing for urinary changes in estrogen and luteinizing hormone, and the results were tracked on a web site. During lactational amenorrhea, urine testing was done in 20-day intervals. When menses returned, the monitor was reset at the onset of each new menstrual cycle. Participants were instructed to avoid intercourse during the identified fertile period. Kaplan-Meier survival analysis was used to calculate unintentional pregnancy rates through the first 12 months postpartum. RESULTS: There were 8 unintended pregnancies per 100 women at 12 months postpartum. With correct use, there were 2 unintended pregnancies per 100 women at 12 months. CONCLUSION: The online postpartum protocol may effectively assist a select group of women in avoiding pregnancy during the transition to regular menstrual cycles.
Asunto(s)
Amenorrea/orina , Periodo Fértil/orina , Métodos Naturales de Planificación Familiar/métodos , Detección de la Ovulación/métodos , Periodo Posparto/orina , Adulto , Lactancia Materna , Protocolos Clínicos , Estrógenos/orina , Femenino , Humanos , Internet , Estimación de Kaplan-Meier , Estudios Longitudinales , Hormona Luteinizante/orina , Persona de Mediana Edad , Métodos Naturales de Planificación Familiar/instrumentación , Evaluación de Procesos y Resultados en Atención de Salud , Detección de la Ovulación/instrumentación , Aceptación de la Atención de Salud , Embarazo , Embarazo no Planeado , Estudios ProspectivosRESUMEN
This pilot study investigates in a group of 20 healthy volunteers with regular cycles and prior experience in natural family planning methods whether self-assessment of the cervical "pupil sign" is feasible and can be used to detect the preovulatory fertile window. All participants were able to assess the cervical pupil sign. Based on this method, the fertile window lasts on average 3 days, which is significantly shorter and more consistent than when defined on basis of the vulvar mucus method.
Asunto(s)
Concienciación , Cuello del Útero/anatomía & histología , Fertilidad , Ciclo Menstrual , Métodos Naturales de Planificación Familiar , Detección de la Ovulación , Autocuidado , Adulto , Estudios de Factibilidad , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Moco/metabolismo , Métodos Naturales de Planificación Familiar/instrumentación , Detección de la Ovulación/instrumentación , Educación del Paciente como Asunto , Proyectos Piloto , Autocuidado/instrumentación , Instrumentos Quirúrgicos , Factores de Tiempo , Vulva/metabolismo , Adulto JovenRESUMEN
We report two cases of female contraceptive methods, resulting in urological presentation, with bladder foreign bodies. History, mode of diagnosis and surgical extraction technique differed in both patients. The first, where a thermometer was lost intravesically whilst measuring an internal temperature, presented immediately. A plain abdominal X-ray confirmed the position of the foreign body. Extraction was performed cystoscopically with the thermometer intact. A second patient, with recurrent urinary tract infections, was found to have an intrauterine contraceptive device (IUCD) in her bladder on ultrasound. Attempts to remove it endoscopically failed, and an, open procedure was required to free the IUCD from the bladder sidewall.