Fertility Awareness-Based Methods: Another Option for Family Planning

Stephen R. Pallone, MD; George R. Bergus, MD


J Am Board Fam Med. 2009;22(2):147-157. 

In This Article

Symptothermal Method

The Symptothermal Method combines BBT, cervical methods, cervical position, and/or historical cycle data to prospectively and retrospectively identify the peri-ovulatory period. In its most effective form, 2 signs are used to "double check" each phase as confirmation for the couple that the woman is unlikely to be fertile.[20,26] The method has a 0.4% pregnancy rate when used as described.[4,14]

Typical-use unplanned pregnancy rates have been reported as low as 1% to 3% in Europe and India.[7,12,13,14,15,16,19,20] However, unplanned pregnancy rates as high as 13% to 20% have also been reported for typical users of the Symptothermal Method.[4] Critics warn that combining signs and symptoms can overestimate the fertile phases by a couple of days or more. On the other hand, because there is no requirement to abstain every other day before the fertile phase, the total abstinence time is approximately equivalent to cervical secretion methods. There is a trend of increased intercourse among couples who use barrier back-up methods concurrently. This trend, however, may be confounded because women using barrier backup are generally younger.[49]


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