Publicaties over Sensiplan (=NFP-DAG) en gerelateerd
Natürliche Familienplanung
Sensiplan® – eine moderne, verlässliche Methode
Frank-Herrmann et al., 2011 (P. Frank-Herrmann et al, Gynäkologe 2011 · 44:17–22 DOI 10.1007/s00129-010-2659-5)
Auf dem Gebiet der natürlichen Methoden der Familienplanung gibt es immer wieder Weiter- und Neuentwicklungen. Damit einher geht derzeit eine gewisse Unübersichtlichkeit bezüglich Qualität, Indikation und Anwenderprofil der verschiedenen Methoden, die sich vor allem in ihrer kontrazeptiven Sicherheit und Praktikabilität unterscheiden. Zur besseren Abgrenzung und Unterscheidung werden einzelne Methoden nicht mehr nur unter dem Sammelbegriff natürliche Familienplanung gefasst, sondern zunehmend auch mit Eigennamen versehen.
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Natürliche Familienplanung
Frank-Herrmann et al., 2010 (P. Frank-Herrmann et al, Gynäkologe 2010 · 43:341–350 DOI 10.1007/s00129-010-2541-5)
ZUSAMMENFASSUNG
Frauen können heute mit wenig Aufwand sowohl ihr fertiles Fenster als auch ihr Fertilitätsoptimum im Zyklus selbstständig und zuverlässig bestimmen und dies in verschiedenen Bereichen nutzen. Empfängnisverhütung. Zur Bestimmung von Anfang und Ende der fertilen Phase werden nach dem Prinzip „double check“ jeweils zwei Parameter herangezogen, die sich gegenseitig absichern. Empfohlene Variante ist die symptothermale Methode der Arbeitsgruppe Natürliche Familienplanung (NFP-DAG). Bei dieser liegt die Methodensicherheit bei 0,4 Schwangerschaften pro 100 Frauenjahre, sofern kein ungeschützter Geschlechtsverkehr in der fertilen Phase stattfindet. Damit ist diese Methode auch eine Option für Risikopatientinnen. Kinderwunsch. NFP ermöglicht das Erkennen des Fertilitätsoptimums auch in unregelmäßigen Zyklen und die Optimierung der Ovulations- und Lutealphasendiagnostik. Zyklusmonitoring in verschiedenen Lebensphasen. Bei Zyklus- und Hormonstörungen ist ein differenziertes Zyklusmonitoring über längere Zeiträume hinweg möglich.
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Study to evaluate the long-term use of the NFP-DAG method in the Netherlands
Van Steinvoorn et al., 2010 (Van Steinvoorn et al, Eur. J. of Contraception and Reprod. Health Care, 15, Suppl 1 (2010) (Book of Abstracts XIth ESC Congress, P170) p. 154)
Cycle Monitors and Devices in Natural Family Planning
Freundl G, Frank-Herrmann P, Gnoth C.; J. Reproduktionsmed. Endokrinol 2010; 7 (Sonderheft 1), 90-96
Physicians
may be asked to provide advice about sexual and lifestyle practices
relating to procreation. Currently, there are no uniform counseling
guidelines or evidence-based recommendations available. This document
will provide practitioners with guidelines, based on a consensus of
expert opinion, for counseling couples about how they might optimize the
likelihood of achieving pregnancy when there is no history of or reason
to question their potential fertility.
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Optimizing natural fertility
Practice Committee of the American Society for Reproductive Medicine in collaboration with the Society for Reproductive Endocrinology and Infertility. Fertil Steril 2008;90:S1–6)
Physicians may be asked to provide advice about sexual and lifestyle practices relating to procreation. Currently, there are no uniform counseling guidelines or evidence-based recommendations available. This document will provide practitioners with guidelines, based on a consensus of expert opinion, for counseling couples about how they might optimize the likelihood of achieving pregnancy when there is no history of or reason to question their potential fertility.
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The effectiveness of a fertility awareness based method to avoid pregnancy in relation to a couple’s sexual behaviour during the fertile time: a prospective longitudinal study
Frank-Herrmann et al., 2007 (P. Frank-Herrmann et al, Human Reproduction, Vol 22 Issue 5 (2007) pp. 1310-1319. DOI: 10.1093/humrep/dem003)
BACKGROUND: The efficacy of fertility awareness based (FAB) methods of family planning is critically reviewed. The objective was to investigate the efficacy and the acceptability of the symptothermal method (STM), a FAB method that uses two indicators of fertility, temperature and cervical secretions observation. This paper will recommend a more suitable approach to measure the efficacy. METHODS: Since 1985, an ongoing prospective observational longitudinal cohort study has been conducted in Germany. Women are asked to submit their menstrual cycle charts that record daily basal body temperature, cervical secretion observations and sexual behaviour. A cohort of 900 women contributed 17 638 cycles that met the inclusion criteria for the effectiveness study. The overall rates of unintended pregnancies and dropout rates have been estimated with survival curves according to the Kaplan–Meier method. In order to estimate the true method effectiveness, the pregnancy rates have been calculated in relation to sexual behaviour using the ‘perfect/imperfect-use’ model of Trussell and Grummer-Strawn. RESULTS: After 13 cycles, 1.8 per 100 women of the cohort experienced an unintended pregnancy; 9.2 per 100 women dropped out because of dissatisfaction with the method; the pregnancy rate was 0.6 per 100 women and per 13 cycles when there was no unprotected intercourse in the fertile time. CONCLUSIONS: The STM is a highly effective family planning method, provided the appropriate guidelines are consistently adhered to.
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In-vitro-Fertilisation im Vergleich zur natürlichen Fruchtbarkeit
Freundl & Beck, 2007 (Gynäkologische Endokrinologie 2007 - 5:167–170; DOI: 10.1007/s10304-007-0187-8)
Vergleiche zwischen der normalen Fruchtbarkeit des Menschen und den Ergebnissen der In-vitro-Fertilisation lassen erkennen, dass der Befruchtungsvorgang im Eileiter in vergleichbarer Weise abläuft wie bei der In-vitro-Fertilisation und dass die geburtshilflichen Ergebnisse (Baby-take-home-Rate) ebenfalls vergleichbar sind.
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Managing infertility with fertility-awareness methods
Brosens et al.., 2006 (Sexuality, Reproduction & Menopause, Vol. 4, No. 1, May 2006, pp. 13-16)
Recent epidemiological studies show the potential value of observing vaginal humidity for women wishing to get pregnant. When the couple/woman is concerned about a delay in conception, fertility-awareness methods not only maximize the chances for spontaneous conception, they also provide early stage information on reproductive function.
Key points:
■ The likelihood of pregnancy is highest when intercourse is timed for the day of the most fertile-type cervical mucus.
■
There is evidence that timing of sexual intercourse to the day of peak
fertility increases pregnancy rates in couples with male factor or
unexplained infertility.
■ The information yielded by
fertility-awareness methods can be used to tailor further investigation
to the individual infertile couple, preventing both underand
over-treatment.
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Mucus observations in the fertile window: a better predictor of conception than timing of intercourse
Jamie L.Bigelow, Gnoth et al.., 2003 (Human Reproduction Vol.19, No.4 pp. 889-892, 2004 DOI: 10.1093/humrep/deh173)
BACKGROUND: Intercourse results in a pregnancy essentially only if it occurs during the 6-day fertile interval ending on the day of ovulation. The strong association between timing of intercourse within this interval and the probability of conception typically is attributed to limited sperm and egg life times. METHODS: A total of 782 women recruited from natural family planning centres in Europe contributed prospective data on 7288 menstrual cycles. Daily records of intercourse, basal body temperature and vaginal discharge of cervical mucus were collected. Probabilities of conception were estimated according to the timing of intercourse relative to ovulation and a 1±4 score of mucus quality. RESULTS: There was a strong increasing trend in the day-specific probabilities of pregnancy with increases in the mucus score. Adjusting for the mucus score, the day-speci®c probabilities had limited variability across the fertile interval. CONCLUSIONS: Changes in mucus quality across the fertile interval predict the observed pattern in the day-speci®c probabilities of conception. To maximize the likelihood of conception, intercourse should occur on days with optimal mucus quality, as observed in vaginal discharge, regardless of the exact timing relative to ovulation.
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Opinion: Natural family planning and the management of infertility
Gnoth et al.., 2002 (Arch Gynecol Obstet (2002) 267:67–71)
Abstract Reproductive behaviour in modern western society has changed dramatically in the last two decades. Parenthood is now well planned. If planned pregnancies do not occur as expected, early infertility care is often demanded with the risk of over-treatment. Live birth rates in untreated subfertile couples reach nearly 55% in 36 months. During this period, self-monitoring with natural family planning (NFP) methods may be all that is necessary, especially in couples with unexplained infertility.
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