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For these women, the rhythm method formula incorrectly identifies a few fertile days as being in the infertile period. [19] Roughly 30-50% of women have phases outside this range. [34] Finally, calendar-based methods assume that all bleeding is true menstruation. However, mid-cycle or anovulatory bleeding can be caused by a number of factors. [35]
Most commonly, the Pearl Index is used to calculate effectiveness rates, but some studies use decrement tables. [42] The failure rate of fertility awareness varies widely depending on the system used to identify fertile days, the instructional method, and the population being studied.
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The days in which a woman is most fertile can be calculated based on the date of the last menstrual period and the length of a typical menstrual cycle. [4] The few days surrounding ovulation (from approximately days 10 to 18 of a 28-day cycle), constitute the most fertile phase.
The Pearl Index, also called the Pearl rate, is the most common technique used in clinical trials for reporting the effectiveness of a birth control method. It is a very approximate measure of the number of unintended pregnancies in 100 woman-years of exposure that is simple to calculate, but has a number of methodological deficiencies.
What has changed over the last 20 years is fertility testing, assisted reproduction techniques and the corresponding success rates. “There’s a better understanding of what’s happening when ...
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