S2k-Guideline Non-hormonal Contraception, Part 2: Intrauterine Devices and Sterilization: Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry No. 015 - 095, January 2024).

This official guideline was published and coordinated by the DGGG, OEGGG and SGGG with the involvement of other medical societies. The aim was to provide a consensus-based overview of non-hormonal forms of contraception based on an evaluation of the relevant literature. The first part of these summarized statements and recommendations presents natural family planning methods such as lactational amenorrhea, barrier methods and coitus interruptus.

S2k-Guideline Non-hormonal Contraception, Part 1: Natural Family Planning, Lactational Amenorrhea, Barrier Methods, Coitus Interruptus: Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry No. 015 - 095, January 2024).

This official guideline was published and coordinated by the DGGG, OEGGG and SGGG with the involvement of other medical societies. The aim was to provide a consensus-based overview of non-hormonal forms of contraception based on an evaluation of the relevant literature. The first part of these summarized statements and recommendations presents natural family planning methods such as lactational amenorrhea, barrier methods and coitus interruptus.

Low androgen signaling rescues genome integrity with innate immune response by reducing fertility in humans.

Development of the gonads under complex androgen regulation is critical for germ cells specification. In this work we addressed the relationship between androgens and genomic integrity determining human fertility. We used different study groups: individuals with Differences of Sex Development (DSD), including Complete Androgen Insensitivity Syndrome (CAIS) due to mutated androgen receptor (AR), and men with idiopathic nonobstructive azoospermia.

Genomic instability in individuals with sex determination defects and germ cell cancer.

The ability to transmit genetic information through generations depends on the preservation of genome integrity. Genetic abnormalities affect cell differentiation, causing tissue specification defects and cancer. We addressed genomic instability in individuals with Differences of Sex Development (DSD), characterized by gonadal dysgenesis, infertility, high susceptibility for different types of cancer, especially Germ Cell Tumors (GCT), and in men with testicular GCTs.

Sex chromosome DSD individuals with mosaic 45,X0 and aberrant Y chromosomes in 46,XY cells: distinct gender phenotypes and germ cell tumour risks.

")," individuals with rearranged Y chromosome breaks in their 46,XY cells are reported with male and female gender phenotypes and differences in germ cell tumour (GCT) risk. This raised the question of whether male or female gender and GCT risk depends on the site of the break and/or rearrangement of the individual´s Y chromosome. In this paper, we report molecular mapping of the breakpoint on the aberrant Y chromosome of 22 individuals with a 45,X/46,XY karyotype reared with a different gender.

Gonadoblastoma Y locus genes expressed in germ cells of individuals with dysgenetic gonads and a Y chromosome in their karyotypes include DDX3Y and TSPY.

Study Question: Which Y genes mapped to the 'Gonadoblastoma Y (GBY)' locus on human Y chromosome are expressed in germ cells of individuals with some Differences of Sexual Development (DSD) and a Y chromosome in their karyotype (DSD-XY groups)?

Summary Answer: The GBY candidate genes DDX3Y and TSPY are expressed in the germ cells of DSD-XY patients from distinct etiologies: patients with mixed gonadal dysgenesis (MGD) and sex chromosome mosaics (45,X0/46,XY; 46,XX/46,XY); patients with complete androgen insensitivity (CAIS), patients with complete gonadal dysgenesis (CGD; e.g. Swyer syndrome).

Plausibility of Menstrual Cycle Apps Claiming to Support Conception.

The interval of peak fertility during the menstrual cycle is of limited duration, and the day of ovulation varies, even in women with fairly regular cycles. Therefore, menstrual cycle apps identifying the "fertile window" for women trying to conceive must be quite precise. A deviation of a few days may lead the couple to focus on less- or non-fertile days for sexual intercourse and thus may be worse than random intercourse.

Natural conception rates in subfertile couples following fertility awareness training.

Purpose: To analyze cumulative pregnancy rates of subfertile couples after fertility awareness training.

Methods: A prospective observational cohort study followed 187 subfertile women, who had received training in self-observation of the fertile phase of the menstrual cycle with the Sensiplan method, for 8 months. The women, aged 21-47 years, had attempted to become pregnant for 3.

A new method to detect significant basal body temperature changes during a woman's menstrual cycle.

Objective: To compare the results of a computer programme based on the Trigg's tracking system (TTS) identification of the basal body temperature (BBT) shift day from daily records of BBT values (TTS transition day), with the BBT shift day identified from the same records using the Sensiplan(®) symptothermal method of natural family planning.

Methods: A computer programme was written to display the daily BBT readings for 364 menstrual cycles from 51 women aged 24 to 35 years, obtained from the German Natural Family Planning (NFP) database. The TTS transition day so identified from each record was then compared with the BBT shift day estimated from the same record by the Sensiplan(®) method.

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.

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), an 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.

Determination of the fertile window: reproductive competence of women--European cycle databases.

Objectives: The objective of the present paper is to review the main results of recent European cycle databases on ovulation detection and determination of the fertile window performed by the women themselves.

Methods: The ongoing German Long-term Cycle Database currently comprises 32788 prospectively collected cycle charts of 1551 women, the I European Cycle Database (10 countries) 1328 women/19048 cycles, the II European Cycle Database (six countries) 782 women/6724 cycles, and the World Health Organization Database (one European country) 234 women/2808 cycles. The women record cycle parameters (cervical mucus changes, temperature rise, etc.

Definition and prevalence of subfertility and infertility.

A common definition of sub- and infertility is very important for the appropriate management of infertility. Subfertility generally describes any form of reduced fertility with prolonged time of unwanted non-conception. Infertility may be used synonymously with sterility with only sporadically occurring spontaneous pregnancies.

Estimated maximum failure rates of cycle monitors using daily conception probabilities in the menstrual cycle.

Background: A number of menstrual cycle monitors have been developed to detect the fertile window of the menstrual cycle, mainly for contraceptive purposes. Reliable data on most of these systems are still missing but are urgently needed because many women use them and the tested systems differ enormously in price and effectiveness. We suggest a new efficacy estimating method to evaluate cycle monitors prior to full prospective clinical trials.

Time to pregnancy: results of the German prospective study and impact on the management of infertility.

Background: The likelihood of spontaneous conception in subsequent cycles is important for a balanced management of infertility. Previous studies on time to pregnancy are mostly retrospective and biased because of exclusion of truly infertile couples. The study aim was to present a non-parametric estimation of cumulative probabilities of conception (CPC) in natural family planning (NFP) users illustrating an ideal of human fertility potential.

Opinion: natural family planning and the management of infertility.

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.

Cycle characteristics after discontinuation of oral contraceptives.

Nearly 60% of the women between 20 and 40 years of age who do not want to conceive choose oral contraceptives (OCs) for contraception in Germany. In an ongoing prospective study on the use of natural family planning in Germany, 175 women have been observed for 3,048 cycles immediately after having discontinued OCs (post-pill group). They were compared to a control group of 284 women observed for 6,251 cycles, who had never taken OCs.

Research and quality control in natural family planning with relational database systems.

Research and quality control in natural family planning (NFP) is based on continuous data collection in prospective studies. The quality of the data is determined by the reliability of collection, input, management, and retrieval. During a period of ten years, different relational databases were programmed to manage the large number of very different data in NFP studies.

Results of an efficacy-finding study (EFS) with the computer-thermometer Cyclotest 2 plus containing 207 cycles.

Prospectively collected cycles of 207 women were used to find out the efficacy of the Cyclotest 2 plus algorithm in detecting the fertile time in a woman's cycle. The results of the device were compared with the beginning and the end of the fertile time identified by the symptothermal method (STM) of natural family planning (NFP). It was found that the algorithm led to dangerous reduction of the fertile time (FT) in only 2 out of 207 woman cycles (0.

Retrospective clinical trial of contraceptive effectiveness of the electronic fertility indicator Ladycomp/Babycomp.

The Babycomp/Ladycomp (Valley Electronics Ltd., Eschenlohe, Germany) is an electronic device that combines the temperature method and calendar method for planning and preventing pregnancy by identifying the fertile and infertile phases of the menstrual cycle. In a retrospective clinical trial, the system was tested as a contraceptive aid.

Natural family planning with and without barrier method use in the fertile phase: efficacy in relation to sexual behavior: a German prospective long-term study.

A large prospective long-term study with users of natural family planning (NFP) methods has been conducted to analyze the relation between unintended pregnancy rates and sexual behavior with special reference to barrier method use in the fertile phase. Seven hundred and fifty eight NFP beginners, 19-45 years of age, 14870 cycles, 28 unintended pregnancies were studied. Of the couples, 54.

The CUE Fertility Monitor compared to ultrasound and LH peak measurements for fertile time ovulation detection.

A prospective study of the reliability of the CUE Fertility Monitor to identify the fertile time of the menstrual cycle was conducted. The device provides a digital measurement of the electrical resistance of saliva (SER) and vaginal secretions (VL). The readings of the device were compared with the fertile time detected by ultrasonography of the growing follicle and estimation of the LH surge to detect ovulation.

[How do self-observed cycle symptoms correlate with ovulation?].

The symptoms of self-observation of the menstrual cycle (basal body temperature, mucus symptom, autopalpation of the cervix) are often regarded as not reliable for ovulation detection. In a prospective study 87 NFP cycles are monitored additionally with ultrasound and LH tests to calculate the correlation of the ovulation-time with the symptoms of self-observation. Our results show that the symptoms of self-observation allow a reliable detection of the time of ovulation.