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, 54.2% use NFP only or predominantly and 45.9% use mixed methods (additional barrier method use in the fertile phase in 55.7% of the cycles). The overall pregnancy rate after 12 cycles of exposure is 2.2% according to the actuarial method. There is no significant difference between NFP users and mixed methods users and also no significant effect of duration of use in the first 5 years of exposure. During "perfect use" the pregnancy rate at 12 months is 0.63%. When only protected intercourse takes place in the fertile phase the pregnancy rate is 0.45%. The symptothermal method of NFP is most unforgiving for imperfect use (unprotected intercourse in the fertile phase). However, it is extremely effective when either abstinence or protected intercourse is used in the fertile phase.

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. Thirteen women participated in the study. Sixteen cycles contained both signals (SER, VL) for the beginning and the end of the fertile period. In 2 cycles a CUE signal could not be found by the device. Using a computerized algorithm for evaluation of the CUE signals, the beginning of the fertile period was accurately detected in 14 cycles; in 2 cycles the signal was found less than five days prior to ovulation. The last day of fertility was identified correctly by the CUE Fertility Monitor in 10 cycles; in 6 it was incorrectly identified during the time when the woman was still fertile. This suggests that the CUE Fertility Monitor utilizing the algorithm on which it currently is based cannot be recommended for natural family planning. However, we think that the algorithm for evaluation should be improved as useful signals in the menstrual cycle are detected.

Effectiveness and acceptibility of the symptothermal method of natural family planning in Germany.

Throughout Germany, 851 women who were instructed in natural family planning participated in a prospective study. Of these, 255 women with 3174 cycles used only natural family planning for family planning and 274 women with 3995 cycles occasionally used barrier methods in the fertile phase. For natural family planning--only users, the Pearl rate for unplanned pregnancy was 2.3 and for mixed-method users 2.1. Most pregnancies resulted from unprotected intercourse during the fertile phase, and the use of barrier methods does not reduce risk-taking.

[Has family planning behavior in West Germany changed since 1985?]. / Hat sich das Familienplanungsverhalten in der BRD seit 1985 verändert?

A survey on the family planning behaviour in the Federal Republic of Germany was conducted by interviewers of the EMNID institute in 1985 (n = 1267) and 1989 (n = 950). The survey was carried out with women of 15 to 45 years of age. It was the aim of the 1989 study, to look into changes of the last four years generally and with regard to the increasing knowledge about AIDS. As the use of a combination of family planning methods has significantly increased in 1989, the overall percentage went very much beyond 100% (1985: 106.1% vs 1989: 138.5%). Hence, for comparison of the figures, we omitted any sociodemographic weighting. For each method, the percentage of the users is reported independently of any additional method used. The figures (%) for use of reversible methods of contraception 1985 vs 1989 were as follows: the pill (52.2/61.9), condom (10.0/24.8), IUD (14.1/10.8), withdrawal (5.8/6.6), mini-pill (1.7/6.5), NFP (8.8/6.0), locally applied chemical device (2.6/5.2), vaginal diaphragm (3.0/3.0). The frequency of sterilisation was 6.9 vs 5.7%; the frequency of unwanted pregnancies 26.6 vs 20.9%. 12.3% of the women aged 18-45 years stated, that family planning behaviour has changed in the last two years. 1/3 of these declared, that AIDS has played an important part in their decision. Answers to other questions are compared 1985 vs 1989, like "reasons for selecting a particular method", "need for use of contraceptives", "frequency of unwanted pregnancies" and "importance of natural methods".

[Results of a physician survey on the status of knowledge and attitude to natural family planning in West Germany 1988]. / Ergebnisse einer Arzte-Befragung über Kenntnisstand und Einstellung zur natürlichen Familienplanung in der Bundesrepublik Deutschland 1988.

Based on a questionnaire, reporters of the EMNID Poll Institute interviewed 229 general practitioners and 237 practising gynaecologists by telephone. When questioned which method for family planning was, in the physicians' opinion, most frequently used and which was most frequently recommended by physicians, contraceptive pills were far ahead of any other method. Somewhat surprising was the fact that up to 36% of the interviewed physicians considered that the intrauterine device is either the most frequently used or the most recommended method. Even the quantity of reports on condoms being the most frequently used method was relatively high (8-10%). 6% of the questioned physicians stated NFP methods as being mainly used, and 10% of the physicians recommended these methods. NFP methods also held the fourth place preceded by contraceptive pills, IUD and condom in the 1985 EMNID survey. Among the NFP methods, body basal temperature was reported to be the most popular and most frequently recommended method. The sympto-thermal method which is world-wide proposed as first choice by the experts, is still fairly unknown. The results arising from this survey indicate the necessity for physicians to gain a more thorough knowledge of modern NFP methods. Unjustified prejudices should be removed, the high reliability, which may be achieved at present, should be propagated and the undeniable advantages of NFP methods should be pointed out. The possible difficulties due to the necessary abstinence during the fertile period should, however, be kept in mind.

[Results of a representative survey of family planning behavior in West Germany 1985]. / Ergebnisse einer repräsentativen Umfrage zum Familienplanungsverhalten in der Bundesrepublik Deutschland 1985.

A report on the result of a representative survey of family planning behavior in the Federal Republic of Germany in 1985. Interviewers from the EMNID Institute questioned 1267 German women aged between 15 and 45. Of the women interviewed, 6.1% had been sterilized, while in 1.3% of cases, their partner had been sterilized. Regarding the use of reversible methods of contraception, the following figures were established: pill, 37.1%; IUD, 10.3%; condom, 5.9%; rhythm method, 3.9%; withdrawal 3.4%; vaginal diaphragm, 2.1%; mini-pill, 1.3%; locally effective chemical substances, 0.8%. A few women (1.9%) stated that they used a mixture of methods. No information about family planning methods was offered by 13.4% of the women interviewed. The figures obtained were further differentiated according to age, marital status, school education, religion, number of children, desire for more children, profession, and net income. The authors' own questions concerned the early use of contraceptives, the reasons for abandoning a particular method, the reasons for choosing a certain type of contraceptive, sources of information about family planning, the frequency of changes from one type of contraceptive to another, and opinions about the rhythm method. Finally, the result of the EMNID survey is compared with that of known studies both at home and abroad.

Effect of cocultivation of brain tissues on leucine and glycerol-3-phosphate incorporation.

Studies on the interaction between cortex grey matter (CC), diencephalon (DE), mesencephalon (ME) and pure glial cells free of neurons were undertaken in explant cultures. The culture system provided the formation of neuritic bridges between individual tissue pieces. Cocultivation of different brain tissues resulted in changes of leucine and glycerol-3-phosphate incorporation characteristic for individual brain areas. Glial cell (GC) did not respond to innervation by neurites of various sources. Glycerol-3-phosphate uptake rates were substantially altered in cocultures containing neurons and glia.