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Fertility app 'Dot' found to be as effective as other family planning methods

March 18, 2019

WASHINGTON - Results of a first-of-its-kind prospective study with a family planning app find it to be as effective as other modern methods for avoiding an unplanned pregnancy.

Researchers from the Institute for Reproductive Health (IRH) at Georgetown University Medical Center studied women's use of the Dot app over 13 menstrual cycles, or about one year.

Their study, published in the European Journal of Contraception and Reproductive Healthcare, is the first to test a fertility app using best-practice guidelines for assessing effectiveness of family planning methods. (13-cycle Perfect and Typical-use Effectiveness of the Dot Fertility App; Results From a Prospective Contraceptive Trial)

Using historical cycle data and a woman's period start dates, Dot's algorithm predicts pregnancy risk for each day of her menstrual cycle, flagging days of high and low fertility. As the app "learns" about her cycle over time, it personalizes a user's fertile window - the days of her cycle when pregnancy is likely.

The researchers found that the app had a typical-use failure rate of 5 percent and a perfect-use failure rate of 1 percent, which makes Dot comparable to family planning methods such as the pill, vaginal ring, and other fertility awareness-based methods.

"More and more women are using apps as a family planning method, so having an option backed by strong evidence of effectiveness is critical," says Victoria Jennings, PhD, principal investigator of the Dot effectiveness study and director of the IRH. "Women must be able to base their app choice on solid evidence about how well the method works and what's involved in using it. That's why it was so important that an app like Dot undergo a rigorous effectiveness trial conducted according to established study guidelines used to study other methods."

Researchers applied a research software to the existing app that included pop-up reminders, surveys, and instant messages. Using this software, 718 participants were prospectively enrolled in the study and followed for up to 13 cycles of use, with fewer participants "lost to follow up" than is typical for an online study. Participants provided daily sexual history data for 6,616 menstrual cycles." There were 24 confirmed pregnancies from cycles when participants used the method incorrectly (such as having unprotected sex on days of high fertility). One pregnancy occurred in a cycle in which the participant used Dot correctly.

The participant profile reflected the general United States population of women 18-39. The researchers found no association between pregnancy and sociodemographic characteristics such as age, ethnicity, and relationship status.

"This is a particularly important finding because it suggests that Dot can be appropriate for a wide range of women," Jennings says. "Given the widespread use of mobile technology, a digital method like Dot has the potential to reach many women with an unmet need for family planning."
-end-
This study was supported by the United States Agency for International Development grant (OAAOAO13O00083). Dot is owned by Cycle Technologies, which is solely responsible for the app.

About the Institute for Reproductive Health

The Institute for Reproductive Health at Georgetown University Medical Center has more than 30 years of experience in designing and implementing evidence-based programs that address critical needs in sexual and reproductive health. The Institute's areas of research and program implementation include family planning, adolescents, gender equality, fertility awareness, and mobilizing technology for reproductive health. The Institute is highly respected for its focus on the introduction and scale-up of sustainable approaches to family planning and fertility awareness around the world. For more information, visit http://www.irh.org.

About Georgetown University Medical Center

Georgetown University Medical Center (GUMC) is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through MedStar Health). GUMC's mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis -- or "care of the whole person." The Medical Center includes the School of Medicine and the School of Nursing & Health Studies, both nationally ranked; Georgetown Lombardi Comprehensive Cancer Center, designated as a comprehensive cancer center by the National Cancer Institute; and the Biomedical Graduate Research Organization, which accounts for the majority of externally funded research at GUMC including a Clinical and Translational Science Award from the National Institutes of Health. Connect with GUMC on Facebook (Facebook.com/GUMCUpdate), Twitter (@gumedcenter) and Instagram (@gumedcenter).

Georgetown University Medical Center

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